راهنمای بالینی درمان اوتیسم

در سال‌های اخیر، درک ما از علل و درمان اختلال طیف اوتیسم دستخوش تحولاتی شگرف شده است و نیاز به راهنماهای بالینی روشن و مبتنی بر شواهد بیش از پیش احساس می‌شود. کتاب راهنمای بالینی درمان اوتیسم، به ویرایش اریک هالندر و اودوکیا آناگنوستو، پاسخی جامع و روزآمد به این نیاز ضروری است. این اثر که توسط انتشارات معتبر انجمن روانپزشکی آمریکا منتشر شده، رویکردهای درمانی متعددی را که توسط پژوهشگران بین‌المللی توسعه و برای ایمنی و کارآیی آزمایش شده‌اند، در اختیار متخصصان قرار می‌دهد.

دربارهٔ کتاب راهنمای بالینی درمان اوتیسم

کتاب راهنمای بالینی درمان اوتیسم با زبانی مستقیم و ساختاری منسجم، نخست به موضوع تشخیص و ارزیابی این اختلال می‌پردازد و با ارائه مثال‌ها و دستورالعمل‌هایی برای سنجش افراد در تمام سنین و سطوح عملکردی، ابزارهای مناسب برای ارزیابی اولیه را معرفی می‌کند. این کتاب که دارای سیزده فصل است، در بخش عمد‌های از آن (فصول سوم تا هفتم) به بررسی دقیق شواهد مربوط به درمان‌های دارویی می‌پردازد. این فصل‌ها طیف وسیعی از داروهای رایج مانند مهارکننده‌های انتخابی بازجذب سروتونین، داروهای ضد تشنج، تثبیت‌کننده‌های خلق، داروهای ضدروان‌پریشی، محرک‌ها و غیرمحرک‌ها را پوشش می‌دهند و بر کاربرد آن‌ها برای نشانه‌های هدف خاص تأکید دارند. با این حال، دامنهٔ کتاب صرفاً به رویکردهای دارویی محدود نمی‌شود. فصول هشتم تا یازدهم کتاب به تشریح مداخلات روانی-اجتماعی و آموزشی معتبر اختصاص یافته است که شامل روش تحلیل رفتار کاربردی، رویکرد ارتباطی مبتنی بر تفاوت‌های فردی، مدل TEACCH و مداخلاتی برای بهبود روابط با همسالان است. در فصول پایانی نیز به درمان‌های مکمل و جایگزین و همچنین مسیرهای جدید و امیدوارکننده درمانی، از جمله داروهای هدف‌گیرندهٔ سیستم‌های گلوتامات و اکسی‌توسین در مغز، پرداخته شده است. سبک نگارش کتاب به‌گونه‌ای است که با وجود عمق علمی، برای طیف وسیعی از متخصصان حوزه سلامت روان قابل‌استفاده است.

دربارهٔ نویسنده

اریک هالندر، پزشک و استاد برجستهٔ روانپزشکی، از چهره‌های شاخص در زمینهٔ مطالعه و درمان اختلالات طیف اوتیسم و اختلال وسواس فکری-جبری است. او پیش‌تر کرسی استادی و ریاست دپارتمان روانپزشکی را در دانشکدهٔ پزشکی کوه سینا بر عهده داشته و مدیر مرکز تعالی اوتیسم سیور و نیویورک بوده است. هالندر که در حال حاضر مدیر برنامهٔ اوتیسم و طیف وسواس در مرکز پزشکی مونتفیور و استاد دانشگاه آلبرت اینشتین است، بیش از پنجصد مقالهٔ علمی منتشر کرده و ویراستار بیست کتاب تخصصی از جمله کتاب درسی اختلالات طیف اوتیسم بوده است. اودوکیا آناگنوستو نیز متخصص مغز و اعصاب کودکان و استادیار سابق در دپارتمان روانپزشکی دانشکدهٔ پزشکی کوه سینا است. او در حال حاضر معاون پژوهشی مؤسسهٔ تحقیقاتی بلورویو و دارندهٔ کرسی تحقیقاتی کانادا در زمینهٔ درمان‌های ترجمه‌ای در اوتیسم است و تمرکز تحقیقاتی او بر بهبود کیفیت زندگی کودکان و بزرگسالان مبتلا به این اختلال است.

