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Medications, Supplements, and Dietary Strategies for HFA and AS

"Obviously there's no 'cure' for autism, but are there any medications or supplements that parents have used that help treat some of the symptoms in their high-functioning autistic child?"

There are no medications that specifically treat High-Functioning Autism (HFA) or Aspergers (AS), but there are some medications, supplements, and dietary strategies that may improve certain associated symptoms (e.g., anxiety, depression, hyperactivity, etc.) that can occur in many kids on the autism spectrum.

Some examples include the following:

1. SSRIs: Drugs such as Luvox may be used to treat depression or to help control repetitive behaviors. Possible side effects include restlessness and agitation.

2. Risperdal: This medication may be prescribed for agitation and irritability. It may cause trouble sleeping, a runny nose and an increased appetite. This drug has also been associated with an increase in cholesterol and blood sugar levels.

3. Zyprexa: Olanzapine is sometimes prescribed to reduce repetitive behaviors. Possible side effects include increased appetite, drowsiness, weight gain, and increased blood sugar and cholesterol levels.

4. Revia: This medication, which is sometimes used to help alcoholics stop drinking, may help reduce some of the repetitive behaviors associated with HFA and AS. However, the use of low-dose naltrexone (doses as low as two to four mg a day) has been gaining favor recently. But, there's no good evidence that such low doses have any effect on the disorder.

5. Intuniv: This medication may be helpful for the problems of hyperactivity and inattention in kids on the autism spectrum. Side effects may include drowsiness, irritability, headache, constipation and bed-wetting.

6. Abilify: This drug may be effective for treating irritability related to the disorder. Side effects may include weight gain and an increase in blood sugar levels.


Because there are no definitive treatments for HFA or AS, some moms and dads may turn to complementary or alternative therapies. However, most of these treatments haven't been adequately studied. It's possible that by focusing on alternative treatments, you may miss out on behavior therapies that have more evidence to support their use.

Of greater concern, however, is that some treatments may not be safe. The FDA has warned about over-the-counter chelation medications. These drugs have been marketed as a therapy for autism and other conditions. Chelation is a therapy that removes heavy metals from the body, but there are no over-the-counter chelation therapies that are approved by the FDA. This type of therapy should only be done under the close supervision of medical professionals. According to the FDA, the risks of chelation include dehydration, kidney failure and even death.

Other examples of alternative therapies that have been used for HFA and AS include:

1. Avoidance diets: Some moms and dads have turned to gluten-free or casein-free diets to treat Aspergers. There's no clear evidence that these diets work, and anyone attempting such a diet for their youngster needs guidance from a registered dietitian to ensure the child's nutritional requirements are met.

2. Melatonin: Sleep problems are common in kids on the spectrum, and melatonin supplements may help regulate the youngster's sleep-wake cycle. The recommended dose is 3 mg, 30 minutes before bedtime. Possible side effects include excessive sleepiness, dizziness and headache.

3. Other dietary supplements: Numerous dietary supplements have been tried in children with HFA and AS. Those that may have some evidence to support their use include: Carnosine, Omega-3 fatty acids, Vitamin B-6, Magnesium, and Vitamin C (usually in combination with other vitamins).

4. Secretin: This gastrointestinal hormone has been tried as a potential treatment. Numerous studies have been conducted on secretin, and none found any evidence that it helps.

Other therapies that have been tried, but lack objective evidence to support their use include:
  • transcranial magnetic stimulation
  • massage and craniosacral massage
  • immune therapies
  • hyperbaric oxygen therapy
  • chiropractic manipulations
  • antifungal drugs
  • antibiotics



This is a serious issue and a difficult one for parents to deal with. It is almost impossible for any parent to know all of the potential risks associated with medications. Speak with your physician and your pharmacist about any medications your child may need to take. Keep asking questions until you feel that you are prepared. Your local pharmacist is a wealth of information about the medications he or she is dispensing and can be a valuable resource.


