findings concerning the neurobiology of behaviors in autism. Future research offers the possibility of developing or refining medications based on the specific mechanisms that maintain problem behaviors in children with autism and related disorders. The new field of pharmacogenomics goes farther by hoping ultimately to match medications to genetic profiles for individual patients.
Although there are some effective interventions to address sensory aspects of behavior problems, e.g., substituting appropriate sources of kinesthetic, visual, auditory, or olfactory stimulation for aberrant ones (Favell et al., 1982), there is a pressing need for more basic and applied research in this area. Interventions such as relaxation training (Groden et al., 1998) and physical exercise (Quill et al., 1989; Kern et al., 1984), appropriately adapted for young children, are also promising avenues for stress reduction and concomitant decreases in problem behaviors.
Problem behaviors such as property destruction, physical aggression, self-injury, stereotypy, and tantrums put young children at risk for exclusion from social, educational, family, and community activities. Serious behavior problems occur in a minority of young children with autistic spectrum disorders, but they are costly financially, socially, and academically to children, their families, and their classmates. The concept of problem behaviors in autism varies depending on whether the problem is defined in terms of the child’s needs or the effect of the behavior on the home or classroom environment. Both research evidence and clinical judgment agree that the primary approach to problem behaviors in young children should be prevention by providing the child with the skills needed to effectively deal with the physical, academic, social, and sensory aspects of his family’s school, preschool, early childhood, or community environment.
The foundation of prevention of problem behaviors is an appropriate and fully implemented IEP. Critical elements of effective, comprehensive educational programs and of focused, problem-specific applied behavior analysis programs, identified for young children with autistic spectrum disorders, need further independent replication, direct comparison of different treatment approaches, and clinical trials of methods that have proven effective in what Rogers (1998) notes as the clinical equivalent of “open trials.” Broader implementation and evaluation of functional behavioral assessment and positive behavioral interventions and supports should lead to an expanded array of effective strategies for the majority of