The Propriety of Psychotropic Medications in the Treatment of Pervasive Developmental Disorder in the Pediatric Population: A Review of the Evidence

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Recommended: Diagnosis of Pervasive Developmental Disorder

Pervasive Developmental Disorder (PDD) encompasses a multiplicity of developmental disorders which are typically diagnosed in childhood. Diagnoses typically grouped under PDD include various functional levels of autism, Rhett’s syndrome, PDD not otherwise specified (PDDNOS), Asperger’s syndrome, and childhood disintegrative disorder (Sung, Fung, Cai, & Ooi, 2010). As of 2009, the global prevalence of PDD was estimated to be 60-70/10,000 children (Fombonne, 2009). Pharmacological intervention for this delicate population is challenging and the use of psychotropic medications to control target behaviors is often used off-label. Examples of target behaviors include self-injurious behavior (SIB), stereotypy, echolalia, or excessive fears (de Bildt, Mulder, Scheers, Minderaa, & Tobi, 2006). The objective of this review is to examine a current collaborative behavioral protocol from The Learning Tree, “a nonprofit organization dedicated to providing educational, residential and support services for children and adolescents with developmental disabilities, including autism” (www.learning-tree.org). Specific attention to the pharmacological aspects of this protocol will be examined.
Pharmacological interventions intended to control behaviors in children with PDD often fall under the classification of psychotropic medications. These drugs include any medication with a potential neurological effect such as anti-depressants, typical and atypical anti-psychotics, stimulants, neuroleptics, and anti-hypertensives (Lopata et al., 2013; Sung et al., 2010). Of the broad array of drugs used to treat specific and non-specific behaviors in PDD, only risperidone has been approved by the United States Food and Drug Administration for manageme...

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...der, behavior problems, and psychotropic drug use in children and adolescents with mental retardation. Pediatrics, 118(6), 1860-1866. doi:10.1542/peds.2005-3101 Fombonne, E. (2009). Epidemiology of pervasive developmental disorders. Pediatric
Research, 65(6), 591-598. doi:10.1203/PDR.0b013e31819e7203
Lopata, C., Toomey, J.A., Fox, J.D., Thomeer, M.L., Volker, M.A., & Lee, G.K. (2013).
Prevalence and predictors of psychotropic use in children with high-functioning
ASDs. Autism Research and Treatment, 2013, 1-6. http://dx.doi.org/10.1155/2013/384527
Sung, M., Fung, D.S., Cai, Y., & Ooi, Y.P. (2010). Pharmacological management in children and adolescents with pervasive developmental disorder. Australian and New Zealand Journal of Psychiatry, 44, 410-428. doi: 10.3109/00048670903493330
The Learning Tree, Inc. (2014). Retrieved from http://www.learning-tree.org

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