Mental Health Services and Autism Spectrum Disorders

Ann M. Neumeyer, MDMedical Director, Lurie Center / LADDERS Associate Pediatrician and NeurologistMassachusetts General Hospital Assistant Professor in NeurologyHarvard Medical School

March 28, 2011

Autism Spectrum Disorders

Communication

Atypical BehaviorsSocial Interaction

Causes of Autism

• Genetic • Neurochemical• Neurobiology• Functional changes• Prenatal factors

Genetic

–Many genetic abnormalities can cause autism

–Diseases associated with autism• Rett Syndrome

• Tuberous sclerosis

• Fragile X syndrome

• Angelman Syndrome

–Males > Females (4.5:1)–There is no one “autism” gene

Neurochemical

• Monoamines• Glutamate• Alpha amino hydroxybutyrate• Neuropeptides• Oxytocin

Neurobiology

• Neuroanatomic Changes- Bauman and Kemper, 1984 • Cortical, callosal and limbic abnormalities, amygdala,

fusiform gyrus• MRI/ PET studies: Cortical White Matter

Functional Changes

–Functional MRI–Autonomic Nervous System

People with Autism have different brains

Increased likelihood of mental health issues

Mental health disease and Autism

• Depression• Anxiety• Obsessive Compulsive Disorder and features• Attention Deficit Hyperactivity Disorder• Aggression

• Intellectual Disability is not a part of 38%!!!!

Approach to treatment of Autism Spectrum Disorders

Speech andOccupational

Therapy

Psychopharm.Treatment

EducationBehaviorTherapy

Vocational Skills

Training

Social SkillsTherapy

MedicalNeurological

Treatment

Improved Function

Results of Treatments?

• Less mental illness• Improved adaptive functioning

–Communication–Social Skills–Vocational skills

• Improved Learning• More independent living skills

• Higher functioning in our society• Lower cost to state

The Solution?

• Work together • Wrap around services

Collaborative Integrated Care

Medical Care

Education

Mental/ BehavioralHealth Care

Dedication

To the many children and their families who have taught me about autism.

Special thanks to Dr Margaret Bauman