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| Measuring the Effects of Psychotropic Medication on Behavioral Outcomes |
| Monday, September 30, 2019 |
| 8:00 AM–8:50 AM |
| Stockholm Waterfront Congress Centre, Level 6, A3/A4 |
| Area: DDA/BPN; Domain: Translational |
| Chair: Jennifer R. Zarcone (The May Institute) |
| CE Instructor: Jennifer R. Zarcone, Ph.D. |
| Abstract: This symposium will cover several aspects of measuring behavioral outcomes when individuals have been prescribed psychotropic medication. While the focus is on individuals with developmental disabilities, this information could be used with a wide range of individuals with a variety of diagnoses. The presentations will focus on methods for collecting data via several different analog (e.g., functional analysis) and assessment procedures that can inform decision making about whether the psychotropic medication is having the intended effect. The goal is to provide practitioners with assessments that they are able to implement in a variety of settings. |
| Instruction Level: Intermediate |
| Target Audience: graduate students, faculty, clinical providers, educators, administrators, researchers |
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| The Impact of Medication Changes on Functional Analysis Outcomes |
| (Applied Research) |
| LYNN G. BOWMAN (Kennedy Krieger Institute and Johns Hopkins University School of Medicine) |
| Abstract: Numerous studies have demonstrated drug specific effects on functional analysis (FA) outcomes (i.e., Crosland et al 2003; Zarcone et al 2004); however, few descriptive studies have examined how medication changes impact the clarity (i.e., differentiation) or results (i.e., masked functions) of subsequent FAs conducted with the same participant. The purpose of this study was to examine the extent to which psychotropic medication changes altered FA outcomes on an inpatient unit. A review of electronic medical charts was conducted between the years 1995-2014. Twelve cases had sufficient evidence (i.e., multiple FAs, detailed medication changes) for further review. Participants were aged 7 to 21 years and were diagnosed with IDD. Attending psychiatrists directed medication changes with the guidance of the senior behavior analyst, and therapists who collected data during the FAs remained blind to medication changes. To determine differentiation, criteria were established similar to Hagopian et al. (1997), and a quotient score was generated. In half of the cases, alterations to medication (dosage and/or type) led to different conclusions, while the other half did not. In 10 of the 12 cases quotient scores were improved following medication changes. Implications for practicing clinicians will be offered. |
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Polypharmacy and Problem Behavior: An Evaluation of Behavior When Medication Regimens are Altered |
| (Applied Research) |
| MARIA G. VALDOVINOS (Drake University) |
| Abstract: Psychotropic medications are commonly prescribed in a polypharmacy fashion to adults with intellectual and developmental disabilities who engage in problem behavior to treat and reduce behavior; however, the impact these medications (and subsequent changes in medication) have on the behavior they are intended to treat are not well understood. A study was conducted to evaluate the extent to which changes in psychotropic medication regimens altered functional relations between problem behavior and the environment for adults with intellectual and developmental disabilities. This presentation will provide data for two of the participants whose behaviors (i.e., aggression, self-injurious behavior, stereotypy, and presence of adverse side effects) were monitored over several months (7 and 23 month) via direct observation and functional analyses. The results of this study revealed that changes in medication were associated with changes in assessment results. These findings suggest continued surveillance of behavior function when using psychotropic medication to address problem behavior (Funding: NICHD grant #: 1R15HD072497-01). |
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| Behavioral Indicators to Measure the Impact of Psychotropic Medication |
| (Applied Research) |
| JENNIFER R. ZARCONE (The May Institute), Cara L. Phillips (The May Institute) |
| Abstract: This presentation will focus on two innovative analog assessments that we developed to evaluate the behavioral effects of medication for individuals with autism and other developmental disabilities. These analogs were developed to measure specific behavioral effects that go beyond measures of frequency of problem behavior. In the first case, we will describe a behavioral analog that we developed to measure the impact of two attention-deficit hyperactivity disorder (ADHD) medications on out of seat and problem behavior. The trial showed that the initial medication (atomoxetine) was more effective than methylphenidate on out of seat behavior but had no significant impact on problem behavior. In the second case, we measured the effects of two antipsychotic medications on reinforcement choice in a self-control analog. Results showed that neither medication affected the individual’s choice or ability to engage in self-control. These data indicate that we may be able to use analog conditions to determine how medications are affecting problem behavior and other related behavior within relevant contexts. These analogs assessments can be useful in clinical and educational settings. |
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