Growing Up with Autism: Incorporating Behavioral Management and Medication to Manage Self-Injurious Behavior

Abstract

Autism spectrum disorder (ASD) is often complicated by psychiatric and medical comorbidities such as intellectual disability, epilepsy, anxiety, mood disorders, sleep issues, and gastrointestinal problems. Behavioral issues including self-injury and aggression are common and cause need for hospitalization and escalating pharmacotherapeutic intervention. The case described below is of an adolescent whose autism and comorbid intellectual disability were complicated by dangerous self-injury. The optimal management included careful analysis of behavioral reinforcers and institution of both a closely monitored and dynamically modified behavioral plan integrated into his home, school, and therapeutic environment. It also included judicious use of a range of psychotropic medications to ensure safety and maximize his capacity to build skills, utilize available therapies, and flourish in the setting of his complex constellation of challenges.