Bressler Clinical and Research Program for Autism Spectrum Disorders
Alan and Lorraine Bressler Clinical and Research Program for Autism Spectrum Disorders
Warren Building 624
Massachusetts General Hospital
55 Fruit Street
Boston, MA 02114
Explore This Treatment Program
The Alan and Lorraine Bressler Clinical and Research Program for Autism Spectrum Disorders is dedicated to three missions:
- Improving the clinical care of children and adults with autism spectrum disorders (ASD)
- Advancing the education of patients, families and service providers about these conditions
- Expanding the scientific understanding of these disorders
Autism spectrum disorders are characterized by difficulty with social interactions, communication and behavioral skills. Our program offers complete psychiatric evaluation, including psychopharmacological, neuropsychological, behavioral and social service consultations, for patients with ASD.
What to Expect at the Bressler Program
The Bressler Program provides comprehensive psychiatric assessments with a specialized psychiatrist for individuals with Autism Spectrum Disorders (ASD).
Before your appointment
When you contact our program, a coordinator will ask you a number of questions regarding:
- The person’s history of ASD (whether or not he or she has been previously diagnosed)
- Medication and treatment history
- General medical history
- Family history
- School status
You also receive a packet with additional questions to be completed for your first appointment. The coordinator will answer any questions you have about the program, facilitate registration and help schedule your appointment.
During the first appointment, you will have a consultation with a specialized psychiatrist. Depending on your individual needs, the psychiatrist may recommend you have consultations with other specialists as needed.
Your care plan
Our specialists will monitor your care plan, adjust medications as necessary for maximum effectiveness and serve as a focal point for synthesizing information.
Autism spectrum disorder is a constellation of psychological conditions characterized by difficulty with social interactions, communication and behavioral skills. Autism spectrum disorders (ASD) include autism, Asperger’s syndrome and pervasive developmental disorder (PDD). Recent estimates suggest that autism spectrum disorders may affect as many as one in 100 children.
How can I recognize a person with ASD?
Some children show signs and symptoms very early, but many are not diagnosed until they enter school. They may exhibit many or only a few of the characteristic ASD traits, and these behaviors may be mild or pronounced.
Characteristic ASD behaviors include:
- Difficulty with peer relationships
- Little or no eye contact
- Lack of reciprocal behavior (one-sided conversations, monologues)
- Increased need for reassurance
- Preoccupation with objects or activities such as video games or surfing the Internet
- Overreaction to small situations
- Organizational difficulties
- Physical clumsiness
- Difficulties with transitions and changes in routine
- Desire for sameness
What can parents and teachers do if they suspect a child has an autism spectrum disorder?
Parents and teachers are often the first to notice signs and symptoms of these disorders. It is important to seek evaluation as early as possible, because early intervention can have a beneficial effect in reducing symptoms and improving the child’s ability to learn and function.
Ongoing Research Studies at the Bressler Program
Behavioral and neural response to memantine in youth with autism spectrum disorder
This 12-week study seeks to evaluate the safety and efficacy of Namenda (memantine) for the treatment of core features of Autism Spectrum Disorder (ASD) in children and adolescents. Deficits in social interaction are the central feature of ASD and often result in significant impairment for individuals with High Functioning-ASD. Available data from past treatment studies of Namenda demonstrates improvements in a range of impairments including attentional and social skills in individuals with ASD. Eligible subjects, children ages 8-17 with a DSM-V diagnosis of ASD, will be enrolled to receive either placebo or Namenda. Subjects also complete a pre- and post-treatment brain scan before and after treatment with Namenda.
Find more information on ClinicalTrials.gov:
An open-label treatment trial to assess the short-term tolerability, safety and efficacy of methylphenidate hydrochloride extended-release liquid formulation in high-functioning autism spectrum disorder adults with AD/HD
The purpose of this 6-week study is to assess the use of an FDA-approved extended-release liquid formulation (Quillivant XR-methylphenidate hydrochloride) for the treatment of Attention-deficit/Hyperactivity Disorder (ADHD) in adults with high-functioning Autism Spectrum Disorder (ASD). Quillivant XR offers a gradual mode of delivery that may offer improved tolerability. ADHD is the most common psychiatric disorder recognized in youth and adults with ASD. We plan to enroll up to 40 subjects of both genders, ages 18-40 with intact intellectual functions.
Find more information on ClinicalTrials.gov: https://clinicaltrials.gov/ct2/show/NCT02096952
An open-label trial of oxytocin in adolescents with autism spectrum disorders
This 8-week study aims to evaluate the effects of long-term Oxytocin administration on social impairment in adolescents with ASD, a central feature of this disorder. Oxytocin is a naturally occurring hormone that has been reported to play a powerful role in social behaviors in both humans and other mammals. Participants include children or adolescents ages 11-17 with a DSM-IV diagnosis of autism, Asperger’s disorder or Pervasive Developmental Disorder-not otherwise specified (PDD-NOS).
