The following extracts are from Autism: recognition, referral, diagnosis and management of adults on the autism spectrum. (2012). London: National Institute for Health and Clinical Excellence. Full Item
188.8.131.52 Before initiating other interventions for challenging behaviour, address any identified factors that may trigger or maintain the behaviour (see recommendation 184.108.40.206) by offering:
220.127.116.11 Offer a psychosocial intervention for the challenging behaviour first if no coexisting mental or physical disorder, or problem related to the physical or social environment, has been identified as triggering or maintaining challenging behaviour.
18.104.22.168 When deciding on the nature and content of a psychosocial intervention to address challenging behaviour, use a functional analysis. The functional analysis should facilitate the targeting of interventions that address the function(s) of problem behaviour(s) by:
22.214.171.124 In addition to the functional analysis, base the choice of intervention(s) on:
126.96.36.199 Psychosocial interventions for challenging behaviour should be based on behavioural principles and informed by a functional analysis of behaviour (see recommendation 188.8.131.52).
184.108.40.206 Psychosocial interventions for challenging behaviour should include:
220.127.116.11 Consider antipsychotic medication in conjunction with a psychosocial intervention for challenging behaviour when there has been no or limited response to psychosocial or other interventions (such as environmental adaptations). Antipsychotic medication should be prescribed by a specialist. Informed consent should be obtained and documented and quality of life outcomes monitored carefully. Review the effects of the medication after 3-4 weeks and discontinue it if there is no indication of a clinically important response at 6 weeks.
18.104.22.168 Consider antipsychotic medication for challenging behaviour on its own when psychosocial or other interventions could not be delivered because of the severity of the challenging behaviour. Antipsychotic medication should be prescribed by a specialist and quality of life outcomes monitored carefully. Review the effects of the medication after 3-4 weeks and discontinue it if there is no indication of a clinically important response at 6 weeks.
22.214.171.124 Do not routinely use anticonvulsants for the management of challenging behaviour in adults with autism.