An Urgent Call for an Evidence Based Management of Aggressive Behaviors in Autism Spectrum Disorder

Abstract

Background Majority of children diagnosed with autism spectrum disorder (ASD) meet criteria for intellectual disability (ID). The prevalence of ASD has an increasing trend for unknown reasons; currently it is estimated to be approximately 1.5% in developed countries. The multifactorial etiology of ASD is still poorly understood. Persons with ASD have problems in social communication and interaction, and restrictive, repetitive patterns of behavior, interests and activities. Method This paper describes the diagnostic and therapeutic challenges related to the management of neuropsychiatric disorders in intellectually disabled patients with ASD in clinical wards. Results The most severe forms of behavioral disorders associated with ASD and ID include selfdestructive behavior and/or aggression against other people or property. These symptoms require hospitalization, since in the most severe cases the behavioral symptoms do not respond to conventional non-pharmacological and pharmacological treatments. Conclusions A need for multidisciplinary team work and new treatment options are evident. Because of the heterogenicity of this patient population, controlled, randomized clinical trials may not be sufficient to bring the much needed evidence based solutions to the challenges in clinical realm. Individually designed clinical trials are suggested in search for appropriate treatment protocols for the most severe cases of ASD related behavioral disorders.