چرا باید راهنمای بالینی درمان اوتیسم را بخوانید؟

دسترسی به اطلاعات مبتنی بر شواهد و به‌روز؛ این کتاب با گردآوری رویکردهای درمانی که توسط پژوهشگران بین‌المللی توسعه و برای ایمنی و کارآیی آزمایش شده‌اند، یک مرجع قابل‌اعتماد برای درمان مبتنی بر شواهد است. بررسی جامع رویکردهای دارویی و روانی-اجتماعی؛ کتاب ضمن پوشش طیف کاملی از داروهای رایج، به تشریح مداخلات رفتاری و آموزشی مؤثر مانند تحلیل رفتار کاربردی و رویکرد TEACCH نیز می‌پردازد و تصویری کامل از گزینه‌های درمانی ارائه می‌کند. راهنمایی عملی برای تشخیص و ارزیابی؛ فصول آغازین کتاب با ارائه دستورالعمل‌هایی روشن برای ارزیابی و تست‌گیری از افراد با سنین و سطوح عملکردی مختلف، به متخصصان در فرایند تشخیصی اولیه کمک شایانی می‌کند. بررسی درمان‌های مکمل و جایگزین؛ فصل مربوط به درمان‌های مکمل، اطلاعاتی ارزشمند در مورد رویکردهای رایج مانند استفاده از مکمل‌های غذایی ارائه می‌دهد که می‌تواند به خانواده‌ها در تصمیم‌گیری آگاهانه کمک کند. آشنایی با افق‌های جدید درمانی؛ کتاب با بررسی داروهای نوینی که سیستم‌های گلوتامات و اکسی‌توسین را هدف قرار می‌دهند، خواننده را با چشم‌اندازهای آینده در درمان مشکلات شناختی، اجتماعی و زبانی اوتیسم آشنا می‌کند.

این کتاب برای چه کسانی مناسب است؟

راهنمای بالینی درمان اوتیسم منبعی اساسی و کاربردی برای طیف گسترده‌ای از متخصصان سلامت و آموزش است که با افراد مبتلا به اختلال طیف اوتیسم سر و کار دارند. این کتاب به‌طور خاص برای روانپزشکان، متخصصان اطفال، متخصصان مغز و اعصاب، روانشناسان، مربیان آموزشی، و درمانگرانی مانند گفتاردرمانگران و کاردرمانگران طراحی شده است. علاوه بر این، پزشکانی که در جستجوی دستورالعمل‌های روشن و مبتنی بر شواهد برای ارزیابی و درمان هستند، مخاطب اصلی این اثر محسوب می‌شوند و نقاط قوت آن به‌ویژه در راهنمایی‌های مربوط به روان‌داروشناسی به خوبی نمایان است.

سوالات متداول

آیا این کتاب صرفاً به درمان‌های دارویی اختلال اوتیسم می‌پردازد؟

خیر، یکی از نقاط قوت این کتاب، رویکرد جامع آن است. اگرچه فصل‌های متعددی به بررسی دقیق شواهد مربوط به داروهای مختلف اختصاص دارد، کتاب به طور کامل به مداخلات غیردارویی مانند تحلیل رفتار کاربردی، رویکرد مبتنی بر تفاوت‌های فردی و مدل آموزشی TEACCH نیز پرداخته و ترکیبی از روش‌های درمانی را ارائه می‌کند.

آیا مطالب کتاب برای یک روانپزشک عمومی که با بیماران اوتیستیک سروکار دارد، قابل‌استفاده است؟

بله، این کتاب به‌طور خاص برای روانپزشکانی که در مطب خود بیمارانی با اختلال طیف اوتیسم می‌بینند، طراحی شده است. لحن نگارش آن مستقیم و کاربردی بوده و جداول متعددی در مورد دوز مصرف و عوارض جانبی داروها ارائه داده که آن را به یک منبع مرجع سریع و مفید تبدیل کرده است.

