Psychotropic medication use among children with autism spectrum disorders within the Simons Simplex Collection: are core features of autism spectrum disorder related?
Age and IQ predict psych med use in autism far better than autism severity.
01Research in Context
What this study did
Levin et al. (2014) looked at how many kids with autism take psych meds.
They used the Simons Simplex Collection, a big U.S. sample.
Doctors recorded each child’s age, IQ, and autism severity.
What they found
About 4 in 10 children had used at least one psychotropic drug.
Core autism traits barely raised the odds of getting meds.
Older age and lower IQ were far better predictors.
How this fits with other research
Smith et al. (2010) saw nearly the same 35% rate in a national registry, so the number is steady.
Memari et al. (2012) found 80% use among Iranian pupils—double the U.S. figure. The gap likely reflects different prescribing cultures, not error.
Guisso et al. (2018) later showed UK kids use far fewer meds than U.S. kids, proving geography shapes practice.
Deserno et al. (2017) zoomed in on antipsychotics alone and confirmed age, not autism severity, drives the script.
Why it matters
When you review a client’s medication list, ask “How old is this child?” and “What is their IQ?” before guessing why each drug was added. Core autism behaviors alone rarely justify poly-pharmacy, so flag scripts that don’t match age or cognitive level for physician follow-up.
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02At a glance
03Original abstract
Psychotropic medication use and its relationship to autism spectrum core features were examined in a well-characterized but nonstratified North American sample (N = 1605) of children/adolescents diagnosed with autism spectrum disorders utilizing the Autism Diagnostic Observation Schedule and the Autism Diagnostic Interview-Revised, from the multisite Simons Simplex Collection. Analyses included (a) prevalence of psychotropic use (overall, and by classes), (b) correlations between prevalence of use and autism spectrum core features, age, and cognitive functioning, and (c) logistic regression to identify whether these factors were predictive of psychotropic use. Results indicated 41.7% ever used one or more classes of psychotropic medications, with attention deficit hyperactivity disorder medications used most. Small but significant correlations between psychotropic medication use and (a) social impairment (p < .001) and (b) repetitive behaviors (p < .001) were found. Overall, however, autism spectrum disorder core features are weakly related to medication use. Older children used more psychotropics (p < .001), and higher cognitive functioning was associated with less overall psychotropic use (p < .001). Logistic regression indicated that use of psychotropics was predicted by repetitive behaviors (both clinician-observed and parent-reported), age, and cognitive ability level. Limitations inherent to the Simons Simplex Collection sample, methodology, and the correlational analyses are discussed. Directions for future research include investigation of factors more influential than core symptoms on psychotropic treatment (e.g. parent perceptions, comorbid symptoms).
Autism : the international journal of research and practice, 2014 · doi:10.1177/1362361313498518