Efficacy of Low-Dose Buspirone for Restricted and Repetitive Behavior in Young Children with Autism Spectrum Disorder: A Randomized Trial.

OBJECTIVES: To determine safety and efficacy of the 5HT1A serotonin partial agonist buspirone on core autism and associated features in children with autism spectrum disorder (ASD). STUDY DESIGN: Children 2-6 years of age with ASD (N = 166) were randomized to receive placebo or 2.5 or 5.0 mg of buspirone twice daily. The primary objective was to evaluate the effects of 24 weeks of buspirone on the Autism Diagnostic Observation Schedule (ADOS) Composite Total Score. Secondary objectives included evaluating the effects of buspirone on social competence, repetitive behaviors, language, sensory dysfunction, and anxiety and to assess side effects. Positron emission tomography measures of tryptophan metabolism and blood serotonin concentrations were assessed as predictors of buspirone efficacy. RESULTS: There was no difference in the ADOS Composite Total Score between baseline and 24 weeks among the 3 treatment groups (P = .400); however, the ADOS Restricted and Repetitive Behavior score showed a time-by-treatment effect (P = .006); the 2.5-mg buspirone group showed significant improvement (P = .003), whereas placebo and 5.0-mg buspirone groups showed no change. Children in the 2.5-mg buspirone group were more likely to improve if they had fewer foci of increased brain tryptophan metabolism on positron emission tomography (P = .018) or if they showed normal levels of blood serotonin (P = .044). Adverse events did not differ significantly among treatment groups. CONCLUSIONS: Treatment with 2.5 mg of buspirone in young children with ASD might be a useful adjunct therapy to target restrictive and repetitive behaviors in conjunction with behavioral interventions. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00873509.

Gender and nurturance in families of children with neurodevelopmental conditions.

OBJECTIVE: This study tested the hypothesis that gender differences in parent-reported nurturance of children would be attenuated in families of children with neurodevelopmental conditions (NDCs). METHOD: In this cross-sectional study, participants included 49 (29 male) children diagnosed with an NDC and 60 (30 male) typically developing (TD) children. Children in the NDC group had a diagnosis of cerebral palsy (CP; n = 41) or spina bifida (SB; n = 8). Parental nurturance was measured using the nurturance subscale of the Parenting Dimensions Inventory (PDI; Power, 1991). Data were analyzed using a 2 × 2 (gender × diagnosis) analysis of covariance (ANCOVA) with child age as the covariate. RESULTS: As a simple main effect, parents reported more nurturing behavior toward TD girls than TD boys. However, girls with an NDC received less nurturance, thereby eliminating the gender difference in parental nurturance in the NDC sample. This pattern was reflected in the larger ANCOVA as a 2-way interaction between diagnosis and gender. Group differences in other PDI subscales were not statistically significant. CONCLUSIONS AND SIGNIFICANCE: This pattern of results suggests that the parents of girls with NDCs may be less nurturing toward them, thereby attenuating gender differences observed in families with TD children. Findings highlight the need for more research on the gendered dynamics in families with a child with an NDC to develop systemic models of family functioning and targeted parenting interventions for this group.