آیا در این کتاب به درمان‌های مکمل و جایگزین نیز اشاره شده است؟

بله، یکی از فصول کتاب به طور خاص به درمان‌های مکمل و جایگزین اختصاص دارد و در آن رویکردهایی مانند درمان‌های هدف‌گیرنده عملکرد دستگاه گوارش، سیستم ایمنی و استفاده از مکمل‌های غذایی با هدف کمک به خانواده‌ها برای انتخاب‌های آگاهانه بررسی شده است.

Reflecting tremendous gains over the past decade in our understanding of the causes of autism, Clinical Manual for the Treatment of Autism meets the increasing need for clear, up-to-date, and evidence-based treatment. Internationally known researchers who are also skilled in treating patients with autism share treatment approaches they have either developed or thoroughly tested for safety and efficacy. The book describes in a straightforward manner how to diagnose autism, providing examples and guidelines for evaluation and testing of individuals of all ages and levels of functioning. It then evaluates the appropriate role of various medications for specific target symptoms and individuals: SSRIs and antidepressants, anticonvulsants and mood stabilizers, conventional and atypical antipsychotics, cholinesterase inhibitors, and stimulants and nonstimulants. In addition to pharmacological approaches, the book presents psychosocial treatments, including applied behavior analysis, the DIR/Floortime approach, peer relationship interventions, and educational approaches. It also describes complementary and alternative therapies and explores promising new avenues of treatment, making it a state-of-the-art compendium that will help advance the care that people with autism receive.

reflecting Tremendous Gains Over The Past Decade In Our Understanding Of The Causes Of Autism, clinical Manual For The Treatment Of Autism Meets The Increasing Need For Clear, Up-to-date, And Evidence-based Treatment. Internationally Known Researchers—who Are Also Skilled In Treating Patients With Autism—share Treatment Approaches They Have Either Developed Or Thoroughly Tested For Safety And Efficacy.

the Book Describes In A Straightforward Manner How To Diagnose Autism, Recognizing That Patients May Vary Greatly In Intelligence, Language Ability, Disruptive Behavior, And Presence Of Comorbid Disorders. It Outlines The Appropriate Instruments To Use For Particular Patients, Providing Examples And Guidelines For Evaluation And Testing Of Individuals Of All Ages And Levels Of Functioning, With A Focus On Initial Diagnostic Evaluation. It Also Evaluates The Appropriate Role Of Various Medications For Specific Target Symptoms And Individuals: Ssris And Antidepressants, Focusing On The Rationale For Their Use And Clinical Trials In Autism; Anticonvulsants And Mood Stabilizers Used To Treat Disruptive Behaviors And Mood Instability; Conventional And Atypical Antipsychotics, Emphasizing Studies Using Random Assignment To Active And Control Treatments; Cholinesterase Inhibitors, Focusing On Cholinergic Mechanisms And Treatment Experience In Autism; And Stimulants And Nonstimulants For The Treatment Of Pervasive Developmental Disorder Accompanied By Hyperactivity, Distractibility, And Impulsiveness. In Addition To Pharmacological Approaches, The Book Presents Psychosocial Treatments And Includes Well-accepted Psychoeducational Models For Which There Is Sufficient Evidence To Recommend Their Use. In These Chapters, The Book:

• Covers The Use Of Applied Behavior Analysis, The Dir/floortime Approach, And Peer Relationship Interventions.
• Presents Educational Approaches, Based On The Experience Of The Teacch Program In North Carolina, Describing How Its Fundamental Principles Are Utilized Across The Age Spectrum.
• Describes Complementary And Alternative Treatments—such As Therapies Targeting Gastrointestinal Function Or The Immune System Or The Use Of Nutritional Supplements—with An Eye Toward Helping Parents Make Informed Choices.
• Explores Promising New Avenues Of Treatment To Address Issues Related To Cognition And Social And Language Deficits, Focusing Particularly On The Potential Of Medications That Target The Glutamate And Oxytocin Brain Systems.

