Brief report: Electroconvulsive therapy for malignant catatonia in an autistic adolescent.

Doctors treated a young learners autistic boy who stopped eating, talking, or moving. The teen also had intellectual disability. The team called the state malignant catatonia, a rare but deadly shutdown.

They gave two things at once: small electric pulses to the brain (ECT) and the calming drug lorazepam. They watched him every day and wrote down what changed.

After six ECT sessions and daily lorazepam the boy woke up. He ate, spoke, and walked again. No seizures or heart trouble happened. He left the hospital two weeks later.

At one-month check-up he was still doing well. The catatonia had not come back.

Huguenin (2000) already warned that no pill works for every autism crisis. The review lists lorazepam as a short-term rescue only, never as a cure. Elizabeth et al. add ECT to that rescue plan, but still for one-time use.

Kaur et al. (2025) show that single-case reports like this are common in autism and ID. Their big map of 76 studies proves the field keeps using tiny samples when big ones are missing.

Sanberg et al. (2018) used a true single-case design to fix sleep problems with behavior tools alone. Their clean data contrasts with the heavy medical route here, yet both aim to bring a child back to daily life.

Most BCBAs will never see malignant catatonia, but you may spot early signs: sudden stop in speech, eating, or toileting. Know that ECT plus lorazepam is a life-saving option and requires medical doctors. Your job is to record baseline skills, track any rapid loss, and call the physician fast. Share video data and behavior graphs; they help the medical team decide if emergency care is needed.