Transcript 행동치료의 의학적 처방

행동치료의 의학적 처방
Hyun S. Park, MD
Developmental and Behavioral Pediatrician
Neurodevelopmental Center, For OC Kids
Assistant Clinical Professor of Pediatrics, UCI SOM
Autism
• Qualitative Social Interaction Impairments
• Qualitative Communication Impairments
• Repetitive and Restricted Stereotyped
Patterns of Behavior, Activities and Interest
Incidence
• 1 child in 150 has autism spectrum disorder
Characteristic of behaviors
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Dangerous
Hurt self and/or others
Annoying
disturbing
Common Behavior Problems
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Aggression to self and others
Tantrums
Agitation
Obsessions and compulsions
Rocking, spinning, wandering around
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Hyperactivity, jumping, climbing
Inattention, immobility, low energy
Echolalia, non verbal
Excessive talking, screaming, shouting
MELTDOWNS
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moodiness
Fearful, fearless
Pain reaction: too much- too little
Sensory processing difficulties: auditory,
visual, tactile, oral, vestibular.
What to do with behavior
problem
• Identify the problem
• Understand what is going on with them
• Children with autism learn by repetition
Brain learning circuitry
• Reflex
• Associative
Children with autism learn by
repetition of behaviors
• Routine in daily activities, schedules,
environment
• Learned skill not able to generalize to
different settings and situations
• Re-learn the skill in a different setting and
situation
• Visual learners
• Concrete thinkers
• Focus your energy in teaching simple new
skills such as praying, singing, greeting,
sharing
• Reinforced with repetition
• Lack of common sense
• Gradual introduction of change
• Ignoring negative behaviors
Medical consultations
• Primary physician – check for absence of
illness
• Developmental and Behavioral
Pediatrician- developmental and behavioral
problem
• OT, PT, Speech therapist
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Psychiatrist -mental and behavioral problem
Behaviorist- behavioral modification
Neurologist –possible seizure
Gastroenterologist-diarrhea, food
malabsorption, GER
Medications
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Stimulants
Antidepressants
Atypical neuroleptics
Antiseizure
Psychostimulants
• Hyperactivity,inattention, impulsivity
Ritalin, Metadate, Concerta
Dexedrine, Adderall, Vyvanse
Strattera
• Hyperactivity,inattention, impulsivity
Antidepressants, anxiolytics
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Fluoxetine
Paroxetine
Citalopram
Others SSRIs
Atypical neuroleptics
• Risperdal
– Aggressive behavior, irritability, insomnia,
mood swing
What can I do for these children
Be loving, caring, PATIENT, provide warm
environment.
Be understanding of the child and family
Guide and encourage families to seek help
Referrals to….
• Early intervention programs
• Referral to Early Start Programs,
• Regional Center in California
• Public Schools Special Education programs
Education and information
• Mental health
• Community centers
• Medical specialist
You see them for short time, family lives with
child 24/7.