Behavioral Interventions with and without Pharmacological Treatment: A Comparative Study at An Autistic Center in Jordan
DOI:
https://doi.org/10.35516/jjps.v17i2.1974Keywords:
ASD, Risperidone, ABLLSAbstract
Autism spectrum disorder (ASD) is a complex and highly variable neurodevelopmental disorder. This manuscript describes an observational study aimed at evaluating the impact of behavioral and pharmacological treatments on autistic patients at a Jordanian Autism Institution. Patients were evaluated every three months to assess their progress in behavioral treatment using the ABLLS (Assessment of Basic Language and Learning Skills) method, which evaluates 25 skills based on a child’s performance. The researcher collected all previous assessments and observed at least two evaluation periods. Males comprised 90.38% of the study population. Among psychiatric conditions, hyperactivity (36.54%) and irritability (30.77%) showed the highest prevalence. The first interval served as the baseline. Results from the second and third intervals showed slight differences but were not statistically significant. In contrast, the fourth interval demonstrated a statistically significant difference (P < 0.0001). In conclusion, combining pharmacological and behavioral treatments appears more beneficial than behavioral therapy alone, although this benefit may take at least a year to manifest effectively.
References
(APA), A.P.A. Autism spectrum disorder. 2022 [cited 2022 6/2022]; Available from:
https://www.apa.org/topics/autism-spectrum-disorder.
WHO. Autism. 2022 5/30/2022]; Available from: https://www.who.int/news-room/fact-sheets/detail/autism-spectrum-disorders.
Zeidan, J., et al. Global prevalence of autism: A systematic review update. Autism Res. 2022; 15(5):778-790. DOI: https://doi.org/10.1002/aur.2696
Hodges, H., C. Fealko, and N. Soares, Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation. Transl Pediatr. 2020. 9(Suppl 1):S55-S65. DOI: https://doi.org/10.21037/tp.2019.09.09
(CDC), C.f.D.C.a.p. Increase in Devlopmental Disabilities Among Children in the United States. Developmental Disabilities [cited 2022; Available from: https://www.cdc.gov/ncbddd/developmentaldisabilities/features/increase-in-developmental-disabilities.html.
Benjamin Zablotsky, L.I.B., Matthew J. Maenner, Laura A. Schieve,
a. Melissa L. Danielson, Rebecca H. Bitsko, Stephen J. Blumberg, Michael D. Kogan, Coleen A. Bo. Prevalence and Trends of Developmental Disabilities among Children in the United States: 2009–2017. Pediatrics. 144(4).
Lai, M.C., et al. Evidence-based support for autistic people across the lifespan: maximising potential, minimising barriers, and optimising the person-environment fit. Lancet Neurol. 2020; 19(5):434-451. DOI: https://doi.org/10.1016/S1474-4422(20)30034-X
James, S.N. and C.J. Smith, Early Autism Diagnosis in the Primary Care Setting. Semin Pediatr Neurol. 2020. 35:100827. DOI: https://doi.org/10.1016/j.spen.2020.100827
Chiarotti, F. and A. Venerosi. Epidemiology of autism spectrum disorders: a review of worldwide prevalence estimates since 2014. Brain sciences. 2020; 10(5):274. DOI: https://doi.org/10.3390/brainsci10050274
Alzghoul, L., et al. The association between levels of inflammatory markers in autistic children compared to their unaffected siblings and unrelated healthy controls. Turkish journal of medical sciences. 2019; 49(4):1047-1053. DOI: https://doi.org/10.3906/sag-1812-167
Christensen, D.L., et al. Prevalence and characteristics of autism spectrum disorder among children aged 8 years—autism and developmental disabilities monitoring network, 11 sites, United States, 2012. MMWR Surveillance Summaries. 2018; 65(13):1. DOI: https://doi.org/10.15585/mmwr.ss6513a1
Napolitano, A., et al. Sex Differences in Autism Spectrum Disorder: Diagnostic, Neurobiological, and Behavioral Features. Front Psychiatry. 2022; 13:889636. DOI: https://doi.org/10.3389/fpsyt.2022.889636
Association, A.P. Autism-Spectrum-Disorder. 2022.
