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Yonago Acta Medica May 2024Self-injurious, stereotyped, and aggressive/destructive behaviors exhibited by individuals with intellectual disabilities and autism spectrum disorders are called...
Self-injurious, stereotyped, and aggressive/destructive behaviors exhibited by individuals with intellectual disabilities and autism spectrum disorders are called challenging behaviors (CBs). Severe CBs often require long-term treatment involving psychosocial approaches based on behavioral interventions and/or medication. A boy with severe CB enrolled in a special needs school, with diagnoses of autism and intellectual disability, was the client of the study. This case report describes the long-term outcomes of eight years of continuous school consultation. The student's severe CB improved with environmental adjustments in the classroom, unified teacher involvement, instruction of leisure and communication skills, and medication. Long-term research on changes in CBs through school consultation is limited, and this case report provides important insights into the development of effective educational programs and curricula for severe CBs in school-aged children.
PubMed: 38803589
DOI: 10.33160/yam.2024.05.006 -
Innovations in Clinical Neuroscience 2024Stimulants are the first-line pharmacological treatment for attention deficit hyperactivity disorder (ADHD). We present the unique case of a patient who developed a...
Stimulants are the first-line pharmacological treatment for attention deficit hyperactivity disorder (ADHD). We present the unique case of a patient who developed a chewing compulsion when taking mixed amphetamine salts (MAS). A 32-year-old female patient with a past medical history of gastroesophageal reflux disease (GERD), gastroparesis, and migraines was seen for initial psychiatric assessment due to concerns for irritability. She was diagnosed with post-traumatic stress disorder (PTSD); generalized anxiety disorder; ADHD, inattentive type; and unspecified bipolar disorder. Lamotrigine was started and titrated to 25mg twice per day, with improved mood stability. MAS immediate-release (IR) was started at 2.5mg and titrated to 5mg daily for ADHD. She then experienced an uncontrollable urge to chew, finding relief when chewing on a child's teething necklace, which provided satisfaction and a reduction in anxiety. She denied jaw tightness or teeth grinding. The dose of MAS IR was reduced to 2.5mg daily with improvement in symptoms and later increased again to 5mg daily, which she was then able to tolerate. Stereotyped biting behaviors have been observed in rats with the use of amphetamines, and the onset of compulsive behavior has emerged in children with the use of dextroamphetamine. However, this is the first known case of compulsive chewing or biting movements reported in humans with MAS use. This case highlights the need to assess patients for adverse events, such as compulsive biting and chewing movements or other oral facial stereotypies, after commencement of stimulants, including MAS.
PubMed: 38938532
DOI: No ID Found -
Autism : the International Journal of... Mar 2024Multi-sensory environments, often called sensory rooms, are widely used with autistic children. However, we know very little about how autistic children choose to spend...
Multi-sensory environments, often called sensory rooms, are widely used with autistic children. However, we know very little about how autistic children choose to spend their time in multi-sensory environments. We also do not know how their equipment preferences relate to their individual characteristics such as their sensory differences, level of ability or general autistic behaviours. We measured the frequency and duration of visits to multi-sensory environment equipment of 41 autistic children during 5 min of free play. The bubble tube and touch, sound and light board were both highly popular, with the fibre optics and tactile board receiving less attention. The children displayed significantly more sensory seeking behaviours in the multi-sensory environment than sensory-defensive behaviours. These sensory seeking behaviours, as well as the sensory behaviours that their parents reported they showed in daily life, were associated with specific patterns of multi-sensory environment equipment use. Non-verbal ability was also associated with multi-sensory environment equipment use, but broader autistic behaviours were not. Our findings show that the multi-sensory environment equipment preferences of autistic children are related to individual differences in sensory behaviours and non-verbal ability. This information could be useful for teachers and other practitioners who want to know how best to use multi-sensory environments with autistic children.
Topics: Child; Humans; Autistic Disorder; Autism Spectrum Disorder; Stereotyped Behavior; Educational Personnel; Parents
PubMed: 37421130
DOI: 10.1177/13623613231180266 -
Epilepsy & Behavior Reports 2024We describe a case of focal epilepsy with a semiology consisting of behaviors indicating an enthusiastic desire for those around him to get along and engage in friendly...
We describe a case of focal epilepsy with a semiology consisting of behaviors indicating an enthusiastic desire for those around him to get along and engage in friendly relations, which we refer to as "amity seizures". The patient was a 41-year-old right-handed male with seizures since age 26. Semiology consisted of stereotyped enthusiastic behaviors such as expressing "Peace! Peace!… Come on, we all on the same team, right?!", and giving hugs, kisses, and high-fives to those around him. On SEEG evaluation, 2 independent areas of seizure onset were identified, the right hippocampus and right posterior orbitofrontal area. Locally confined seizures had bland manifestation. However, spread from right hippocampus to right orbitofrontal area, or vice versa, elicited his typical amity seizure semiology. To our knowledge this is the first report of the seizure semiology we have coined "Amity seizures". While emotions were once thought to localize to discrete brain regions, they are now accepted to arise from networks across multiple brain regions. The fact that this behavior only occurred when seizures spread from either of 2 onset zones to the other suggests that this semiology results from network engagement between, and likely beyond, either onset zone.
PubMed: 38323089
DOI: 10.1016/j.ebr.2024.100649