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OCD and Autism


Updated March 27, 2009

Question: OCD and Autism
Can you give me any information on therapies for Obsessive Compulsive Disorder (OCD) tendencies in a 7 year old diagnosed with PDD-NOS?
Answer: Answer from Dr. James Coplan, a Pennsylvania-based developmental pediatrician specializing in autism spectrum disorders (ASD):

People with ASD frequently have intensely repetitive thoughts and behaviors, much like those seen in persons with Obsessive Compulsive Disorder (OCD).

People with OCD usually feel uncomfortable with their symptoms, and would like to be rid of them, whereas people with ASD usually are not bothered by their obsessions, and in fact may embrace them. People with autism spectrum disorders also have a range of other social, language, and cognitive differences not seen in people with OCD.

That said, there are two forms of treatment for repetitious behaviors in ASD: medication, and behavioral therapy. The most commonly prescribed medications are the selective serotonin reuptake inhibitors (SSRIs). The use of SSRIs to treat obsessions in ASD in children is not an FDA-approved indication, but there are good clinical research data to show that these medications work very well in a large number of cases.

Behavioral therapy will vary, depending on the child’s age and IQ or functional cognitive level, starting with applied behavior analysis for younger and/or lower functioning children, and moving on to more traditional talk therapy in older, brighter, and/or more verbal children.

Medication and behavioral therapy work together. Medication alone is seldom the answer, but medication can help a child become more “available” for behaviorally-based interventions. Behavioral therapy is difficult, however, because children with ASD do not perceive their obsessions as intrusive or unwelcome -– unlike people with OCD.

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