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Practice Parameter for the Assessment and Treatment of Children and Adolescents With Autism Spectrum Disorder

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Autism spectrum disorder is characterized by patterns of delay and deviance in the development of social, communicative, and cognitive skills that arise in the first years of life. Although frequently associated with intellectual disability, this condition is distinctive in its course, impact, and treatment. Autism spectrum disorder has a wide range of syndrome expression and its management presents particular challenges for clinicians. Individuals with an autism spectrum disorder can present for clinical care at any point in development. The multiple developmental and behavioral problems associated with this condition necessitate multidisciplinary care, coordination of services, and advocacy for individuals and their families. Early, sustained intervention and the use of multiple treatment modalities are indicated.

Key Words

autism
Practice Parameters
guidelines
developmental disorders
pervasive developmental disorders

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This Parameter was developed by Fred Volkmar, MD, Matthew Siegel, MD, Marc Woodbury-Smith, MD, Bryan King, MD, James McCracken, MD, Matthew State, MD, PhD, and the American Academy of Child and Adolescent Psychiatry (AACAP) Committee on Quality Issues (CQI): William Bernet, MD, Oscar G. Bukstein, MD, MPH, and Heather J. Walter, MD, MPH, co-chairs; and Christopher Bellonci, MD, R. Scott Benson, MD, Regina Bussing, MD, Allan Chrisman, MD, Tiffany R. Farchione, MD, John Hamilton, MD, Munya Hayek, MD, Helene Keable, MD, Joan Kinlan, MD, Nicole Quiterio, MD, Carol Rockhill, MD, Ulrich Schoettle, MD, Matthew Siegel, MD, and Saundra Stock, MD.

The AACAP Practice Parameters are developed by the AACAP CQI in accordance with American Medical Association policy. Parameter development is an iterative process between the primary author(s), the CQI, topic experts, and representatives from multiple constituent groups, including the AACAP membership, relevant AACAP committees, the AACAP Assembly of Regional Organizations, and the AACAP Council. Details of the Parameter development process can be accessed on the AACAP Web site. Responsibility for Parameter content and review rests with the author(s), the CQI, the CQI Consensus Group, and the AACAP Council.

The AACAP develops patient-oriented and clinician-oriented Practice Parameters. Patient-oriented Parameters provide recommendations to guide clinicians toward best assessment and treatment practices. Recommendations are based on the critical appraisal of empirical evidence (when available) and clinical consensus (when not) and are graded according to the strength of the empirical and clinical support. Clinician-oriented Parameters provide clinicians with the information (stated as principles) needed to develop practice-based skills. Although empirical evidence may be available to support certain principles, principles are based primarily on clinical consensus. This Parameter is a patient-oriented Parameter.

The primary intended audience for the AACAP Practice Parameters is child and adolescent psychiatrists; however, the information contained therein also may be useful for other mental health clinicians.

Kristin Kroeger Ptakowski and Jennifer Medicus served as the AACAP staff liaisons for the CQI.

This Practice Parameter was reviewed at the Member Forum at the AACAP annual meeting in October 2006.

From March to June 2012, this Parameter was reviewed by a consensus group convened by the CQI. Consensus group members and their constituent groups were Oscar G. Bukstein, MD, co-chair; R. Scott Benson, MD, and John Hamilton, MD (CQI); Doug Novins, MD, and Christopher Thomas, MD (topic experts); Bryan King, MD (AACAP Autism and Intellectual Disability Committee); Melissa DelBello, MD (AACAP Research Committee); John Rose, MD, and Syed Naqvi, MD (AACAP Assembly of Regional Organizations); and Louis Kraus, MD, and Tami Benton, MD (AACAP Council).

This Practice Parameter was approved by the AACAP Council on July 8, 2013.

This Practice Parameter is available on the Internet (http://www.aacap.org).

Disclosures: Fred Volkmar, MD, receives or has received research funding from the National Institute of Child Health and Human Development and the National Institute of Mental Health and has intellectual property with John Wiley & Sons, Inc., Guilford Publications, Inc, and Springer. Matthew Siegel, MD, has no financial conflicts of interest to disclose. Marc Woodbury-Smith, MD, has no financial conflicts of interest to disclose. Bryan King, MD, has or has received research funding from the National Institutes of Health (NIH), Seaside Therapeutics, and Health Resources and Services Administration and serves or has served as an advisor/consultant with the U.S. Department of Justice. James McCracken, MD, has or has received research funding from Seaside Therapeutics and Bristol-Myers Squibb, serves or has served as an advisor/consultant to BioMarin Pharmaceuticals, Inc., and receives or has received honoraria as a speaker for Veritas, Discovery Channel Health CME, and CME Outfitters, LLC. Matthew State, MD, has or has received research funding from the NIH and Howard Hughes Medical Institute and has an exclusive license agreement with Athena Diagnostics. Oscar Bukstein, MD, MPH, co-chair, has served as a consultant for Ezra Innovations and for PRIME CME. He receives royalties from Routledge Press. Heather Walter, MD, MPH, and William Bernet, MD, co-chairs, have no financial relationships to disclose. Disclosures of potential conflicts of interest for all other individuals named above are provided on the AACAP Web site on the Practice Parameters page.

Correspondence to the AACAP Communications Department, 3615 Wisconsin Avenue, NW, Washington, D.C. 20016.

This article can be used to obtain continuing medical education (CME) at www.jaacap.org.