|Evaluating the Impact of Psychotropic Medication Changes in Persons With Intellectual and Developmental Disabilities|
|Sunday, May 28, 2023|
|11:00 AM–11:50 AM |
|Hyatt Regency, Centennial Ballroom F|
|Area: BPN/CBM; Domain: Applied Research|
|Chair: Autumn Kozluk (Brock University)|
|Discussant: Maria G. Valdovinos (Drake University)|
|CE Instructor: Maria G. Valdovinos, Ph.D.|
Demographic research reports that up to 50% of persons with intellectual and developmental disability engage in challenging behaviour (Sheehan et al., 2015), with treatment options often including psychopharmacological interventions, behavioural interventions, or concurrent intervention approaches. Some behaviour analytic researchers have suggested that psychotropic medications may act as motivating operations, in that they can alter the effectiveness of stimuli as reinforcers or punishers (Carlson et al., 2012; Zarcone et al., 2004). Thus, an individual’s experience with environmental variables and stimuli may change in accordance with a psychotropic medication adjustment (i.e., medication increases, medication decreases, medication introduction, or medication discontinuation). The applied behavioral pharmacology literature base is relatively limited. One possible explanation is that the barriers to investigating drug-behavior interactions are rather insurmountable. For example, behavioral researchers seldom have ‘control’ over the primary independent variable (i.e., medication change). Despite this, there may be creative methodology to help circumvent these barriers. The purpose of this symposium is to illustrate the utility of systematically monitoring the behavioral effects of psychotropic medication adjustments, including shifts in reinforcer preference and in rate and function of challenging behaviour.
|Instruction Level: Intermediate|
|Keyword(s): challenging behaviour, functional analysis, psychotropic medication, reinforcer preference|
|Target Audience: |
Participants should have some knowledge and experience in running functional analyses as well as reinforcer preference assessments. Skills in analyzing complex data sets will be helpful.
|Learning Objectives: At the conclusion of the presentation, participants will be able to: (1) describe research trends in behavioural medicine and identify the gaps in research knowledge related to psychotropic medication efficacy in persons with intellectual and developmental disabilities; (2) describe and employ various research methods to assess reinforcer preference and rate and function shifts across psychotropic medication changes; (3) identify how to analyze the results from both functional analyses and reinforcer preference assessments of individuals who are undergoing psychotropic medication changes and how to make clinical recommendations based on outcomes.|
Do Medication Changes Shift Reinforcer Preferences for Children With Disabilities? An Exploration Using Concurrent Operants
|GABRIELLE CROWELL (Vanderbilt University ), Blair Lloyd (Vanderbilt University), Marney Squires Pollack (Vanderbilt University), Jessica Torelli (Western Kentucky University)|
School-age children with disabilities and challenging behavior are often prescribed medication as a component of intervention (Olfson et al., 2010). However, psychotropic medications can have impacts beyond the behaviors for which they are prescribed, and these changes can alter the effectiveness of other treatment components (Bird et al., 2022; Lloyd et al., 2016). For example, both Dicesare et al. (2005) and Northup et al. (1997) found that stimulant medication decreased childrens’ motivation to earn social positive reinforcement (i.e., tangibles and attention). We explored potential impacts of medication changes on reinforcer preference for 19 school-age children with disabilities who had been prescribed medication to address behavioral challenges. We completed a series of concurrent operant analyses (COAs) at two time points: one before the medication change and one after the medication change. Children were given a choice between two concurrently available reinforcement configurations, and we collected data on the total time spent in each condition. Visual analysis of estimation plots and results of within-subjects t-tests indicated no consistent shifts in preference following medication changes. We discuss potential explanations for our study results and identify what future studies are needed to better understand the effects of medication on reinforcer preference.
|Monitoring Behavior Rate and Function Across PRN Medication Conditions in Individuals with Intellectual and Developmental Disabilities who Engage in Challenging Behavior|
|MONICA PETERS (Nova Scotia Health), Autumn Kozluk (Brock University), Andreas Dimopoulos (Brock University), Tina Vo (Brock University), Alison Cox (Brock University)|
|Abstract: Psychopharmacological and behavioral interventions are common strategies to address challenging behavior among adults with intellectual and developmental disabilities (Sheehan et al., 2015). Presently, psychopharmacological interventions as a treatment have been considered controversial, in part due to the relatively limited efficacy of evidence (Lunsky et al., 2018; Sheehan et al., 2015). Regardless of the status of the evidence, demographic research suggests up to 40% of adults with intellectual and developmental disabilities are being prescribed at least one psychotropic medication (Lunksy et al., 2018). The field of behavior analysis may address existing knowledge gaps by conducting research that incorporates systematically monitoring the behavioral effects across psychotropic medication changes. The current study’s objective was primarily to explore rate and function changes across PRN and daily medication conditions. The study featured four adults with intellectual and developmental disabilities who engaged in challenging behavior and were undergoing psychotropic medications changes, as per their psychiatric team. The research team followed participants across successive medication changes, systematically conducting functional analysis (and other assessments). Preliminary results suggest idiosyncratic patterns across participants, albeit some pattern commonalities may have been observed. Clinical implications and future research will be discussed in relation to study outcomes.|