clinical Manual For The Treatment Of Autism Is An Essential Resource For A Broad Range Of Professionals, Including Psychiatrists, Pediatricians, Neurologists, Psychologists, Educators, And Behavioral, Speech, And Occupational Therapists. It Is A State-of-the-art Compendium Of Treatments That Will Help Advance The Care That People With Autism Receive.

doody Review Services

reviewer:robin Shapiro, Md(rush University Medical Center)
description:this Review Of Treatments For Autism Covers Diagnosis, Medications, Psychosocial Treatments, And Other Therapeutic Interventions.
purpose:this Is A Resource For A Broad Range Of Treating Clinicians, Providing Evidence-based Reviews Of Current Medications And Therapeutic Interventions For The Treatment Of Autism.
audience:it Is Intended For A Wide Spectrum Of Clinicians From Pediatricians And Psychiatrists To Occupational Therapists. The Authors Feel It Is Even Appropriate For Highly Informed Caregivers. The Book Appears Appropriate For All Of The Above, As It Is Fairly Concise And The References Lead To More In-depth Information For Those Who Seek It.
features:major And Commonly Used Pharmacological Agents Are Covered In Concise, Clearly Defined Chapters. The Chapters Include Useful Tables Covering Psychotropics With Possible Side Effects, Dosing, And Sometimes Current, Evidence-based Research. The End Of Each Chapter Has Conclusions Followed By A Long But Useful List Of References. The Latter Half Of The Book Covers Nonpharmacological Treatments Such As Aba. These Chapters Are Particularly Helpful Because They Cover The Major/commonly Used Therapeutic Modalities, Explaining Them In Detail. In Addition, The Authors Cover Complementary/alternative Medicine Treatments With An Easy To Read Chart Covering The Research, Or Lack Thereof. Because The Reference Section At The End Of Each Chapter Is Fairly Dense, It Might Have Been Helpful If The Editors Had Highlighted A Handful Of Recommended Citations.
assessment:this Is A Useful, High Quality Resource For The Treatment Of Autism. One Can Easily Read The Book Through Or Use It As A Reference. The Charts Are Extremely Useful And The Book Is Detailed Yet Easy To Read.