More resources for parents of children and teens with High-Functioning Autism and Asperger's:

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's

 ==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

 ==> Launching Adult Children with Asperger's and High-Functioning Autism: Guide for Parents Who Want to Promote Self-Reliance

 ==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism

 ==> Parenting Children and Teens with High-Functioning Autism: Comprehensive Handbook

==> Unraveling The Mystery Behind Asperger's and High-Functioning Autism: Audio Book
==> Parenting System that Reduces Problematic Behavior in Children with Asperger's and High-Functioning Autism


COMMENTS FROM PARENTS:

•    Anonymous said... I have decided to start our 12 year old son on melatonin for getting off to sleep. I don't know how that will work yet. We use to give him daily "rescue remedy" herbal drops when he was feeling nervous which seemed to help a little.

•    Anonymous said... I take a low dose of antidepressants, and have since I was 15. It helps with the anxiety, especially socially

•    Anonymous said... It is hit or miss with what chemical reaction works for any individual and their body. I giver our household Omega 3 supplement pilss with olive oil, safflower oil, ++ recommended brand that helps all of us with focus. my Aspie uses Adderrall 20mg in the AM and then 5mg in the afternoon to get him through til bedtime. he says the pills help his brain to not overwhelm him and we visually see a difference in 30 minutes from the time he takes his pill on his body control and ability to respond to his own needs and others talking to him.

•    Anonymous said... Low dose anti-depressant, plus Atenelol to help with impulsivity.

•    Anonymous said... My daughter does not have the hyperactivity with her ADD...That would actually help. Most of those kinds of meds would make her worse...as they tent to treat the hyper part. Is there something that can make her focus without the drowsiness part?

•    Anonymous said... My daughter is 10 weeks into Lovan (anti depressant) I cannot tell you the difference it has made for not only our family but mostly for her. For the first time she is a happy 9 year old that enjoys life without the stress, anxiety, depression, anger, impulsiveness the list goes on!! It is only early days yet, but I wish we had considered this a year ago when it was first offered. She has high functioning autism/aspergers, and recently the pead thinks she is exhibiting ADHD tendencies. There are minor side affects such as a little tiredness which just makes it harder to do homework (care factor zero), a little loose bowel movements and weight loss. So far she has lost 2.5kgs which is fine as he felt she was slightly over the recommended weight anyway. Will just have to keep an eye on it for now. Everyone is different, but so far we have had a positive experience

•    Anonymous said... My son is 7 years old and he is on Risperidone, Zoloft at night and Ritalin. I NEVER wanted to medicate him, but after many consultations we were left with no choice. He is happy, and is a lot more focused.

•    Anonymous said... My son started on Prozac (generic) a year ago, after we resisted the idea of med for a long time. He still takes the starter dose, in liquid form. Takes it together with cran-grape juice to mute the taste. It made him drowsy the first few weeks, but now it's just a good thing to calm his panicky edge, so he is less reactive, hostile, defensive. His humor can shine through, he can calmly consider options, etc. Of course everyone's different. Oh, also has long half-life, so if forget a dose it's not a dramatic up/down.

•    Anonymous said... Risperdal or abilify and adderral. Huge difference in behaviors. I too refused to medicate until my son was 8 he is now 16. My decision changed his life monumentally (no pun intended lol). If you don't offer the medication, you are doing a grave disservice to them and your entire family.

•    Anonymous said... My son who has Aspergers has been taking Low Dose Naltrexone, as mentioned in this article for a year now. He started on 3mg and now is at 4.5mg 2x per day. Once in the morning and once at night before bed. It has helped with his mood, energy, and production and he hardly gets colds or other illnesses anymore. I am also taking it at 4.5mgs per day for Fibromyalgia and am pain free because of it.

•    Anonymous said... My 14 year old son's dr wants to try Abilify for aggression. I am afraid of some side effects. Anyone else tried this med and been met with alarming side effects such as stiffened muscles and twitches?

•    Anonymous said... my sons doctor referred to ability and reaper idol as "the big guns" and wanted to try an sari med first. She said that while it was more anxiety causing the aggression than depression, the med would treat both. Also, for our daughter, we got her off meds with a product called stress relief complex. It can be found at autism.myshaklee.com.

•    Anonymous said... I highly recommend Namenda. Research it.

