Snowkloster1591

Emotion regulation (ER) is the ability to modify arousal and emotional reactivity to achieve goals and maintain adaptive behaviors. ER impairment in autism spectrum disorder (ASD) is thought to underlie many problem behaviors, co-occurring psychiatric symptoms, and social impairment, and yet is largely unaddressed both clinically and in research. There is a critical need to develop ER treatment and assessment options for individuals with ASD across the life span, given the multitude of downstream effects on functioning. This article summarizes the current state of science in ER assessment and treatment and identifies the most promising measurement options and treatments.Feeding difficulties among individuals with autism spectrum disorder are common. The science of applied behavior analysis (ABA) has been employed to address these difficulties. Ample publications exist that demonstrate that ABA is consistently effective in increasing the consumption of new foods and drinks, increasing chewing and swallowing behavior, decreasing problem behavior at mealtime, and improving skills such as self-feeding. This article details the application of the basic principles of ABA, reinforcement, extinction, and punishment to treat feeding difficulties.Gastrointestinal disorders are one of the most common medical conditions that are comorbid with autism spectrum disorders. These comorbidities can cause greater severity in autism spectrum disorder symptoms, other associated clinical manifestations, and lower quality of life if left untreated. Clinicians need to understand how these gastrointestinal issues present and apply effective therapies. Effective treatment of gastrointestinal problems in autism spectrum disorder may result in marked improvements in autism spectrum disorder behavioral outcomes. This article discusses the gastrointestinal disorders commonly associated with autism spectrum disorders, how they present, and studied risk factors.Epilepsy and autism frequently co-occur. Epilepsy confers an increased risk of autism and autism confers an increased risk of epilepsy. Specific epilepsy syndromes, intellectual disability, and female gender present a particular risk of autism in individuals with epilepsy. Epilepsy and autism are likely to share common etiologies, which predispose individuals to either or both conditions. Genetic factors, metabolic disorders, mitochondrial disorders, and immune dysfunction all can be implicated.Individuals with autism spectrum disorder (ASD) have a significantly higher risk for developing a substance use disorder (SUD) than the general population yet literature addressing cooccurring ASD and SUD is scarce. This article explores connections between ASD and SUD and the impact on development, screening and treatment. The article proposes culturally constructed narratives associated with both diagnoses may be responsible for the dearth of research and literature. Constructed narratives of ASD and SUD do not naturally intersect and the resulting disconnect can create a cognitive dissonance that could allow the medical and general community to neglect this life-threatening dual diagnosis.The mechanism of action of electroconvulsive therapy (ECT) is not fully elucidated, with prevailing theories ranging from neuroendocrinological to neuroplasticity effects of ECT or epileptiform brain plasticity. Youth with autism can present with catatonia. ECT is a treatment that can safely and rapidly resolve catatonia in autism and should be considered promptly. The literature available for ECT use in youth with autism is consistently growing. Under-recognition of the catatonic syndrome and delayed diagnosis and implementation of the anticatatonic treatment paradigms, including ECT, as well as stigma and lack of knowledge of ECT remain clinical stumbling blocks.Catatonia was first described by Karl Ludwig Kahlbaum in 1874, occurring in association with other psychiatric and medical disorders. However, in the nineteenth century the disorder was incorrectly classified as a subtype of schizophrenia. This misclassification persisted until the publication of DSM-5 in 2013 when important changes were incorporated. Although the etiology is unknown, disrupted gamma-aminobutyric acid has been proposed as the underlying pathophysiological mechanism. Key symptoms can be identified under 3 clinical domains motor, speech, and behavioral. Benzodiazepines and electroconvulsive therapy are the only known effective treatments. Timely recognition and treatment have important outcome, and sometimes lifesaving, implications.Autism seldom occurs in its pure form. Often labeled as behavioral disorders or psychological reactions, comorbid psychiatric disorders are common. Bipolar disorder is one of the most common psychiatric disorders that occur in persons with autism across their life spans. It can be comorbid with and mistaken for several other conditions. Similarly, psychosis occurs in several psychiatric disorders. Schizophrenia is the prototype psychotic disorder that has a close but controversial relationship with autism. Assessment and treatment of bipolar disorder and psychosis should be based on their individual characteristics, family dynamics, and community resources.A beautiful word. Probably one of the simplest concepts a mind can hold, but equally controversial and conflictual in its application. An action often assumed to be altruistic but potentially more enriching than any conceivable indulgence. At times so difficult to enact and sometimes even harder to receive. Perhaps most arduous to extend to ourselves.The following describes the case of Miguel and a missed diagnosis in an undocumented minor. Miguel Estrada (all names changed to protect identity) was a 10-year-old boy of Central American origin initially seen at age 8 years in our university outpatient child psychiatry clinic. check details During the initial evaluation with a native Spanish-speaking provider, his mother, Mrs. Estrada, reported behavioral problems beginning at age 5 with diagnoses of attention-deficit/hyperactivity disorder and intellectual disability; a trauma history was denied. Over the subsequent 2 years, Miguel continued treatment in our outpatient service and later transitioned to our school-based clinic. At the intake visit, Mrs. Estrada explained (with the assistance of his school paraprofessional educator and translator) that they crossed the United States/Mexico border illegally when Miguel was 5 years old. Miguel's behavioral problems began when Immigration and Customs Enforcement officials separated him from his parents, his father was deported, and he was exposed to harsh conditions.