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Children and adolescents with autism spectrum disorder (ASD) present with social-communication deficits, restricted interests and repetitive behaviors, and sensory sensitivities, all of which render them more vulnerable to emotion dysregulation (ED).
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Associated features of ASD also contribute to ED, including difficulties with sleep and feeding, shifting attention appropriately, understanding and expressing emotions, and executive functions.
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It is essential to assess the timeline of ED throughout
Child and Adolescent Psychiatric Clinics of North America
Understanding, Assessing, and Intervening with Emotion Dysregulation in Autism Spectrum Disorder: A Developmental Perspective
Section snippets
Key points
Development of emotion regulation in autism spectrum disorder
Children with ASD have difficulties with both the reactive and regulatory components of ER from birth.1 Core features of ASD, that is, deficits in social and communication functioning and rigid, repetitive behaviors, link to ED.3,4 For example, social-communication deficits reduce a child’s capacity to benefit from caregivers to serve as emotional regulators, in addition to interfering with the child’s ability to understand and express emotions. Restricted and repetitive behaviors are most
Assessing emotion dysregulation
There are several approaches to assessing ER in ASD including parent interview, direct observation, and checklist/rating scales.
A careful history and observation should cover each of the developmental domains associated with ER. In addition to administration of instruments such as the Autism Diagnostic Observation Schedule-2 (ADOS-2)27 and the Autism Diagnostic Interview –Revised (ADI-R),28 routine questions should be asked about the child’s mood, level of irritability, and the frequency,
Treatment of emotion dysregulation in autism spectrum disorder
ED and irritability resulting in aggressive behavior directed at self and/or others is a serious problem, and often a psychiatric emergency. Addressing these behaviors is essential to improving outcomes.
Summary
The ER deficits of children with ASD can be both reactive and regulatory and are often the reason for a family seeking treatment. Such difficulties can be conceptualized as sequelae of the core symptoms of ASD or an independent construct. Understanding the ER in ASD deficits from a developmental perspective provides a context for both assessment and intervention. A detailed assessment of the function and intensity of ER provides the basis for intervention. Evidence-based interventions include
Disclosure
The authors have nothing to disclose.
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Narrative Review: Impairing Emotional Outbursts: What They Are and What We Should Do About Them
2023, Journal of the American Academy of Child and Adolescent PsychiatryCitation Excerpt :Others needed the addition of divalproex or risperidone to further treat aggression, although children who needed adjunctive medication never improved as much as children on stimulants alone.68,117 Of the available classes of medications, antipsychotics have been studied the most for reducing aggression and outbursts in the context of psychotic illnesses,118 bipolar disorder,118 and autism spectrum and developmental disorders.119 In the pediatric population, the best evidence currently available for reactive aggression is risperidone.120
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2024, Expert Opinion on Emerging Drugs
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