•    Katina said... We got the results we wanted with Abilify, but my 13 year old daughter gained 50 pounds in 9 months. She's been off it for 4 months, and has lost 20 pounds so far.

•    Caren said... My son has Aspergers and general anxiety disorder. We avoided drugs until 3rd grade, when we put him n risperadal. Then I felt bad for not getting him on drugs earlier. Unfortunately for us, risperadal had a small sweet spot for our son, where too much caused more aggression, and after a growth spurt we couldn't find it again. We were on a merry go round of different drugs, so at one point I took him off of everything to see what he was like unmedicated. Unmedicated for us means daily meltdowns with physical aggression. So we slowly added medications back, attempting to max out the benefit of a drug before adding another or deciding to try something else. My son is 13 now, and takes depakote, abilify, and lexapro. They enable him to remain calm enough to think and use his "tools" to avoid a melt down. Depakote has been the difference between physical aggression that would make it impossible for him to stay in our home and a normal life. Luckily, we live in Chicago and have access to top medical facilities. The depakote and abilify have caused him to gain weight, so we watch his diet. He has blood tests every few months to monitor drug levels in his blood and insure everything is fine. We were anti medication when we started this journey, but the relief and happiness that my son feels now that he has enough self-control have convinced us it was the right treatment for him.

•    We have had no bad side effects, other than weight gain. I recommend trying meds, but doing it slowly and only one medicine at a time. If it doesn't work, then stop, but when it does work, life becomes so much easier.

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High-Functioning Autism and Anxiety Overload

"Our child (high functioning) gets quite worried and anxious about most things that fall out of his comfort zone. Problem is, we are never really sure what is in - and what is out - of this zone. Any tips for a very anxious little boy?"

Autism spectrum disorders and anxiety often go hand-in-hand. High Functioning Autism (HFA) and Asperger's (AS) may affect a youngster’s ability to communicate effectively with others and to understand the world around him -- and that’s bound to cause anxiety. 
 
Anxiety can become even worse when there is a change in the child’s routine. Even positive and “fun” changes (e.g., school field trip, visit to the zoo) can increase anxiety and aggressive behaviors.

For parents, the best course of action is to anticipate upcoming changes and help the child prepare for them. Many moms and dads find it helpful to use social stories and pictures to prepare their "special needs" child for impending disruptions.

If it’s a field trip to the zoo, for example, use pictures to show your son what he’ll see at the zoo, what the zoo will be like, and what sort of things to expect. Do this each day for three or four days prior to the trip. That way, when the trip actually happens, your son won’t be entirely out of his element, but will already understand and appreciate some of what will be happening.

This father reported the following: “Social stories and plans do the trick for my son. we use plans also to become familiar with the fact of change: we put them up together on a piece of paper for the activity in question, and he takes it with him. if something changes he notes it down on the plan. we do this often as a game: he is the news reporter and takes notes during the activities and tells me all about afterwards.” 
 
==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's
 
Other changes in routine are less enjoyable, but still necessary. Getting a new teacher can be traumatic, as can moving to a new house. If at all possible, try to spread out the major changes. If you move to a new house, try to do it during the summer, so that your son won’t have to deal with the added anxiety of getting a new school and new teacher mid-year.

You can also introduce your son to the concept of “change” in a positive way by practicing with non-negative things. For example, just for practice, give him a little extra TV time instead of homework time one night, to show that changes in the routine can often be fun and good. Then practice with a neutral change (e.g., homework after dinner instead of before dinner), then with a negative one (e.g., changing play time into chore time). This process can help your son grow accustomed to the idea of change and learn to adapt without becoming anxious.

As one mother stated, "We have two boys, one diagnosed, and one suspected. They both have different triggers for anxiety and both have very different personalities. We find they need more preparation in advance, they need to know it may make them uncomfortable, and that it will end. We suggest coping strategies beforehand, and sometimes we have code words so they don't feel singled out by our suggesting coping strategies for them in the situation. Sometimes, the only solution is to take them out of the situation and trying another run at it another time."

