This study examined (1) the prevalence of psychotropic medication use for a sample of children with high-functioning autism spectrum disorders (HFASDs), (2) the extent to which psychotropic agents were linked to targeted symptoms, and (3) predictors of psychotropic use. A total of 115 children, ages 6–13, with HFASDs who were enrolled in psychosocial treatment trials were included in this study. Parents completed extensive background and rating forms prior to treatment that included data on demographic characteristics, child health, child medication use, and child ASD-related symptoms. Results indicated that 33% ( ) of the sample was taking psychotropic medication with the most common being stimulants (25%; ), antidepressants (10%; ), and neuroleptics (6%; ). All children taking stimulants had target symptoms that were appropriate for stimulant medication, whereas 57% of those taking neuroleptics and 42% of those taking antidepressants did not have targeted symptoms consistent with the medication. Logistic regression for the major psychotropic drug categories indicated that lower IQ was a significant predictor of increased antidepressant and neuroleptic use. A higher level of ASD-related symptoms was related to the likelihood of stimulant use. 1. Introduction Autism spectrum disorders (ASDs) are characterized by social and communicative impairments and circumscribed behaviors and interests [1]. Among the broader ASD population is a unique subgroup characterized as high functioning (HFASDs). Although this high-functioning subgroup exhibits core features of ASDs including impairments in social relatedness and stereotyped and repetitive behaviors and interests [1], they are differentiated from others with ASDs based on relative strengths in cognitive and formal language abilities [2]. Beyond core diagnostic symptoms, individuals with ASDs/HFASDs commonly exhibit a range of associated psychiatric symptoms that significantly disrupt daily functioning [3]. A number of studies have documented significantly elevated externalizing (e.g., ADHD, oppositional-defiant disorder, and conduct disorder) and internalizing symptoms in this population (e.g., depression and anxiety [4–7]). Although generally not approved to treat core ASD symptoms, psychotropic medications are frequently used to manage a range of cooccurring behavioral and psychiatric symptoms. Surveys have illustrated the common use of psychotropic medications in the broader ASD population, with prevalence rates ranging from 30% to 60% (e.g., [8, 9]). Aman and colleagues [10–12] completed several studies
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