Autism and Anxiety

Autism is, as most everyone knows, a developmental disorder that begins by age 3 and includes major disturbances in a child's social skills and ability to communicate. It strikes 1 in 100 babies born in America. Recently, data emerged showing that a comprehensive program to identify autistic children as toddlers and deliver an integrated behavioral treatment plan including lots of play and human interaction improves the IQs of autistic children. This is good news and a very good reason to increase our efforts to identify autistic children as early as possible and provide them the care they need. As a psychiatrist who has worked with both adults and children with developmental disorders, I also believe that it is important to treat most or all autistic children very early for what I think are very clear symptoms of unwieldy anxiety. After all, autistic children can shun human interaction, stiffen at human touch, often gravitate toward repetitive and soothing movements, seem drawn to objects or machines that generate predictable rhythms (like fans) and can act out angrily when their routines are altered. All of these signs are also consistent with those of an anxiety disorder. It is possible that, in the end, autism will be understood as a severe anxiety disorder starting in early childhood. Remember, OCD (obsessive-compulsive disorder) is classified as an anxiety condition. Anxiety is the core driving force for the repetitive thoughts or actions that plague so many. Obviously, the desire of an autistic child to maintain a specific routine or repeat a specific behavior or watch a spinning plate seems very similar to the actions of those with obsessions and compulsions. For this reason, not only behavioral techniques, but also medicinal remedies have to be considered front line therapies to interrupt the progression of autism once it is identified. I advise parents of autistic children, therefore, to strongly consider judiciously using medications like serotonin reuptake inhibitors (Paxil, Zoloft, Lexapro and others) immediately when autism is diagnosed. The possibility should at least receive very vigorous consideration from the doctors involved in caring for these children. I also believe that the new treatment already approved for depression called rTMS or repetitive transcranial magnetic stimulation may have benefits for autistic children. It has almost no side effects and reduces anxiety very significantly. Bottom line_ The most vigorous treatment for autism as soon as possible is probably the best way to limit its long-term consequences. If my child were stricken with the disorder, I would include the early use of anti-anxiety medication as part of that strategy.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His book, "Living the Truth: Transform Your Life through the Power of Insight and Honesty" has launched a new self-help movement including www.livingthetruth.com. Dr. Ablow can be emailed at info@keithablow.com.