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The Propriety Of Psychotropic Medications In The Treatment Of Pervasive Developmental Disorder In The Pediatric Population: A Review Of The Evidence

768 words - 4 pages

Pervasive Developmental Disorder (PDD) encompasses a multiplicity of developmental disorders which are typically diagnosed in childhood. Diagnoses typically grouped under PDD include various functional levels of autism, Rhett’s syndrome, PDD not otherwise specified (PDDNOS), Asperger’s syndrome, and childhood disintegrative disorder (Sung, Fung, Cai, & Ooi, 2010). As of 2009, the global prevalence of PDD was estimated to be 60-70/10,000 children (Fombonne, 2009). Pharmacological intervention for this delicate population is challenging and the use of psychotropic medications to control target behaviors is often used off-label. Examples of target behaviors include self-injurious behavior (SIB), stereotypy, echolalia, or excessive fears (de Bildt, Mulder, Scheers, Minderaa, & Tobi, 2006). The objective of this review is to examine a current collaborative behavioral protocol from The Learning Tree, “a nonprofit organization dedicated to providing educational, residential and support services for children and adolescents with developmental disabilities, including autism” (www.learning-tree.org). Specific attention to the pharmacological aspects of this protocol will be examined.
Pharmacological interventions intended to control behaviors in children with PDD often fall under the classification of psychotropic medications. These drugs include any medication with a potential neurological effect such as anti-depressants, typical and atypical anti-psychotics, stimulants, neuroleptics, and anti-hypertensives (Lopata et al., 2013; Sung et al., 2010). Of the broad array of drugs used to treat specific and non-specific behaviors in PDD, only risperidone has been approved by the United States Food and Drug Administration for management of aggression and irritable behaviors associated with PDD (Sung et al., 2010). Consequently, most pharmacological treatment is off-label and therefore requires close monitoring. According to Sung et al. (2010), treatment for those affected with PDD should utilize multiple treatment modalities and disciplines and should include intense scrutiny of underlying medical issues, life events, pharmacological interventions, potential side effects of medications, and intermittent evaluations of the need to continue medication. An evaluation of the protocol used by The Learning Tree for treatment of PDD reveals compliance with these recommendations.
The Learning Tree uses a multimodal, interdisciplinary approach to evaluate, treat, and monitor the treatments provided for children diagnosed with PDD. Children who enter the program are evaluated by a psychiatrist at the initial appointment....

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