Objectives: This study was undertaken to estimate of the number, proportion and demographic distribution of children with ASD receiving pharmacotherapy with psychoactive drugs, in the New Jersey metropolitan region, in 2006, to describe the number of children with ASD receiving polypharmacy and to define the frequency of psychoactive treatment by drug type, over time.
Methods: Data were collected as part of the New Jersey Autism Study (NJAS), a population-based ASD surveillance investigation carried out in Essex, Union, Hudson and Ocean Counties. ASD ascertainment was by an active, retrospective, multiple-source, case-finding method, developed by the Centers for Disease Control and Prevention (CDC), based on review and analysis of information contained in health and education records. Demographic variables and case-specific data, including information on the prescription of psychoactive medicines were analyzed. Current findings, representing 8-year olds (1998-born), in 2006, were compared to baseline findings for a cohort of 8-year olds born in 1992. The socioeconomic status (SES) of ASD cases was represented by the District Factor Group (DFG) ranking, a community-level index. Chi-square tests were used to test associations.
Results: 528 children with ASD, born in 1998, were identified from a total 8-year old population of over 30,000. 148 of the 528 ASD children (28%) were prescribed one or more psychoactive drug, at any time before or during their eighth year. 44 ASD children (8.3%) were prescribed two or more psychoactive drugs. Stimulants were the most frequently used drug-type, being prescribed to 80 children (15% of the total ASD cohort). 46 children with ASD (8.7%) were prescribed anti-psychotics, while anti-depressants were prescribed to 17 children (3.2%) and alpha-adrenergic agonists were prescribed to 15 children (2.8%). Anti-convulsant drugs were prescribed to 23 children with ASD (4.4%), while sedatives (2%) and other psychoactive drugs (10%) were prescribed less frequently. Overall, neither the frequency of psychoactive prescription, nor the distribution of prescribed medicines varied by sex, race or SES. However, boys with ASD were more likely to receive polypharmacy than girls with ASD ((9.3% vs 3.5%; p<0.05).
Conclusions: The proportion of ASD children in metropolitan New Jersey treated with psychoactive medicines and the pattern of drug-type use remained stable between 2000 and 2006. While stimulants continued to be the most frequently prescribed medicines, the proportion of children treated with stimulants decreased in the period. The frequent prescription of stimulants to children with ASD underscores the importance of attention deficits as an associated feature of ASD. Continued monitoring of children with ASD in the region by our population-based method may disclose trends in the frequency and pattern of psychoactive treatments provided to children with ASD.