Carbone, P.S., et al. Primary Care Autism Screening and Later Autism Diagnosis. Pediatrics. 2020; 146(2). DOI: https://doi.org/10.1542/peds.2019-2314
van 't Hof, M., et al. Age at autism spectrum disorder diagnosis: A systematic review and meta-analysis from 2012 to 2019. Autism.; 2021; 25(4):862-873. DOI: https://doi.org/10.1177/1362361320971107
Lord, C., et al., Autism spectrum disorder. Lancet, 2018. 392(10146): p. 508-520. DOI: https://doi.org/10.1016/S0140-6736(18)31129-2
Hyman, S.L., et al. Identification, Evaluation, and Management of Children With Autism Spectrum Disorder. Pediatrics. 2020; 145(1). DOI: https://doi.org/10.1542/9781610024716-part01-ch002
Bal, V.H., et al., Autism spectrum disorder symptoms from ages 2 to 19 years: Implications for diagnosing adolescents and young adults. Autism Res. 2019. 12(1):89-99. DOI: https://doi.org/10.1002/aur.2004
Magiati, I., X.W. Tay, and P. Howlin. Cognitive, language, social and behavioural outcomes in adults with autism spectrum disorders: a systematic review of longitudinal follow-up studies in adulthood. Clin Psychol Rev. 2014; 34(1):73-86. DOI: https://doi.org/10.1016/j.cpr.2013.11.002
Esbensen, A.J., et al. Age-related differences in restricted repetitive behaviors in autism spectrum disorders. J Autism Dev Disord. 2009; 39(1):57-66. DOI: https://doi.org/10.1007/s10803-008-0599-x
Eissa, N., et al. Current Enlightenment About Etiology and Pharmacological Treatment of Autism Spectrum Disorder. Front Neurosci. 2018; 12:304. DOI: https://doi.org/10.3389/fnins.2018.00304
Cheroni, C., N. Caporale, and G. Testa. Autism spectrum disorder at the crossroad between genes and environment: contributions, convergences, and interactions in ASD developmental pathophysiology. Mol Autism. 2020; 11(1):69. DOI: https://doi.org/10.1186/s13229-020-00370-1
Alhawamdeh, E., et al. A Cross-sectional Study of the Catalase Genetic Polymorphism (-262 cytosine/ thymine) and Blood Catalase Activity among Jordanian Vitiligo Patients. Jordan Journal of Pharmaceutical Sciences. 2023; 330-344. DOI: https://doi.org/10.35516/jjps.v16i2.438
Panisi, C., et al., Autism Spectrum Disorder from the Womb to Adulthood: Suggestions for a Paradigm Shift. J Pers Med, 2021. 11(2).
Hansen, S.N., et al. Recurrence Risk of Autism in Siblings and Cousins: A Multinational, Population-Based Study. J Am Acad Child Adolesc Psychiatry, 2019; 58(9):866-875. DOI: https://doi.org/10.1016/j.jaac.2018.11.017
Emberti Gialloreti, L., et al. Risk and Protective Environmental Factors Associated with Autism Spectrum Disorder: Evidence-Based Principles and Recommendations. J Clin Med. 2019; 8(2). DOI: https://doi.org/10.3390/jcm8020217
Masini, E., et al. An Overview of the Main Genetic, Epigenetic and Environmental Factors Involved in Autism Spectrum Disorder Focusing on Synaptic Activity. Int J Mol Sci. 2020; 21(21). DOI: https://doi.org/10.3390/ijms21218290
Zwaigenbaum, L., et al. Early Intervention for Children With Autism Spectrum Disorder Under 3 Years of Age: Recommendations for Practice and Research. Pediatrics. 2015; 136 Suppl 1:S60-81. DOI: https://doi.org/10.1542/peds.2014-3667E
Anagnostou, E., Clinical trials in autism spectrum disorder: evidence, challenges and future directions. Curr Opin Neurol. 2018; 31(2):119-125. DOI: https://doi.org/10.1097/WCO.0000000000000542
LeClerc, S. and D. Easley. Pharmacological therapies for autism spectrum disorder: a review. P T. 2015; 40(6):389-97.
