For very agitated children, an atypical antipsychotic may be helpful. Risperidone and aripiprazole are the only two approved for use in children with autism spectrum disorders. Both are available in oral dissolvable tablets.
Oral ketamine – alone or in conjunction with midazolam – is a possibility for the combative child, Dr. Chun noted. "It’s not evidence based, but some say that it should be a first-line drug," for these cases.
A Matter of Time
Autism is on the rise in the United States, according to a new report from the Centers for Disease Control and Prevention (MMWR 2012;61[SS-3]:1-19). The report estimated a 78% increase in cases from 2002-2008. The report suggests that one in every 88 children has some form of autism spectrum disorder.
"Emergency physicians are going to be seeing more and more children with autism. That is a fact. This is not a rare disorder we’re talking about. It’s out there, the prevalence is growing, and you’re going to see it" in the emergency department, Dr. Horrigan said.
None of the physicians interviewed for this article reported any relevant financial conflicts.