Contents......Page 6 Contributors......Page 14 Foreword......Page 20 Historical Background......Page 24 The DSM-IV Field Trial......Page 31 Alternative Approaches to Classification......Page 32 Areas of Diagnostic Controversy......Page 36 Clinical Diagnostic Assessment and Differential Diagnosis......Page 40 Conclusions......Page 44 References......Page 45 2 Evaluation and Testing for Autism......Page 50 Diagnostic Evaluations......Page 53 Assessment of Core Autism Spectrum Disorder Domains......Page 61 Other Critical Domains for Assessment......Page 63 References......Page 67 3 Treatment of Autism With Selective Serotonin Reuptake Inhibitors and Other Antidepressants......Page 74 Mechanism of Action......Page 75 Rationale for Use of Selective Serotonin Reuptake Inhibitors in the Treatment of Autism......Page 76 Serotonin Reuptake Inhibitors: Clomipramine......Page 78 Selective Serotonin Reuptake Inhibitors......Page 80 Serotonin-Norepinephrine Reuptake Inhibitors......Page 87 Conclusions and Future Directions......Page 88 References......Page 99 4 Treatment of Autism With Anticonvulsants and Mood Stabilizers......Page 104 Comorbid Disorders in Autism......Page 105 Mechanism of Action of Anticonvulsants......Page 107 Clinical Evidence for Anticonvulsant Efficacy in Autism......Page 108 Conclusions......Page 115 References......Page 116 5 Treatment of Autism With Antipsychotics......Page 122 Rationale for the Use of Antipsychotics in Autism......Page 123 Conventional Antipsychotics......Page 124 Atypical Antipsychotics......Page 127 References......Page 139 6 Cholinesterase Inhibitor Therapy in Patients With Autism Spectrum Disorders......Page 144 History of Cholinesterase Inhibitors......Page 145 Cholinergic Mechanisms in Autism......Page 146 Treatment Experience With Cholinesterase Inhibitors in Autism......Page 147 Conclusions......Page 150 References......Page 151 7 Stimulants and Nonstimulants in the Treatment of Hyperactivity in Autism......Page 154 Stimulants......Page 157 Alpha-Adrenergic Agonists......Page 160 Antidepressants......Page 163 Amantadine......Page 165 Naltrexone......Page 166 Antipsychotics......Page 167 References......Page 170 8 Applied Behavior Analysis in the Treatment of Autism......Page 176 Research on Applied Behavior Analysis and Models of Service Delivery......Page 178 Applied Behavior Analysis Intervention Methods......Page 184 Conclusions......Page 192 References......Page 193 9 The Developmental Individual-Difference, Relationship-Based (DIR/Floortime) Model Approach to Autism Spectrum Disorders......Page 202 The DIR/Floortime Model......Page 203 The DIR/Floortime Assessment......Page 205 Core Psychological Deficit in Autism and the Developmental Pathways to Joint Attention, Pattern Recognition, Theory of Mind, Language, and Thinking......Page 206 The DIR/Floortime Intervention Program......Page 212 Selected Research on the DIR/Floortime Model and Outcome Studies......Page 219 References......Page 228 10 Educational Approaches for Autism—TEACCH......Page 234 Background and Structure of TEACCH......Page 235 Core Principles and Values......Page 237 Applications of TEACCH Methods and Strategies......Page 240 Treatment Effectiveness......Page 249 References......Page 252 11 Peer Relationships of Children With Autism: Challenges and Interventions......Page 258 Peer Interaction Challenges for Children With Autism......Page 259 Peer Relations, Social Acceptance, and Inclusion......Page 262 Peer Interventions and Autism......Page 264 Predictors and Correlates of Treatment Response......Page 272 Conclusions......Page 273 References......Page 274 12 Complementary and Alternative Therapies for Autism......Page 282 Helping Parents Make Informed Choices About CAM Treatments......Page 283 Specific CAM Therapies......Page 286 References......Page 303 13 Promising New Avenues of Treatment and Future Directions for Patients With Autism......Page 312 Pharmacological Treatments......Page 313 Advocacy......Page 317 References......Page 318 A......Page 322 C......Page 325 D......Page 326 E......Page 328 G......Page 329 J......Page 330 M......Page 331 P......Page 332 S......Page 334 T......Page 336 Z......Page 337 Contents 6 Contributors 14 Foreword 20 1 Clinical Diagnosis of Autism 24 Historical Background 24 The DSM-IV Field Trial 31 Alternative Approaches to Classification 32 Areas of Diagnostic Controversy 36 Clinical Diagnostic Assessment and Differential Diagnosis 40 Conclusions 44 References 45 2 Evaluation and Testing for Autism 50 Diagnostic Evaluations 53 Assessment of Core Autism Spectrum Disorder Domains 61 Other Critical Domains for Assessment 63 Conclusions 67 References 67 3 Treatment of Autism With Selective Serotonin Reuptake Inhibitors and Other Antidepressants 74 Mechanism of Action 75 Rationale for Use of Selective Serotonin Reuptake Inhibitors in the Treatment of Autism 76 Serotonin Reuptake Inhibitors: Clomipramine 78 Selective Serotonin Reuptake Inhibitors 80 Serotonin-Norepinephrine Reuptake Inhibitors 87 Conclusions and Future Directions 88 References 99 4 Treatment of Autism With Anticonvulsants and Mood Stabilizers 104 Comorbid Disorders in Autism 105 Mechanism of Action of Anticonvulsants 107 Clinical Evidence for Anticonvulsant Efficacy in Autism 108 Conclusions 115 References 116 5 Treatment of Autism With Antipsychotics 122 Mechanism of Action 123 Rationale for the Use of Antipsychotics in Autism 123 Conventional Antipsychotics 124 Atypical Antipsychotics 127 Conclusions 139 References 139 6 Cholinesterase Inhibitor Therapy in Patients With Autism Spectrum Disorders 144 History of Cholinesterase Inhibitors 145 Cholinergic Mechanisms in Autism 146 Treatment Experience With Cholinesterase Inhibitors in Autism 147 Conclusions 150 References 151 7 Stimulants and Nonstimulants in the Treatment of Hyperactivity in Autism 154 Stimulants 157 Alpha-Adrenergic Agonists 160 Antidepressants 163 Amantadine 165 Naltrexone 166 Antipsychotics 167 Conclusions 170 References 170 8 Applied Behavior Analysis in the Treatment of Autism 176 Research on Applied Behavior Analysis and Models of Service Delivery 178 Applied Behavior Analysis Providers 184 Applied Behavior Analysis Intervention Methods 184 Manuals and Curriculum Guides 192 Conclusions 192 References 193 9 The Developmental Individual-Difference, Relationship-Based (DIR/Floortime) Model Approach to Autism Spectrum Disorders 202 The DIR/Floortime Model 203 The DIR/Floortime Assessment 205 Core Psychological Deficit in Autism and the Developmental Pathways to Joint Attention, Pattern Recognition, Theory of Mind, Language, and Thinking 206 The DIR/Floortime Intervention Program 212 Selected Research on the DIR/Floortime Model and Outcome Studies 219 Summary 228 References 228 10 Educational Approaches for Autism—TEACCH 234 Background and Structure of TEACCH 235 Core Principles and Values 237 Applications of TEACCH Methods and Strategies 240 Treatment Effectiveness 249 Conclusions 252 References 252 11 Peer Relationships of Children With Autism: Challenges and Interventions 258 Peer Interaction Challenges for Children With Autism 259 Peer Relations, Social Acceptance, and Inclusion 262 Peer Interventions and Autism 264 Predictors and Correlates of Treatment Response 272 Outcomes of Peer Interventions 273 Conclusions 273 References 274 12 Complementary and Alternative Therapies for Autism 282 Helping Parents Make Informed Choices About CAM Treatments 283 Specific CAM Therapies 286 Conclusions 303 References 303 13 Promising New Avenues of Treatment and Future Directions for Patients With Autism 312 Pharmacological Treatments 313 Educational and Psychosocial Interventions 317 Advocacy 317 References 318 Index 322 A 322 B 325 C 325 D 326 E 328 F 329 G 329 H 330 I 330 J 330 K 331 L 331 M 331 N 332 O 332 P 332 Q 334 R 334 S 334 T 336 U 337 V 337 W 337 Y 337 Z 337

