Objective
The use of psychotropic medication to address challenging behavior in individuals diagnosed with intellectual disabilities is common practice; however, very few studies have examined how multiple medication use (or combination treatment) impacts the behaviors these medications are prescribed to treat.
Method
The current study followed eight individuals over a two-year period as they experienced changes in their psychotropic medication regimens. During that time, data from functional analyses and indirect assessments of challenging behavior were collected.
Results
The results suggest that changes in psychotropic medication regimens can produce changes in functional assessment outcomes, suggesting a need for continued behavioral assessment to better inform medication practices and behavioral treatment. Of the eight participants in the study, five participants’ behaviors varied in rate of responding in FAs across all medication changes. Additionally, three participants’ FAs produced changes in outcomes; however, those changes were not consistent across all medication changes, that is, not every medication change yielded different outcomes from previous assessments.
Conclusion
This study demonstrates how the outcome of an FA can be used to monitor the effects of psychotropic medication changes, specifically when medications are combined, on challenging behavior in individuals with intellectual and developmental disabilities.
Psychotropic medications are often prescribed to reduce challenging behavior in individuals with intellectual and developmental disabilities (IDD). Functional analyses (FAs) have demonstrated utility in assessing medication impact on behavior; however, the impact of adverse side effects (ASE) on challenging behavior is under-assessed. The purpose of this study was to develop a methodology, similar to FAs, to explore potential medication ASE impact on challenging behavior in seven individuals with IDD. Results revealed response rate differences in designed ASE conditions for most participants. Outcomes support further development and use of this methodology to assess the presence and impact of ASEs.
The brief experimental analysis (BEA) is an empirical method for comparing multiple academic interventions in a short amount of time and predicting intervention effects in subsequent extended evaluations. This study extended the BEA literature by evaluating its utility for identifying effective interventions for decreasing problem behavior and increasing compliance for two individuals diagnosed with autism spectrum disorder and intellectual disability who engaged in escape‐maintained problem behavior. Across individuals, four treatment arrangements were compared to a baseline‐control condition: noncontingent reinforcement (NCR) with food, NCR with toys, differential reinforcement of other behaviors (DRO) with food, and DRO with toys. Using an alternating treatment embedded within a withdrawal design, conditions from the BEA associated with the lowest rates of problem behavior and the highest rates of adaptive behavior (i.e., compliance) were further evaluated during schedule thinning. For both individuals, the two most effective interventions from the BEA maintained effects during extended application and schedule thinning. These findings extend the utility of the BEA to identify durable interventions for decreasing problem behavior and increasing adaptive behavior.
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