Integrating behavioral and pharmacological interventions in treating clients with psychiatric disorders and mental retardation

Sevin, Jay A.; Bowers-Stephens, Cheryll; Hamilton, Martha; Ford, Almarie

doi:10.1016/s0891-4222(01)00084-1

Cited by 20 publications

(7 citation statements)

References 18 publications

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“…The pathway draws on different aspects of treatment models proposed for people with developmental or intellectual disabilities such as the neurobehavioral model, [67][68][69][70] which describes the tandem usage of psychiatric assessment and applied behavioral analysis for the treatment of severe problem behavior. A recent article by Minshawi et al 71 provides a similar approach to the treatment of selfinjurious behavior, specifically in ASD.…”

Section: Discussionmentioning

confidence: 99%

Irritability and Problem Behavior in Autism Spectrum Disorder: A Practice Pathway for Pediatric Primary Care

McGuire

Fung

Hagopian³

et al. 2016

Pediatrics

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OBJECTIVE: Pediatric primary care providers (PCPs) caring for patients with autism spectrum disorder (ASD) often encounter irritability (vocal or motoric outbursts expressive of anger, frustration, or distress) and problem behavior (directed acts of aggression toward other people, self, or property). The Autism Intervention Research Network on Physical Health and Autism Speaks Autism Treatment Network charged a multidisciplinary workgroup with developing a practice pathway to assist PCPs in the evaluation and treatment of irritability and problem behavior (I/PB). METHODS:The workgroup reviewed the literature on the evaluation and treatment of contributory factors for I/PB in ASD. The workgroup then achieved consensus on the content and sequence of each step in the pathway. RESULTS:The practice pathway is designed to help the PCP generate individualized treatment plans based on contributing factors identified in each patient. These factors may include medical conditions, which the PCP is in a key position to address; functional communication challenges that can be addressed at school or at home; psychosocial stressors that may be ameliorated; inadvertent reinforcement of I/PB; and co-occurring psychiatric conditions that can be treated. The pathway provides guidance on psychotropic medication use, when indicated, within an individualized treatment plan. In addition to guidance on assessment, referral, and initial treatment, the pathway includes monitoring of treatment response and periodic reassessment. CONCLUSIONS:The pediatric PCP caring for the patient with ASD is in a unique position to help generate an individualized treatment plan that targets factors contributing to I/PB and to implement this plan in collaboration with parents, schools, and other providers. Dr McGuire contributed to the design of the practice pathway, played a leading role in drafting the initial manuscript, and revised the manuscript; Drs Fung, Hagopian, Vasa, Mahajan, Bernal, and Coury and Ms Silberman and Ms Wolfe contributed to the design of the practice pathway and reviewed and revised the manuscript; Drs Hardan and Veenstra-VanderWeele contributed to the conceptualization and design of the practice pathway and reviewed and revised the manuscript; Dr Whitaker played a leading role in conceptualizing and designing the practice pathway, drafted portions of the initial manuscript, and reviewed and revised the manuscript; and all authors approved the fi nal manuscript as submitted.

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Section: Discussionmentioning

confidence: 99%

Irritability and Problem Behavior in Autism Spectrum Disorder: A Practice Pathway for Pediatric Primary Care

McGuire

Fung

Hagopian³

et al. 2016

Pediatrics

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“…In some cases, priming can take the form of Bdry run^pre-activity rehearsal in the actual setting in which the activity will later occur. Sevin et al (2001) used a priming procedure to assist a young woman with an ASD who cooperated with caregiver prompts to go through the steps of hygiene activities but would get stuck at each step and wait for caregivers to verbally prompt her through each and every step of the task. She could not transition from step to step without a specific verbal prompt.…”

Section: Priming Strategiesmentioning

confidence: 99%

A Review of Behavioral Strategies and Support Considerations for Assisting Persons with Difficulties Transitioning from Activity to Activity

Sevin¹,

Rieske

Matson

2015

Rev J Autism Dev Disord

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Repetitive and restricted behaviors and interests are a major feature of Autism Spectrum Disorder (ASD). Insistence on sameness, rigid adherence to rituals and routines and resistance to change, and related symptoms can have a highly disruptive impact on an individual's ability to transition from one task to the next and progress through the different steps within a task. Difficulties with transitions can represent a major barrier in treatment and care, impede learning, and contribute to significant distress in individuals with an ASD. A number of behavioral approaches to facilitating transitions in persons with an ASD have been investigated. The current paper reviews the available research on strategies to support individuals in transitions between daily activities and tasks. Current trends and future directions are discussed.

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“…For psychiatrists, a key feature of these studies is the need to integrate behavioral and pharmacological treatments in a fashion that maximizes the efficacy of both interventions [16,17]. Another feature supports the usefulness and efficacy of multi-modal or multi-systems therapy [18,19].…”

Section: Multimode Treatmentmentioning

confidence: 99%

Treatment Models for Treating Patients with Combined Mental Illness and Developmental Disability

2008

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The presence of co-occurring psychiatric disorders among individuals with developmental disability (DD) requires clinicians to adjust and modify standard mental health assessment and treatment planning. In particular, assessment includes input from a multi-disciplinary team and as a result, diagnosis is frequently a synthesis of data from many different points of view. Treatment planning and implementation commonly include a collection of highly specialized, individualized programs that focus on the long term management of both disorders. Crises and recurrence of mental disorders are commonplace in part due to the presence of ongoing risk and vulnerability factors for mental disorders. As a result, the need for emergency interventions, specialized respite services, hospitalization and other transition services is extensive. The quality, availability and access to these services vary considerably. Many programs are concentrated in metropolitan or university-based centers and pose hardships based on geographic distance. The availability and utilization of services is affected by political, economic, socio-cultural and psychological forces that impact both the willingness to use services and the distribution of professionals trained and qualified to manage individuals with dual diagnoses. The complex interaction between each of these factors determines the structure, function, and capacity for innovation built into current service models.

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Integrating behavioral and pharmacological interventions in treating clients with psychiatric disorders and mental retardation

Cited by 20 publications

References 18 publications

Irritability and Problem Behavior in Autism Spectrum Disorder: A Practice Pathway for Pediatric Primary Care

Irritability and Problem Behavior in Autism Spectrum Disorder: A Practice Pathway for Pediatric Primary Care

A Review of Behavioral Strategies and Support Considerations for Assisting Persons with Difficulties Transitioning from Activity to Activity

Treatment Models for Treating Patients with Combined Mental Illness and Developmental Disability

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