Another parent had this to say, “Just roll with it. let him guide you. he is the driver in his world quite frankly. my child is the same. he gets very nervous and anxious about trying new things like sports, which he is very great at, but he's afraid people are watching him and picking on him, so he wont participate. maybe some confidence boosters of some sort will help. mine 13 y.o. is still this way. he sure would make one heck of a basketball player, but just wont do it. and I dont make him. I let him drive his life. and with gentle loving guidance he does ok.”





For continual, severe anxiety, some moms and dads have begun using anti-anxiety medications for their HFA and AS children. Usually, the medications are selective serotonin reuptake inhibitors (SSRIs) (also used for obsessive-compulsive disorder and depression). Prozac, Luvox, Zoloft and Anafranil are all common medications for anxiety in these young people.

Medication should be the last resort for anxiety, not the first. You and your doctor should monitor your child’s progress very closely, using the lowest dose of medication possible, to see if what improvements it makes and whether there are any adverse reactions. There are a number of natural remedies available if you don’t want to go down the drug route. But try behavioral and dietary modifications first, to see what improvements can be made naturally.

==> Need some tips on how to handle your child's fixations and obsessions? You'll find more than you'll need right here...

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30 Famous Autistic People in History

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Coping with Transitions: Tips for Teachers of Students on the Autism Spectrum

"One of my new students this year has Autism (high functioning female, age 6). She will throw a major temper tantrum whenever she is asked to stop one activity and get ready for the next one, which is very disruptive to the entire class. What can I do to help her move from one task to the next quickly and without resistance? It's like she has to complete the first project completely and perfectly before she is willing to go to the next."

First of all, your student may be experiencing a "meltdown" rather than a tantrum (click here to see the difference). Transitions are very difficult for children with ASD, or High-Functioning Autism. It's an interruption to their day and a change in their schedule. In order to minimize difficulty in transition, try to keep their schedule as routine as possible. Always let them know ahead of time that a transition in routine is coming. 

Using sensory integration techniques can be very helpful for some ASD students. It is best to have an occupational therapist work with you to first determine if your student is hyper-sensitive or hypo-sensitive (e.g., does she crave movement and the feeling of different textures and stimulation, or does she avoid movement and textures?).

There was a young autistic student who had a great deal of difficulty with the transition from home to school, and with transitions that occurred in his school day. The school created a sensory room that was just his. He craved movement, running and jumping on furniture, loved to feel his saliva against smooth surfaces, and loved strong odors. In his sensory room, there was a large hammock for him to lie in that would hold him tight. 
 
The ceiling was lined with colored lights. There were boxes with potpourri for him to smell. He would spend 20 minutes in this room at the beginning of his school day, 20 minutes before lunch, and 20 minutes before returning home. While he was in the room, he was encouraged to take in as much sensory information as he could. Once he left the room, he was calm and ready to learn.

Of course, not every school has the resources for a sensory room - and this won't work for every "special needs" student - but demonstrates how some creative thinking can benefit even the most challenging behaviors. Prior to the intervention of the sensory room, the school was ready to expel him. With the sensory room in place, he became much more compliant, calm and willing to work with teachers and other students.




 
Here are some additional techniques that will help make transitions easier for your autistic student:

•    When attempting a transition, keep the focus on the enjoyment your student had with her activity and ask questions while you move on to the next activity. It helps her shift from being upset about leaving the current activity to keeping the good feeling with her longer (it’s like saying, “Don’t be upset that the activity is over …be happy that it happened”).

•    Try to avoid giving sudden orders and directions. Before wanting your student to transition, go into her “safe zone” (i.e., whatever she is doing at the moment) and connect with her mentally, emotionally and physically. Talk to your student about what she is doing or something she truly loves. Then, keep that connection going and take it with you while you both move to the next activity.

•    Talk to your student about transitions, and be willing to listen and observe. A good way to start a discussion about transitions, in general, is through social stories. Consider creating a story around “how to calmly move from one task to the next.”

•    Picture schedules and cards can be helpful for ASD students who have a hard time following verbal directions. Pointing to the picture of the next activity, or handing your student the picture and letting her carry it to the next activity can be helpful in transitioning.

