Catatonia in autism: a distinct subtype?

A teen with autism stopped talking and moving. Doctors called it catatonia. They gave one course of electroconvulsive therapy (ECT). The team watched what happened next.

This was a single-case report. No control group. Just one boy and his outcome.

After ECT the boy spoke and moved again. Daily life skills came back. The team said the change was clear and quick.

They urge BCBAs to screen for catatonia when any autistic teen suddenly regresses.

Hare et al. (2004) first wrote about 'autistic catatonia' as a new profile. Walley et al. (2005) added the first proof that ECT can treat it.

Petkova et al. (2022) later showed clozapine can also work. Together the papers give two medical options for the same rare crisis.

Hasan et al. (2025) pooled 45 studies and found six catatonia clusters in autism. Their data include the 2005 case, so the positive ECT result sits inside the wider symptom map.

If your client with autism stops talking, eating, or toileting overnight, think catatonia—not just 'autistic regression.' Score the Bush-Francis Catatonia Scale, call the pediatric psychiatrist the same day, and ask about ECT or clozapine. Early referral can restore language and self-care in weeks instead of months.