Clinical practice pathways for evaluation and medication choice for attention-deficit/hyperactivity disorder symptoms in autism spectrum disorders

Rajneesh Mahajan, Maria Pilar Bernal, Rebecca Panzer, Agnes Whitaker, Wendy Roberts, Benjamin Handen, Antonio Hardan, Evdokia Anagnostou, Jeremy Veenstra-Vander Weele

Research output: Contribution to journalArticle

Abstract

BACKGROUND AND OBJECTIVE: Hyperactivity, impulsivity, and inattention (referred to as "ADHD [attention-deficit/hyperactivity disorder] symptoms") occur in 41% to 78% of children with autism spectrum disorders (ASDs). These symptoms often affect quality of life, interfering with learning or interventions that target primary ASD symptoms. This practice pathway describes the guidelines for evaluation and treatment of children and adolescents with ASD and comorbid ADHD symptoms. METHODS: Current research in this area is limited, and, therefore, these recommendations are based on a systematic literature review and expert consensus in the Autism Speaks Autism Treatment Network Psychopharmacology Committee. RESULTS: The recommended practice pathway includes the Symptom Evaluation Pathway for systematic assessment of ADHD symptoms across settings; examination for comorbid sleep, medical, or psychiatric comorbidities that may contribute to symptoms; and evaluation of behavioral interventions that may ameliorate these symptoms. For children for whom medication is being considered to target the ADHD symptoms, the medication choice pathway provides guidance on the selection of the appropriate agent based on a review of available research, assessment of specific advantages and disadvantages of each agent, and dosing considerations. CONCLUSIONS: These recommendations provide a framework for primary care providers treating children who have ASD and ADHD symptoms. Our systematic review of the current evidence indicates the need for more randomized controlled trials of the medications for ADHD symptoms in ASD. There will also be a need for studies of the effectiveness of these practice pathways in the future.

Original languageEnglish (US)
JournalPediatrics
Volume130
Issue numberSUPPL. 2
DOIs
StatePublished - Nov 2012

Fingerprint

Critical Pathways
Attention Deficit Disorder with Hyperactivity
Symptom Assessment
Autistic Disorder
Psychopharmacology
Impulsive Behavior
Research
Psychiatry
Comorbidity
Primary Health Care
Consensus
Sleep
Randomized Controlled Trials
Quality of Life
Autism Spectrum Disorder
Autism Spectrum Disorders
Attention Deficit Hyperactivity Disorder
Clinical Practice
Evaluation
Medication

Keywords

  • ADHD symptoms
  • Autism spectrum disorders
  • Hyperactivity
  • Impulsivity
  • Inattention

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Arts and Humanities (miscellaneous)

Cite this

Clinical practice pathways for evaluation and medication choice for attention-deficit/hyperactivity disorder symptoms in autism spectrum disorders. / Mahajan, Rajneesh; Bernal, Maria Pilar; Panzer, Rebecca; Whitaker, Agnes; Roberts, Wendy; Handen, Benjamin; Hardan, Antonio; Anagnostou, Evdokia; Veenstra-Vander Weele, Jeremy.

In: Pediatrics, Vol. 130, No. SUPPL. 2, 11.2012.

Research output: Contribution to journalArticle

Mahajan, R, Bernal, MP, Panzer, R, Whitaker, A, Roberts, W, Handen, B, Hardan, A, Anagnostou, E & Veenstra-Vander Weele, J 2012, 'Clinical practice pathways for evaluation and medication choice for attention-deficit/hyperactivity disorder symptoms in autism spectrum disorders', Pediatrics, vol. 130, no. SUPPL. 2. https://doi.org/10.1542/peds.2012-0900J
Mahajan, Rajneesh ; Bernal, Maria Pilar ; Panzer, Rebecca ; Whitaker, Agnes ; Roberts, Wendy ; Handen, Benjamin ; Hardan, Antonio ; Anagnostou, Evdokia ; Veenstra-Vander Weele, Jeremy. / Clinical practice pathways for evaluation and medication choice for attention-deficit/hyperactivity disorder symptoms in autism spectrum disorders. In: Pediatrics. 2012 ; Vol. 130, No. SUPPL. 2.
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