•    Give your student a notice when transitions are approaching. A simple, "In 10 minutes, we are going to do our history lessons," is enough to give her a little warning. This lets your student know she should be finishing up what she is working on and allows her the chance to ease into a new state of mind.

•    Create a list of “classroom rules” and review them with your student periodically. The rules should include what to do during specific transitions (e.g., how to move from study-time to getting ready for recess). Post the rules where your student can see them. She will become accustomed to the rules, and understand what to do and what to expect throughout the day.

•    Allow your student enough time to transition. Whether you are preparing for a short-term transition from reading-time to lunch-time, remember that children on the spectrum process change in their own time; they need time to “grow through” the change depending on how drastic that change is going to be.

Transitions will always be difficult for kids on the autism spectrum. Developmentally, they're simply not well-equipped to leave an activity they're enjoying and move to a potentially less desirable one. But thankfully, there are many ways teachers can help their students through these transitions.


Resources for parents of children and teens on the autism spectrum:
 

==> Videos for Parents of Children and Teens with ASD

 
PARENTS' COMMENTS:

•    Anonymous said... Also a lot of the tips work well for all kids of that age. That way it won't make her feel singled out and self conscious which can cause more meltdowns. I know my daughter is a perfectionist and has high expectations of herself. Anything that makes her feel like she stands out negatively will push her tolerance threshold.
•    Anonymous said... Count downs have saved our little guy from time to leave, to bath, to bed and even on trips, always needs to see the count down
•    Anonymous said... Do you have the day's schedule written out? How about a reminder that you are changing tasks in 5 minutes, then 3..
•    Anonymous said... I always give my Aspie daughters a five minute warning before doing a new activity, leaving the park, leaving a friend's house, etc. "Do your last favorite thing," is what I would tell them when they were younger. It seems to work really well! They know what to expect and what is expected of them.
•    Anonymous said... I found that visual timetables DIDN'T really work for my aspie son, but giving him real reason why something needed to happen was the key. He understands reasons. The Time Timer (you can get various sizes from the Sue Larkey website) was and still is the best tool in my arsenal though. Having THAT visual gave him some element of control back. Also giving them the opportunity to finish at a later time can sometimes help. If they finish other work quickly or instead of play...My son would recognise that this was our routine and then transition better knowing that he could come back to it.
•    Anonymous said... I give a fifteen minute countdown with a reminder at each 5 minute mark. Your class environment will go as smoothly as you plan it to. Learn about Aspergers and talk to her parents. They will give you tips and they'll work iF you follow through with them.
•    Anonymous said... Let her finish the first project.
•    Anonymous said... please listen to the parents about what works best for them at home and adjust that accordingly to fit your particular needs. I have had little success with teachers over the past seven years mainly in part to them not being willing to try the simplest strategies. The child will only benefit if she is comfortable at any given moment and there is an open line of communication between the teachers and parents.
•    Anonymous said... She still might be overwhelmed despite a countdown (I would be); do you have free time built in where she/they can finish unfinished activities? She might also feel better knowing she can come back to it before the end of the day (and knowing exactly when, not "later").
•    Anonymous said... We had this problem in kindergarten. I give my 7 year old daughter a run down of what we will do that day, and then warning half an hour before the event, and I know I will have to get her new teacher to do the same cos it's worked best for us. Now that she can tell time, I can do that as well ("We are going at 10:00 am," etc)
•    Anonymous said... without reading all of the previous comments..... From experience (16 yr old) there is no such thing as 'quickly, without resistance' ! ..... The key is regular warnings/countdowns to the change over time AND as Rebecca ^ stated....'real/true/logical' reasoning...these kids are smart and because they are so black and white....very, very realistic!
•    Anonymous said... Would it hurt you or the other students to give her a little more time and let her finish? I'm sure the "melt down" (not temper tantrum) effect's the other students way more then trying to force her to stop a activity. In my son's IEP he is allowed to get up and wonder around in the class room or go outside. He is not expected to do what all the other students are doing....he isn't the same.
•    Anonymous said... Written schedules help tremendously. Come up with a signal that she and you agree on to let her know the transition is coming, and give her double the warning you give the other kids.
•    Anonymous said... You can't expect anyone with aspergers to transition quickly. They need prompting and visuals. The Time Timer is a wonderful tool. It's useful for all kids and doesn't single her out. Visual schedules posted clearly and reviewed every morning are also helpful for all kids. Don't assume because she has a dx that there aren't other kids in the class being overlooked, treat them all the same and things will run smoothly:) Anytime you sneak attack a change in routine, expect the behaviors. Guess what, we as adults are no different. Think about a traffic jam and you have a schedule to keep;) Unmet expectations are frustrating to us all. We need clear cut expectations. Be patient and good luck.
 
