Irritability and Problem Behavior in Autism Spectrum Disorder: A Practice Pathway for Pediatric Primary Care

Integrative review about somatic care improvement tools for people with autistic syndrome disorder

“…In 2016, the Autism Treatment Network Psychopharmacology Committee “Autism Speaks”, in connection with PASD families and clinicians launched “Irritability” working group for the experience to carried out a pilot study conducted by McGuire et al 13 This study was built in two steps: the first consisted in consensual definition of irritability notions in care context (vocal or gestural expression of anger, frustration or distress) and behavioral disorders (aggressive acts directed towards others, oneself or the environment), built on an iterative process based on a literature review. Then the workgroup created a behavioral therapeutic decision tree that pediatricians could use during routine visits with ASD children.…”

“…Thus, mood and behavioral disorders appear to be the main obstacle in somatic care access, identified by several health practitioners and ASD relatives. This may be due to communication and social interaction impairments, and the slow processing of information and sensorial specificities (Nicolaidis et al, 2,13,14 ).…”

“…A literature review workgroup was implemented by McGuire et al 13 to elaborate a decision tree dedicated to helping pediatricians to identify the most accurate treatment of their ASD patient's behavioral disorders. Bultas et al 15 used a cross‐survey to evaluate the parents' and professionals' interests in a psycho‐sensory profiling reporting tool for children with ASD (3–6 years).…”

Behavioral Management of Children With Autism in the Emergency Department

“…Communication impairments can escalate frustration, contributing to risk of externalizing behaviors. Sleep disturbances and maladaptive reinforcement patterns can also be causative 29 …”

“…Sleep disturbances and maladaptive reinforcement patterns can also be causative. 29 The decision to admit a patient for behavior should balance immediate safety concerns with likelihood of benefit, potential harms from disruption of routine and schooling, separation from family and support systems, and cost. Careful consideration should be made as to whether the patient's behaviors have exceeded the family's coping mechanisms.…”