Medical Management Considerations
Autism is a behavioral syndrome characterized by a defined group of behaviors and associated with many genetic and acquired conditions that affect brain development. Its cause is unclear. It is likely to be a heterogenous condition with different causal factors in different cases. The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders-IV defines three necessary diagnostic criteria:
Note: These considerations are in addition to the normal medical care provided to an individual without autism. All recommendations can be addressed through clinical examination by the primary care provider, unless otherwise noted.
Note: Autism is usually not diagnosed until 18 to 24 months of age. Whether diagnosis is made in infancy or early childhood, the following should be performed:
Emphasize importance of specialized educational techniques like small classes; predictable structure and schedule; visual learning; individualized intervention regarding social skills and behavior management. Implement recommendations of speech and language therapists. Monitor school progress; encourage integration with non-disabled peers whenever possible. Assess self-care skills
Monitor for onset of seizures.
Campbell, Magda, et al. (1996). Treatment of Autistic Disorder. Journal of the American Academy of Child and Adolescent Psychiatry 35(2), 134-143.Filipek P, et al. (1999). The Screening Diagnosis of Autism Spectrum Disorders. Journal of Autism & Developmental Disorders, 29(6), 434-484.
Ritvo, E, et al. (1989). The UCLA-University of Utah Epidemiologic Survey of Autism: Recurrence Risk Estimates and Genetic Counseling. American Journal of Psychiatry 146, 1032-1036.
Ritvo, E, et al. (1990). The UCLA-University of Utah Epidemiologic Survey of Autism: The Role of Rare Diseases. American Journal of Psychiatry 147, 1614-1621.
Rogers, SJ, et al. (1998). Empirically Supported Comprehensive Treatment for Young Children with Autism. Journal of Clinical Child Psychology, 27(2), 168-179.
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision). Washington DC: Author.
California Department of Developmental Services. (2002). Autistic Spectrum Disorders: Best Practice Guidelines for Screening, Diagnosis and Assessment. Sacramento, CA: Author.
Capute, Arnold J. & Accardo, Pasquale J. (1996). Developmental Disabilities in Infancy and Childhood vol. I: Neurodevelopmental Diagnosis and Treatment. Baltimore, MD: Paul H. Brookes Publishing Co.
Capute, Arnold J. and Accardo, Pasquale J. (1996). Developmental Disabilities in Infancy and Childhood vol II: The Spectrum of Developmental Disabilities. Baltimore, MD: Paul H. Brookes Publishing Co.
Connecticut Birth to Three System, Autism Task Force. (1998). Intervention Guidelines for Providers and Families of Young Children with Characteristics of PDD or Autism. Retrieved January 27, 2006 from http://www.birth23.org/Publications/autismguide.PDF (page 7).
National Information Center for Children and Youth with Disabilities. (1998). Autism and Pervasive Developmental Disorder fact sheet. Retrieved January 25, 2006 from http://www.nichcy.org/pubs/factshe/fs1txt.htm
New York State Department of Health Early Intervention Program (1999). Clinical Practice Guideline Quick Reference Guide: Autism/Pervasive Developmental Disorders – Assessment and Intervention for Young Children (Age 0-3 Years). Health Education Services, Albany, NY, 1999 Publication No. 4216
Ozonoff, S., Hendren, R.L., Rogers, S.J. (Eds.) (2003). Autism Spectrum Disorders: A Research Review for Practitioners. Arlington, VA: American Psychiatric Publishing.
Association for Autism and Allied Disorders (Canada), 03-5226-1420
Autism Family Support Association (Canada), 03-9885-0533
Autism Research Institute,
Autism Services Center, 304-525-8014
Autism Society of America, 800-328-8476,
California Department of Developmental Services, 916-654-1690,
California Department of Developmental Services
Autistic Spectrum Disorders: Best Practice Guidelines for Screening, Diagnosis and Assessment
California Regional Centers, 916-654-1958,
Center for the Study of Autism,
Exceptional Parent Magazine, 800-247-8080,
Indiana Resource Center for Autism, 812-855-6508
Journal of Autism and Developmental Disorders, 800-221-9369
March of Dimes Birth Defects Foundation, 914-428-7100,
M.I.N.D. Institute (Medical Investigation of Neurodevelopmental Disorders), 888-883-0961, http://www.ucdmc.ucdavis.edu/mindinstitute
New Jersey Center for Outreach and Services for the Autism Community, 609-883-8100, http://www.njcosac.org/cosacindex
Theodore A. Kastner, M.D., M.S.
Felice Weber Parisi, M.D., M.P.H.
Robin L. Hansen, M.D.
Patrick J. Maher, M.D.
James L. Popplewell, M.D.
Funded by a grant from the California Department of Developmental Services
For more information, contact:
Center for Health Improvement
1330 21st Street, Suite 100
Sacramento, CA 95814
This document does not provide advice regarding medical diagnosis or treatment for any individual case, and any opinions or statements contained in this document are not intended to serve as a standard of medical care. Physicians are encouraged to view the considerations presented in this document in light of evolving scientific information. This document is not intended for use by the layperson. Reproduction of this document may be done with proper credit given to California Department of Developmental Services and the Center for Health Improvement.