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Anger-Management "Tools" for Kids on the Autism Spectrum

"Is it common for children with high functioning autism to be highly explosive? My daughter can fly off the handle in a heartbeat for what seems to be rather trivial matters (to me anyway)."

Children with High-Functioning Autism (HFA) often have a difficult time controlling their anger as compared to “typical” children, which is due to the fact that they have problems understanding their emotions and their impact on others.

In addition, they aren’t living in a void in which they don’t understand that they’re different from other kids. Often teased and rejected by their peers, they can have emerging anger they don’t understand and can’t easily control.

Helping these children with anger problems requires direct communication about the effect of their anger on others as well as methods of improving their low self-esteem and poor sense of self-worth, which is often at the root of the youngster’s anger.

Anger that’s acted-out badly needs to be treated like any other unwanted behavior. Some form of reasonable consequence directed at getting the point across that the behavior is wrong needs to be combined with a pragmatic discussion of the meaning behind the anger and other ways to control it. Remember that effective discipline for the HFA child can be much different from the discipline that works for other children.

If the anger seems to be a part of your daughter’s frustration over how she is being treated by others or from depressive feelings, finding better avenues to discuss what is really going on can help her deal with the issues without using anger as an outlet. Most children on the spectrum are of greater than average intelligence and have the resources to understand the relationship between their anger and the underlying social issues their dealing with.




Creating an Anger-Management Plan—

The basic idea in developing an anger-management plan for kids on the autism spectrum is to try many different strategies and find the management techniques that work best for them. This is an ongoing process. As working strategies are identified, they can be added to the anger-management plans and used when the youngster starts to feel angry.

Children on the spectrum should be encouraged to refer to their anger-management plans as their “toolbox” and the specific strategies they use to manage their anger as their “tools.” This analogy can be very helpful. You can take this even further by creating a physical box for your HFA daughter to put the strategies in (i.e., written on pieces of paper).

You could be really creative and have the pieces of paper shaped like various tools. Also, discuss how different tools should be used for different situations (e.g., point out how a screwdriver can be very useful, but not for pounding in nails).

Again, it’s important to identify the specific strategies that work best for your daughter. These strategies should be put down in a formal anger-management plan for referral when your daughter encounters an anger-provoking event. It’s also important to explore how different techniques may be used at different times.

For example, your daughter may feel better after running around in the yard, but this may not be possible when she is getting angry at something in the classroom. Strategies need to be in place to handle the different situations that may arise.

An effective strategy that many kids on the spectrum use is to talk about their feelings with someone that they can trust (e.g., parent or other family member). By discussing anger, they can begin to identify the primary emotions that underlie it and determine whether the thinking and expectations in response to the anger-provoking event are rational.

Often an outsider can see the event from a different point of view, and offer some guiding words of wisdom. HFA kids can sometimes view an event as un-winable or un-escapable when there is a very simple solution which can be reached.

As one mother of a child with Asperger’s stated:

“My son struggled with anger problems throughout elementary and most of middle school. He is now 15, and through many talks, discussions and maturity, he seems to be controlling his anger/frustration rather well. I have always been open and honest with him about how others can be, why they can be that way, and how he is ‘different’ than most kids his age. In time, he grew into his own, better understood himself and his own actions - and I'm so proud of him. I would explain to him why things would affect him the way they do, but he was never to use having Aspergers as an excuse to not be in control of his own actions and emotions. We have an open relationship and he knows he can talk to me about anything. That has been our biggest tool I think. He also did receive consequences when he would misbehave. I don't treat him differently just because he has Aspergers. They get treated differently enough as it is.”

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