Minimally Verbal Individuals with Autism Spectrum Disorders/Intellectual Disability and Challenging Behaviors: Can Strategic Psychiatric Treatment Help?

Jessica A. Hellings (), Saras Chen Singh, Sham Singh and An-Lin Cheng
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Jessica A. Hellings: Department of Psychiatry, University of Missouri-Kansas City, Kansas City, MO 64108, USA
Saras Chen Singh: School of Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, USA
Sham Singh: School of Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, USA
An-Lin Cheng: Department of Biomedical and Health Informatics, University of Missouri-Kansas City, Kansas City, MO 64108, USA

Disabilities, 2024, vol. 4, issue 2, 1-13

Abstract: (1) Background : Psychiatrists are increasingly required to treat minimally verbal (MV) individuals with autism spectrum disorder (ASD), intellectual disability (ID) and behavior problems without much published guidance. (2) Methods : We reviewed 80 charts of MV patients managed strategically for challenging behaviors, following IRB approval. Data extracted included demographics, ASD/ID level, diagnoses, epilepsy and medications. In this descriptive study, we examined the course of assessment and treatment and made recommendations for a strategic, person-centered approach. (3) Results : Of 53 males and 27 females, mean age 34 years (range 7–76), all had ID; 75 had ASD (94%). Diagnoses included seizures in 40/80 (50%), frequent aggression (89%), self-injury (80%), attention-deficit hyperactivity disorder (ADHD) (64%) and obsessive compulsive disorder (OCD) (34%). The commonest medication classes adjusted were antiseizure medications, antipsychotics, and non-stimulant ADHD medications. (4) Conclusions : Clinical impressions suggested that this strategic psychiatric approach was beneficial, notably a review of antiseizure and all other medications for polypharmacy, behavioral and other side effects, followed by a review of possible childhood/current ADHD and a trial of low-dose non-stimulant ADHD medications if warranted. Low-dose risperidone was often effective and tolerable for irritability and self-injury.

Keywords: minimally verbal; epilepsy; psychiatric diagnosis; strategic approach; treatments (search for similar items in EconPapers)
JEL-codes: I (search for similar items in EconPapers)
Date: 2024
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