There are estimates that at least 12% to 18% of people with autism also have a level of catatonia. The actual rate may be higher than this.
It is optimal that catatonia and autism be treated as soon as possible. Symptoms can be managed and some even reversed if handled early enough.
What Is Catatonia?
Catatonia is a behavioral disorder that involves movement, functioning, and speech difficulties that often overlap with autism symptoms. Recognizing catatonic symptoms as early as possible is the best viable option for helping to prevent significant issues and for optimal treatment outcomes.
The best thing you can do to help with catatonia and autism is to recognize the signs and pay attention to differences or increased severity in symptoms. Discuss any changes in your child with your medical team right away.
As a behavioral disorder, catatonia is complex and considered typical, impacting more than 10% of people who have acute psychiatric disorders. It typically involves difficulties moving, functioning, and speaking. It can lead to complete immobility and life-threatening complications.
Catatonia was once considered a subtype of schizophrenia. However, it is now associated with autism spectrum disorder (ASD) and a range of other medical and mental health disorders.
Catatonia and autism can be complexly intertwined, and it can be tricky to differentiate catatonic symptoms from markers of ASD. Catatonia can also present as mild, moderate, or severe and progress gradually. Learning how to recognize the signs and onset of catatonia with autism is key to minimizing potential side effects.
Recognizing Catatonia With Autism
Just as autism is a spectrum disorder, meaning the symptoms can vary in severity, the same is true for catatonia. Symptoms can range from mild to severe and can develop slowly over time. Someone may also show symptoms one day and not the next.
The following are symptoms of a potential catatonia type breakdown in someone with ASD:
- Freezing while doing things
- Slowness and sluggishness in movements and verbal responses
- Troubles starting things or refusing to act
- Inability to complete movements or cross thresholds
- Reduction in speech or complete cessation of speaking
- Increased hesitation and repetitive movements
- Being “frozen” or locked in positions or postures
- Increase in ritualistic and repetitive behaviors
- Decreased functioning and requiring more prompts to function
- Reversal of night and day
- Increased agitation or excitement
- Increased involuntary movements such as tremors and eyerolling
The most significant signs to look out for that can indicate the onset of catatonia with autism are changes and declines in speech, movement, and functioning as well as troubles with voluntary movements. Some people can experience “shutdowns,” then appear more themselves the next day.
Watch for these symptoms, and if you notice any changes in your child’s behaviors, movements, ability to function, and speech patterns, talk to your doctor right away.
Link Between Catatonia & Autism
Catatonia generally occurs in people with ASD between the ages of 15 and 20, with an average age of 18 years old. This means it is most common to develop in adolescents and young adults.
Catatonia can present in younger children; it is just rarer. A traumatic event often triggers the onset of catatonia. Stressful life happenings and environment and the disruption of regular daily routines can potentially trigger catatonia for someone with ASD.
Catatonic and autistic symptoms often overlap, and each disorder can serve to make symptoms of the other more significant. Left untreated, catatonia with autism can lead to substantial weight loss, dehydration, complete loss of speech, and total immobility.
Severe catatonia and autism can be life-threatening. Early intervention can keep this from happening.
Treatment Methods for Autism & Catatonia
Catatonia is most often treated with benzodiazepine medications, such as lorazepam. Benzodiazepines are central nervous system (CNS) depressant medications that help to regulate body and brain activity that can be related to catatonia symptoms. These medications can minimize catatonia symptoms and even potentially reverse them when administered early enough.
When the medications do not work as effectively or when catatonia is more severe, electroconvulsive therapy (ECT) is an effective treatment method. ECT creates a seizure in the brain that can help to recenter brain activity that is irregular due to catatonia. This is generally considered a last resort option after trying other treatment methods.
In addition to medications and medical interventions for catatonia, treatment for autism in adults and adolescents includes behavioral interventions such as cognitive behavioral therapy (CBT) and social skills training. Occupational therapy and sensory integration therapies can be beneficial as well.
There is no one treatment for catatonia and autism so talk to your doctor about optimal methods for you and your family.
Prevention & Intervention Methods
Catatonia is often linked to stressful and traumatic events, and for someone with autism, this can stem from significant changes in routine, major life events, or bullying at school. As a parent, you can help your child manage their autism by staying attuned to their environment and stress levels and helping to make the change as smooth as possible.
When catatonia does occur, you can keep the disorder from progressing and even reverse it completely with early interventions.
Methods for helping to prevent and treat catatonia in children with autism are:
- Checking for an underlying medical condition or medication that can cause the symptoms.
- Identifying and eliminating stress factors and triggers.
- Keeping up with activities that provide enjoyment.
- Maintaining structure and predictability as much as possible.
- Offering more verbal and physical prompts for movement and functional difficulties.
Treating autism and catatonia in children can often include medications, including benzodiazepines, and behavioral interventions such as applied behavior analysis (ABA) therapy. ABA can help reinforce the behaviors you want and aid in discouraging the ones you do not.
Speech therapy, occupational therapy, and social skills training can all help treat autism as well. Comorbid disorders, such as autism and catatonia, are best treated at the same time as their symptoms are often complexly intertwined.
Resources for Parents
One of the best things parents can do for children with autism is to be informed. Learning to recognize your child’s patterns and symptom severity can help you notice changes and aid in getting help sooner for better outcomes.
Some great resources for autism and catatonia include the following:
- Autism Speaks: This organization provides a wealth of information on autism and related disorders for both parents of children with autism and people with autism.
- National Autism Association (NAA): This organization provides resources on local chapters and how to find support groups in your immediate area.
- National Autistic Society: This organization offers a guide for parents on catatonia with autism
- Centers for Disease Control and Prevention (CDC): This organization offers information on autism as well as resources and educational tools.
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Catatonia: Our Current Understanding of its Diagnosis, Treatment and Pathophysiology. (December 2016). World Journal of Psychiatry.
Catatonia in Autism Spectrum Disorder. (2019). Association for Science in Autism Treatment (ASAT).
Catatonia as a Presentation of Autism in a Child: A Case Report. (September 2020). AIMS Neuroscience.
Catatonia in People with Autism: Prevalence and Management. (March 2014). CNS Drugs.
‘Shock Therapy’ May Help Some Autistic Teens with Catatonia. (November 2018). Spectrum.
Autism Speaks. (2021). Autism Speaks.
Find a Support Group. National Autism Association (NAA).
Catatonia. National Autistic Society.
Autism Spectrum Disorder (ASD). (January 2021). Centers for Disease Control and Prevention (CDC).