Behaviour and Anxiety in Angelman Syndrome in the COVID-19 Era

Quick Overview

The talk by Dr. Chris Keary focused on behavioural and anxiety concerns in individuals with Angelman Syndrome during the COVID-19 era. Research shows a high prevalence of aggressive behaviours and anxiety in these individuals, often linked to medical conditions or communication difficulties. Functional behavioural assessments can help identify triggers and inform treatment plans. Hyperactivity is also common, with treatments including sleep, exercise, educational interventions, and occupational therapy. Sleep problems are another issue, with strategies like bedtime fading and medications like melatonin proving helpful. The COVID-19 crisis has exacerbated these behavioural challenges, requiring parents and clinicians to be creative advocates. The Angelman Syndrome Foundation can provide support and connect individuals with clinics.

Introduction

The speaker is excited about tonight’s presentation on Behaviour and Anxiety in Angelman Syndrome in the COVID-19 era. They thank the audience for joining and mention that they will receive a t-shirt for attending the event. The speaker encourages the audience to sign up for the ASF Virtual Walk.

Speaker Introduction

The speaker introduces Dr. Chris Keary, who specializes in child and adolescent psychiatry and neurology. Dr. Chris Keary discusses his experience working with individuals with Angelman Syndrome at the AS Clinic at Mass General Hospital.

Focus of the Talk

The talk focuses on behavioral and anxiety concerns in individuals with Angelman Syndrome during the COVID-19 era. Dr. Chris Keary presents three representative cases to discuss common behavioral concerns in individuals with Angelman Syndrome.

Aggressive Behaviors in Angelman Syndrome

Research studies have shown a high prevalence of aggressive behaviors in individuals with Angelman Syndrome. Aggression in Angelman Syndrome can have different purposes or emotions behind it, such as attention-seeking or communication. Medical conditions, such as constipation or dysmenorrhea, can contribute to aggressive behaviors in individuals with Angelman Syndrome. Functional behavioral assessments can help identify the antecedents and consequences of aggressive behaviors and inform treatment plans.

Anxiety in Angelman Syndrome

Anxiety may be a concern in individuals with Angelman Syndrome, and research studies have shown high rates of anxiety-related behaviors. Buspirone, an anxiety medication, has shown some effectiveness in reducing aggressive behaviors in individuals with Angelman Syndrome. Treatment approaches for aggressive behaviors in Angelman Syndrome include communication strategies, behavioral therapy, and medications.

Hyperactivity in Angelman Syndrome

Hyperactivity is a common symptom in Angelman Syndrome and can be exacerbated during the COVID-19 crisis. Treatment approaches for hyperactivity include adequate sleep and exercise, educational interventions, and occupational therapy. Medications such as alpha agonists and atomoxetine can be helpful in managing hyperactivity in Angelman Syndrome. Dr. Chris Keary presents a case of a child with Angelman Syndrome who experienced increased hyperactivity during the COVID-19 crisis. The family implemented a structured schedule and increased outdoor physical activity to manage the child’s hyperactivity. Advocacy with the school system was also helpful in providing suitable accommodations for the child’s education. Guanfacine was added to help with hyperactivity in one case. Essential therapies like speech therapy and physical therapy were sought outside of school.

Sleep Problems in Angelman Syndrome

Liz, a nine-year-old girl with Angelman syndrome, had sleep problems. Sleep problems are common in individuals with Angelman syndrome. Genetic, medical, and behavioral reasons contribute to sleep problems in Angelman syndrome. Sleep onset associations can make it difficult for individuals with Angelman syndrome to fall asleep. Strategies like bedtime fading, camping out, extinction, and the excuse me drill can help with sleep onset associations. Medications like melatonin, clonidine, trazodone, mirtazapine, and quetiapine can be used to address sleep problems. Liz’s family tried bedtime fading and changed the parent doing the nighttime routine to help with sleep problems.

Challenges during the COVID-19 Crisis

During the COVID-19 crisis, behavioral challenges have worsened. Parents and clinicians need to be creative and effective advocates for individuals with Angelman syndrome. Medications play a role in treatment, but improvement may be mild to moderate. As-needed medications like lorazepam and clonidine can be used for anxiety. Risperidone can be used for severe aggression or self-injury, but it has side effects. Telehealth visits may be possible during the COVID-19 crisis.

Support and Resources

The Angelman Syndrome Foundation can help connect individuals with clinics and provide support. The recording of the talk will be made available soon.