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Treatment plan for Autism

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When a child comes to me, once we've established the diagnosis of Autism, the first thing that I want to make sure is that they're getting therapy. Speech therapy is the number one treatment for Autism. All children with Autism have some type of language impairment and they need speech therapy. The other things that I do is determine if they perhaps need occupational therapy. Sometimes this is needed for fine motor delays or cognitive adaptive delays, which are determined based on the testing that I do in my office. Sometimes they need occupational therapy due to sensory challenges they're experiencing. At times they may have very difficult behaviors, in which case I might refer them to a behaviorist. We recommend a variety of different behavior therapies, whether it's ABA or more of a floor time approach or a mixed approach such as the Denver type of model. I also might refer them to physical therapy if they have any physical delays, although that's a little bit less common for most children who have Autism. The other things that we address are behaviors from a medical perspective. Occasionally or often behaviors are so severe that simple therapy does not address the behaviors and they're very destructive to the family life and to the child in the school setting. Some of the behaviors might include aggression; sleep challenges - trouble going to sleep, waking up, attention issues, and so forth. So we don't have medications that actually treat Autism, yet. But we do have medications that treat some of the symptoms. I might use medications to reduce hyperactivity, to reduce aggression, to improve sleep. Additionally some children may also have seizures. I would evaluate the child for the presence of seizures and treat the child for seizures if necessary. I would recommend at times other modes of communication such as facilitated communication. If the child has been in speech therapy for a while and it hasn't been working, but yet they seem like they would be able to use other modes of communication. And sometimes we also recommend that they participate in research trials. The genetic workup that I do to look for causes of Autism might include sending for a microarray to see if there's a genetic abnormality that's responsible for the child's Autism. I might also look for skin stigmata or spots on the skin that might make me think they have a condition such as neurofibromatosis or tuberous sclerosis that's contributing to the patient's symptoms. I would also send a DNA for fragile X, which is also one of the most common conditions that's associated with Autism. I need to stress that having neurofibromatosis or tuberous sclerosis or even fragile X is exceptionally rare. So most children who have Autism do not have any of these conditions. But this is something we do as part of the neurological evaluation.

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Jane Tavyev Asher, MD

Division of Child Neurology - Cedars-Sinai Medical Center

Dr. Jane Tavyev Asher is a board certified Child Neurologist and Director of the Division of Child Neurology at Cedars-Sinai Medical Center.  Upon attaining her medical degree from Baylor College of Medicine, she completed residency/ fellowship training in Child Neurology and Neurodevelopmental Disabilities at Baylor College of Medicine/ Texas Children’s Hospital, where her clinical training focused on behavioral neurology, specializing in autism and other developmental disorders, and her research focused on epigenetic factors in autism.  She currently maintains a clinical practice at Cedars-Sinai Medical Center in Los Angeles, where she sees patients with a variety of neurologic conditions such as Autism Spectrum Disorders, developmental delay, ADHD, learning disabilities, tics, headaches, and cognitive/ behavioral management in neuromuscular disorders.  She holds an academic/ research appointment as Assistant Professor at UCLA in the Departments of Pediatrics, Psychiatry and Biobehavioral Sciences.  Her current research interest remains in the area of autism.  Dr. Tavyev Asher is proud to contribute to the training of the next generation of physicians including those specializing in Pediatrics, Child Psychiatry, and Child and Adult Neurology, and she enjoys giving talks on various neurologic topics locally and nationally.  She is a member of the Child Neurology Society, American Academy of Child and Adolescent Psychiatry, UCLA CART (Center for Autism Research and Treatment), and The Help Group-UCLA Autism Research Alliance.  She also serves on the Advisory Board of Healthy Child Healthy Child Healthy World.  She enjoys art, music, yoga, skiing, and relaxing with her family.

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