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Michael Aman, PhD


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Autism Study: Is Pill Or Parenting Better? Or Both?

Drug used in ADHD tested in autism, alongside parental training techniques

(COLUMBUS, Ohio) - Ever since her daughter Emma began showing the signs of autism at 18 months of age, Nashua Johnson has been looking for safe and effective therapies to help her.  But just like millions of other parents of children on the autism spectrum, Johnson quickly learned that finding viable options can be difficult and exhausting.

Over the last five years, Johnson has put Emma through physical, speech and occupational therapy, but drew the line at medication.  “People have suggested medications, but I wasn’t interested,” she said.  “Emma was still too young, first of all, and I didn’t want to push anything on her that I wasn’t really sure about.”

Particularly of concern to Johnson were so called psycho-stimulants, commonly used in kids with attention deficit and hyperactivity disorder (ADHD), and more recently in children with autism.  “The side effects were pretty scary,” Johnson said, “at least those you read on the label and those you read on the internet.  I just didn’t feel comfortable with them.”

That’s an understandably cautious reaction, according to Michael Aman, PhD, who says that some doctors prescribe psycho-stimulants with the best of intentions, but aren’t certain what to do if a child with autism doesn’t respond adequately.

“Some doctors who are not experienced with working with children on the autism spectrum may feel that if they only push the dose higher, they’ll gain control over that disruptive behavior,” said Aman, Director of Research of the Nisonger Center at the Wexner Medical Center at Ohio State University.  “When, in fact, it may be the medication itself that’s causing the behavior problems.”

So, in an effort to develop new treatment options for children on the autism spectrum, Aman is helping to conduct a unique study - one that asks a simple but important question: When it comes to treating children on the autism spectrum, is a pill or parenting more effective?  Or both?

To find out, Aman is taking a two-prong approach, testing a new class of medication while analyzing the benefits of parental intervention.  During the study some patients will receive a non-stimulant drug known as atomoxetine, and some parents will be taught professional intervention techniques to better control their children’s symptoms.

“What we’re trying to do is have the greatest possible impact,” said Aman.  “Obviously, it gives us an opportunity to look at each technique in isolation, but more importantly, it enables us to look at the combination of the two treatments and to see if there is a bonus.” 
As for the pill, Aman says “this is the first truly different medicine that has come along in several decades.”  Atomoxetine is a non-stimulant drug already approved for use in children with ADHD, but “this is really the first large-scale study using this drug in children on the autism spectrum.”

“We think there is a better chance that this drug will work on children in which stimulants have failed,” said Aman, “because it actually works on a different neuro-chemical.  So, the chances of seeing a breakthrough on a child who has yet to respond to stimulants is much greater.”

As for the role of the parent, Aman says therapists will teach professional intervention techniques to help parents better manage behavioral issues in children.  There are subtle clues that parents can be taught to recognize that will help prevent problems before they start, he said, as well as certain reward techniques that have proven effective in clinical settings.

“By combining the pill and the parental involvement,” said Aman, “we’re hoping that we’ll see an effect which is greater than with the use of either treatment alone.”  

The study is currently taking place at the Nisonger Center at Ohio State University, in conjunction with the University of Pittsburgh and the University of Rochester in New York.

Emma was randomly chosen to get the pill, but her parents were not selected to receive training in intervention techniques.  Fortunately, the pill has been enough.  “Her social skills started to turn around,” said her mother.  “She started looking at people more, making eye contact, and wanting contact with people,” she said.

“Her teachers couldn’t believe it,” Johnson continued.  “They couldn’t believe how much of an improvement, socially, she had made.  We saw quite a turn around with her.”

If you’d like more information on the study, go to http://nisonger.osu.edu/study_participation and click on “Charts Website”.

 

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