Highlight on Health Concerns: Weight Management

This blog post was submitted by the ASPIRE Research Team at
the UNC School of Medicine.

Approved treatments for autism

Although most readers of this blog will already know, it is still important to note that autism is now considered common. Recent estimates indicate a prevalence of between 1 in every 110 to 1 in every 38 individuals. Luckily, funding for research focused on the treatment of autism has been a priority of the US Congress, the National Institutes of Health and advocacy groups. This funding has been instrumental in conducting rigorous controlled trials of several psychiatric medications. However, only two medications have been approved by the FDA (Food and Drug Administration) to treat irritable and disruptive behaviors in children with autism. These two drugs are Risperdal® (risperidone) and Abilify® (aripiprazole). These drugs are in a class of medications called antipsychotics. Although these are the only two drugs officially approved by the FDA, it is common practice for physicians to prescribe other similar medications such as Geodon® (ziprazidone), Seroquel® (quetiapine) and Zyprexa® (olanzapine).

What has the research told us about these medicines (antipsychotics)?

Approximately 30% of individuals with autism are treated with antipsychotics, with greater rates of treatment during adolescence. The truth of the matter is that these medicines are commonly prescribed because they are very effective in managing symptoms such as irritability, mood swings, aggression and other aspects of behavior. Research has also told us that individuals with disabilities have higher rates of overweight and obesity than individuals without disabilities in both pediatric and adult populations. This is particularly striking because of evidence that antipsychotic medications are associated with very dramatic weight gain in youth. For instance, a recent study of more than 300 youth treated with antipsychotics for the first time found mean increases in weight between 18 to 10 pounds over the first 11 weeks of treatment. There is also evidence that weight gain continues although at a somewhat slower rate with extended treatment. Several studies have also identified increased rates of high cholesterol and triglycerides, high insulin levels in the blood, and elevated liver enzymes in youth treated with antipsychotics.

Bottom line

Although these types of medicines are considered appropriate for children and adolescents, they do not come without risks of side effects. One of the biggest risks of taking these medicines is weight gain. Weight gain in children and adolescents can lead to major problems later on in life. Some of the common problems are high blood pressure, heart disease and diabetes.

What is being done now?

Researchers at the University of North Carolina at Chapel Hill are currently conducting a research study to address these issues. Dr. Linmarie Sikich and her team are currently looking at 3 different strategies to reduce weight gain that is associated with these types of medicines. They are looking for participants who are willing to be in the study for 7 months and come to UNC Hospitals several times. Study related psychiatric care is provided by doctors who specialize in these types of illness and is provided at no cost to the participant or his/her insurance company. In fact, compensation for time will be provided.

If you are interested in finding out more information about this research study, please contact the ASPIRE Research Team by calling us at 1-800-708-0048 or email us at aspire@unc.edu.

Teaching Social Skills Frontwards, by Dan Coulter

Why do we tend to teach social skills backwards? Instead of consistently teaching our kids manners, many of us wait until they do something wrong and then correct them.

Imagine using this approach in a driver’s education class. They’d put you in a manual transmission car with no training. Then they’d turn on the engine and shove the car into the street, expecting you to learn to drive from the helpful suggestions yelled at you by other drivers.

Anybody think that’s an optimal learning situation?

To give us parents the benefit of the doubt, we don’t use poor teaching tools on purpose. We do what seems obvious at the time. But, looking back, I’m sort of amazed that I kept trying the same thing for so long when it wasn’t getting results.

Even though I knew my son had Asperger Syndrome and that he had trouble learning social skills intuitively, for years I still tried to teach him by correcting him after the fact. Or rather, instead of teaching him, I corrected him. And got exasperated when he committed the same transgressions over and over again.

Well, I finally learned that if a door is locked, you have to try another one. In this case, the other door is explaining and demonstrating a social skill and having your kids practice it before they need it. And it pays off.

A little while back, I introduced my 20-year-old son to another adult. My son said, “How do you do?” He made eye contact and listened to what the person said — and never once mentioned Star Wars. He even said, “It was nice to meet you,” before he left. I thought back to ten years ago, when this conversation seemed like an impossible goal. But who was it impossible for? Once I tried the right door, the skill came through.

People with Asperger Syndrome can learn manners and social skills. Of course, how much they learn depends partly on their individual challenges and abilities. But it also depends on how we teach the lessons we want them to absorb.

I have a friend who tells a story about her son using a “script” he’d learned in social skills class when he happened to be seated next to a younger child on an airplane. As the mother of a child with AS, my friend was understandably nervous about how this would work out. It worked out great, because her son asked the other child a series of questions –and listened to the answers.

Hi, what’s your name? What grade are you in? What’s your favorite subject? Etc.

My friend knew this was a prepared script, but for the other child, it worked as a natural conversation. It helped the child with Asperger Syndrome interact in a comfortable way with another person — and it hopefully was a step toward helping the son learn more about conversation and preparing him to depart from the script.

Many of the manners and social skills we want our kids with Asperger Syndrome to learn can be taught, but we need to teach and practice these skills “frontwards,” before they’re needed. And practice is a key to success. A little regular practice time can help embed social skills so they become second nature to our kids.

There’s no adequate way to describe how you feel when you see your son or daughter demonstrate good manners in the real world with no prompting from you.

Sometimes things are only temporarily impossible.

ABOUT THE AUTHOR: Dan Coulter is the author of the video, “MANNERS FOR THE REAL WORLD: Basic Social Skills.” You can read more articles on his website: www.coultervideo.com.

Copyright Dan Coulter 2004 Used by Permission All Rights Reserved