Find more information on ClinicalTrials.gov: https://clinicaltrials.gov/ct2/show/NCT01931033
An open-label trial of buspirone for the treatment of anxiety in youth with autism spectrum disorders
This 8-week study seeks to evaluate the safety and efficacy of Buspar (buspirone) for the
treatment of significant anxiety in children and adolescents with ASD. Buspar is an approved medication for the treatment of anxiety symptoms, which are often present in children with ASD. Participants are children or adolescents ages 6-17 with a diagnosis of autism, Asperger’s disorder or PDD-NOS, and significant features of anxiety.
Find more information on ClinicalTrials.gov: https://clinicaltrials.gov/ct2/show/NCT01850355
Examining the neural correlates of ADHD in adolescents with autism: A preliminary fMRI study
This is an fMRI study in collaboration with Dr. John Gabrieli at MIT. This study with examines the brains of children with ADHD, as well as children with ASD+ADHD and children with neither. The major goal of this study is to use cognitive neuroscience methods to discover whether ADHD-like difficulties in ASD are associated either with the same or different brain characteristics. Eligible male participants, ages 8-17, are divided by diagnostic groups: comorbid ASD+ADHD, ADHD only, and healthy controls.
Emotional dysregulation and autism spectrum disorder: A preliminary spectroscopic neuroimaging study
The goal of this study is to use cognitive neuroscience methods to examine whether emotional dysregulation (ED) in ASD presents in the brain similarly to or differently from typical ED. Emotional dysregulation (ED) is characterized by poor self-regulation that includes symptoms of low frustration tolerance, impatience, quickness to anger, and marked emotional reactivity. Eligible children ages 8-17 are divided into four groups based on the presence of ED and ASD: ASD with ED, ASD without ED, ED without ASD, and healthy controls.
Autism spectrum disorder presentations
- What is Autism Spectrum Disorder?
- Recognition of ASD
- Prevalence of ASD
- Emotional Dysregulation and ASD
- Clinical Studies and Brain Changes
- Attention Deficit Hyperactivity Disorder and ASD
- ASD and Psychiatric Comorbidities
- Namenda Titration Schedule
Screening tools for assessing ASD
- ASD Rating Scale—Informant Rated
- ASD Rating Scale—Clinician Rated
- ASD DSM-5 Diagnostic Symptom Checklist
About the Center
Massachusetts Couple Makes Autism a Priority
Alan and Lorraine Bressler were passionate about giving back to the Boston-area community where they lived for more than half a century and raised three daughters. Lorraine is a long-time overseer of the Museum of Fine Arts, where the couple created a named gallery. Alan, who passed away in September 2012, was a trustee of the Boston Symphony Orchestra. In addition to art and music, the couple supported education through the Boston Latin School Association and other Boston education projects. Over the last decade, the Bresslers became aware of another pressing community need.
Treatment of Co-occurring Psychiatric Conditions
The Bresslers knew that Joseph Biederman, MD, and his colleagues in the Clinical and Research Program in Pediatric Psychopharmacology and Adult ADHD at Mass General were studying how treatment of co-occurring psychiatric conditions can enable individuals with high-functioning autism to reach their potential and lead fulfilling lives. The Biederman team’s research was prompted by their observation that about 15% of the young people they were treating for ADHD, depression, anxiety and bipolar disorder had this form of autism.
“Dr. Biederman and his team were developing a system of coordinated care to provide practical solutions for families dealing with these challenges,” said Alan Bressler in a 2010 interview. “That approach made sense to us, so we began a discussion of how we could support his efforts.” The couple’s overture soon led to the creation of the Alan and Lorraine Bressler Clinical and Research Program for Autism Spectrum Disorders at Mass General. The program opened to patients in October 2007. It is one of only a few in the country to provide comprehensive psychiatric evaluation of children and adults with high-functioning autism and to focus on treating their psychiatric conditions.
“The program made possible by the Bresslers is extraordinary on many levels,” says Dr. Biederman, founding director of the Bressler Program. “In many cases, young people can learn to manage and live with the symptoms of high-functioning autism. But if such a child is inattentive because of ADHD, or agitated, aggressive or violent because of bipolar disorder, teachers cannot reach the child, and he or she is likely to fail in school and function poorly in work, social and family life.”
Treatment in the Bressler Program
Dr. Biederman and colleagues have found that with proper psychiatric treatment, their patients with autism can take fuller advantage of educational, social skills and vocational programs.
Patients come from all over the country to seek evaluation and treatment. “Before the Bressler Program existed, many parents of children with high-functioning autism were at their wits’ end, diagnostically confused and unable to find programs that offered effective treatment,” says Gagan Joshi, MD, scientific director of the Bressler Program. “The Bressler Program offers them a ‘home,’ where their child is fully understood and can receive treatment and support well into adulthood.”
“We knew that supporting this renowned group of psychiatrists and psychologists would yield benefits far beyond what anyone could have imagined, and this has already begun to happen,” said Alan Bressler in the 2010 interview. “We hope that the program will become a national model.” Since the number of referrals exceeds current clinical capacity, the family also hopes that others will step forward to support the program so that the team can help more families and conduct further research.
Joseph Biederman, MD
Pioneering Psychiatry Research
The integration of patient care and clinical research has been a hallmark of the Department of Psychiatry for more than 30 years. Today, the department has the largest clinical research program in the hospital, with studies at the forefront of neuroscience, molecular biology and genetics.