Meltdowns, outbursts, aggressions, and self-injurious behaviors are major contributors to poor quality of life for those with autism, and also create tremendous caregiver stress. In this 2018 lecture from the Simons Foundation lecture series, Matthew Siegel, MD, looks behind what causes these often dangerous and disruptive behaviors. “We are like prisoners held hostage to his aggression,” he quotes one parent as saying, noting this was not unusual. So how do you treat challenging behaviors?
Behavior in autism is typically looked at as “serving a function,” but Dr. Siegel stresses evidence for that is limited and there are other ways to look at severe behaviors, including impairments in regulating physiologic arousal and emotional regulation.
Dr. Siegel draws upon the Autism Inpatient Collection data, a Simons-funded project, to offer preliminary insights into the relationships between physiologic arousal, emotion dysregulation and the occurrence of challenging behaviors. Physiologic arousal may be a biomarker of distress — and an opportunity to predict the onset of challenging behavior in real time, an urgent need for parents and caregivers. The unpredictability of dangerous behaviors that causes the greatest problems, and he discusses a biosensor-based method to pro-actively predict aggressive behavior, one that seems to work with 80% accuracy.
Also discussed:
—Severe autism is sorely under-represented in research.
—Risk factors for psychiatric hospitalization in ASD: low adaptive functioning, higher ASD symptom severity, mood disorder, single-parent household, and sleep problems.
—Most common medications: antipsychotics, stimulants and sleep aids.
Center of Excellence in Autism and Developmental Disorders Virtual groundbreaking Wednesday, June 17 at noon ET
An expansion of Dr. Siegel’s center in Maine is having virtual groundbreaking this Wednesday, June 17 at noon ET, please find more information here. The Center of Excellence campaign aims to build a home for the many needed services for Maine people with Autism and Developmental Disorders. New and expanded services made possible through our building campaign will include:
Child and adult outpatient clinics
Preschool and early intervention in-home services
Child day treatment
Child and adult intensive outpatient treatment programs
(Video is 54 minutes, please note this lecture is fairly academic, delivered to an audience of researchers)
About Dr Siegel:
Siegel is an associate professor of psychiatry and pediatrics at Tufts University School of Medicine, the vice president for medical affairs, developmental disorders service at Maine Behavioral Healthcare, and a faculty scientist at the Maine Medical Center Research Institute. He attended Amherst College, Stanford Medical School and trained at Brown University in child psychiatry, psychiatry, and pediatrics. Siegel is the principal investigator of the Autism Inpatient Collection and is an expert in the inpatient treatment of challenging behaviors in individuals with autism and other developmental disorders.
https://www.youtube.com/watch?v=ZExLwFIPvrI