DeFilippis, M. and K.D. Wagner, Treatment of Autism Spectrum Disorder in Children and Adolescents. Psychopharmacol Bull. 2016; 46(2):18-41.
Masri, A.T., et al. Parental use of conventional and complementary therapy for autism in Jordan. Complement Ther Med. 2020; 48:102275. DOI: https://doi.org/10.1016/j.ctim.2019.102275
Makrygianni, M.K., et al. The effectiveness of applied behavior analytic interventions for children with Autism Spectrum Disorder: A meta-analytic study. Research in Autism Spectrum Disorders. 2018; 51:18-31. DOI: https://doi.org/10.1016/j.rasd.2018.03.006
Yu, Q., et al. Efficacy of Interventions Based on Applied Behavior Analysis for Autism Spectrum Disorder: A Meta-Analysis. Psychiatry Investig. 2020; 17(5):432-443. DOI: https://doi.org/10.30773/pi.2019.0229
Ibrahim Alabbadi, E.M., Nashaat Taani, Safwan Dababneh, Qasem Shersheer, Omar Nimri, Refqi Mahmoud, Rami Hijazeen, Adnan Ishaq, Exploring the Economic Aspects of β-Thalassemia in Jordan in 2019. Jordan Journal of Pharmaceutical Sciences. 2022; 15(3). DOI: https://doi.org/10.35516/jjps.v15i3.412
Mayasah Al-Nema, A.G. Schizophrenia: The Ambiguous Mechanism behind the Disorder. Jordan Journal of Pharmaceutical Sciences. 2022; 15(2). DOI: https://doi.org/10.35516/jjps.v15i2.323
Goel, R., et al. An update on pharmacotherapy of autism spectrum disorder in children and adolescents. Int Rev Psychiatry. 2018; 30(1):78-95. DOI: https://doi.org/10.1080/09540261.2018.1458706
Loomes, R., L. Hull, and W.P.L. Mandy, What Is the Male-to-Female Ratio in Autism Spectrum Disorder? A Systematic Review and Meta-Analysis. J Am Acad Child Adolesc Psychiatry. 2017; 56(6):466-474. DOI: https://doi.org/10.1016/j.jaac.2017.03.013
Ozonoff, S., et al., Recurrence risk for autism spectrum disorders: a Baby Siblings Research Consortium study. Pediatrics. 2011; 128(3):e488-95. DOI: https://doi.org/10.1542/peds.2010-2825
Yip, B.H.K., et al. Caesarean section and risk of autism across gestational age: a multi-national cohort study of 5 million births. Int J Epidemiol. 2017. 46(2):429-439. DOI: https://doi.org/10.1093/ije/dyw336
Stepanova, E., et al. Pharmacotherapy of emotional and behavioral symptoms associated with autism spectrum disorder in children and adolescents. Dialogues Clin Neurosci. 2017; 19(4):395-402. DOI: https://doi.org/10.31887/DCNS.2017.19.4/rfindling
Mano-Sousa, B.J., et al. Effects of Risperidone in Autistic Children and Young Adults: A Systematic Review and Meta-Analysis. Curr Neuropharmacol. 2021; 19(4):538-552. DOI: https://doi.org/10.2174/1570159X18666200529151741
Hollander, E., et al. Divalproex sodium vs placebo for the treatment of irritability in children and adolescents with autism spectrum disorders. Neuropsychopharmacology. 2010; 35(4):990-8. DOI: https://doi.org/10.1038/npp.2009.202
Frazier, T.W., et al. Effectiveness of medication combined with intensive behavioral intervention for reducing aggression in youth with autism spectrum disorder. J Child Adolesc Psychopharmacol. 2010; 20(3):167-77. DOI: https://doi.org/10.1089/cap.2009.0048