Medical management of autism.

The primary care physician should be knowledgeable about the medical issues that children with ASD encounter and also be aware of available treatment options. Included among these are: identification of seizures, treatment of sleep problems, aggressive management of chronic constipation and GERD as well as timely referral for preventive dental care. Due to the scarcity of sub-specialists (Pediatric Neurologist, Developmental Pediatrician, Child Psychiatrist/ Psychologist) managing children with ASD, the primary care physician should likewise be familiar with medication options for challenging behaviors. More importantly, there needs to be a close collaboration and communication between the family, the sub-specialist and the child's primary care physician.

Caretaker perception of child vulnerability predicts behavior problems in NICU graduates.

This study explores parental perception of child vulnerability (PPCV) and parent overprotection (POP) and their relationship to neonatal medical problems, child development and behavior. Participants included 90 lower income parents of NICU graduates ages 22-81 months consecutively enrolled at a high-risk neonatal developmental follow-up clinic. Parents completed the Child Vulnerability Scale (CVS), the Parent Protection Scale (PPS) and the Child Behavior Checklist (CBCL) regarding their children. Step-wise regression analysis revealed the CVS as the sole predictor of child behavior, accounting for 13% of the variance in the CBCL Total T-score (R(2) =.13, $be =.86, p <.006). Neonatal medical problems, Child DQ, and most parental demographic variables did not correlate with CVS or PPS scores. A significant correlation between CVS and the separation subscale of the PPS was noted (r =.31, p <.01). We conclude that NICU graduates perceived vulnerable by their caretakers have significant behavioral difficulties compared to those perceived as not vulnerable. Future research should address early parental antecedents of PPCV, the persistence of PPCV, and its effects on behavioral outcomes.