Reflecting tremendous gains over the past decade in our understanding of the causes of autism, Clinical Manual for the Treatment of Autism meets the increasing need for clear, up-to-date, and evidence-based treatment. Internationally known researchers -- who are also skilled in treating patients with autism -- share treatment approaches they have either developed or thoroughly tested for safety and efficacy.

The book describes in a straightforward manner how to diagnose autism, recognizing that patients may vary greatly in intelligence, language ability, disruptive behavior, and presence of comorbid disorders. It outlines the appropriate instruments to use for particular patients, providing examples and guidelines for evaluation and testing of individuals of all ages and levels of functioning, with a focus on initial diagnostic evaluation. It also evaluates the appropriate role of various medications for specific target symptoms and individuals: SSRIs and antidepressants, focusing on the rationale for their use and clinical trials in autism; anticonvulsants and mood stabilizers used to treat disruptive behaviors and mood instability; conventional and atypical antipsychotics, emphasizing studies using random assignment to active and control treatments; cholinesterase inhibitors, focusing on cholinergic mechanisms and treatment experience in autism; and stimulants and nonstimulants for the treatment of pervasive developmental disorder accompanied by hyperactivity, distractibility, and impulsiveness. In addition to pharmacological approaches, the book presents psychosocial treatments and includes well-accepted psychoeducational models for which there is sufficient evidence to recommend their use. In these chapters, the book: • Covers the use of applied behavior analysis, the DIR/Floortime approach, and peer relationship interventions.• Presents educational approaches, based on the experience of the TEACCH program in North Carolina, describing how its fundamental principles are utilized across the age spectrum.• Describes complementary and alternative treatments -- such as therapies targeting gastrointestinal function or the immune system or the use of nutritional supplements -- with an eye toward helping parents make informed choices.• Explores promising new avenues of treatment to address issues related to cognition and social and language deficits, focusing particularly on the potential of medications that target the glutamate and oxytocin brain systems.

Clinical Manual for the Treatment of Autism is an essential resource for a broad range of professionals, including psychiatrists, pediatricians, neurologists, psychologists, educators, and behavioral, speech, and occupational therapists. It is a state-of-the-art compendium of treatments that will help advance the care that people with autism receive.

Reflecting tremendous gains over the past decade in our understanding of the causes of autism, Clinical Manual for the Treatment of Autism meets the increasing need for clear, up-to-date, and evidence-based treatment. Internationally known researchers — who are also skilled in treating patients with autism — share treatment approaches they have either developed or thoroughly tested for safety and efficacy. The book describes in a straightforward manner how to diagnose autism, recognizing that patients may vary greatly in intelligence, language ability, disruptive behavior, and presence of comorbid disorders. It outlines the appropriate instruments to use for particular patients, providing examples and guidelines for evaluation and testing of individuals of all ages and levels of functioning, with a focus on initial diagnostic evaluation. It also evaluates the appropriate role of various medications for specific target symptoms and individuals: SSRIs and antidepressants, focusing on the rationale for their use and clinical trials in autism; anticonvulsants and mood stabilizers used to treat disruptive behaviors and mood instability; conventional and atypical antipsychotics, emphasizing studies using random assignment to active and control treatments; cholinesterase inhibitors, focusing on cholinergic mechanisms and treatment experience in autism; and stimulants and nonstimulants for the treatment of pervasive developmental disorder accompanied by hyperactivity, distractibility, and impulsiveness. In addition to pharmacological approaches, the book presents psychosocial treatments and includes well-accepted psychoeducational models for which there is sufficient evidence to recommend their use. In these chapters, the book: • Covers the use of applied behavior analysis, the DIR/Floortime approach, and peer relationship interventions.• Presents educational approaches, based on the experience of the TEACCH program in North Carolina, describing how its fundamental principles are utilized across the age spectrum.• Describes complementary and alternative treatments — such as therapies targeting gastrointestinal function or the immune system or the use of nutritional supplements — with an eye toward helping parents make informed choices.• Explores promising new avenues of treatment to address issues related to cognition and social and language deficits, focusing particularly on the potential of medications that target the glutamate and oxytocin brain systems. Clinical Manual for the Treatment of Autism is an essential resource for a broad range of professionals, including psychiatrists, pediatricians, neurologists, psychologists, educators, and behavioral, speech, and occupational therapists. It is a state-of-the-art compendium of treatments that will help advance the care that people with autism receive. Clinical diagnosis of autism Evaluation and testing for autism Treatment of autism with selective serotonin reuptake inhibitors and other antidepressants Treatment of autism with anticonvulsants and mood stabilizers Treatment of autism with antipsychotics Cholinesterase inhibitor therapy in patients with autism spectrum disorders Stimulants and nonstimulants in the treatment of hyperactivity in autism Applied behavior analysis in the treatment of autism The developmental individual-difference, relationship-based (DIR/floortime) model approach to autistic spectrum disorders Educational approaches for autism? TEACCH Peer relationships of children with autism: challenges and interventions Complementary and alternative therapies for autism Promising new avenues of treatment and future directions for patients with autism. Reflecting gains over the past decade in our understanding of the causes of autism, this book meets the need for clear, up-to-date, and evidence-based treatment. Internationally known researchers -- who are also skilled in treating patients with autism -- share treatment approaches they have either developed or thoroughly tested for safety and efficacy