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| Examining the Use and Effects of Psychotropic Medications Within the Field of Behavior Analysis |
| Saturday, May 24, 2025 |
| 3:00 PM–4:50 PM |
| Convention Center, Street Level, 159 AB |
| Area: BPN/DDA; Domain: Applied Research |
| Chair: Matthew O'Brien (The University of Iowa) |
| Discussant: Tracy L. Kettering (Bancroft) |
| CE Instructor: Matthew O'Brien, Ph.D. |
| Abstract: Psychotropic medications are commonly prescribed to children and adolescents to address a broad range of conditions and concerns. Although psychotropic medications have the potential to enhance or interfere with the behavioral assessments and treatments that behavior analysts implement, behavior analysts are usually not included in medication decisions. Nonetheless, behavior analysts are trained in direct measurement of behavior and thus are well-suited to evaluate their use and effects. The four presentations in this symposium demonstrate the role that behavior analysts may play in examining the use and effects of psychotropic medications. The first presentation will explore the effects of stimulant medication on delay discounting in the extant literature and provide preliminary data from a pilot clinical trial examining the effects of stimulants on delay discounting in children with ADHD. The second presentation will present data from a retrospective study examining the use of psychotropic medications among children with challenging behavior at the time they received behavioral assessment and treatment recommendations and changes that may have occurred for up to three years following the assessment. The third presentation will share outcomes from a study that evaluated the relationship between cannabidiol use and the consumption of arbitrary and functional reinforcers among autistic youth. The final presentation will describe a collaborative intervention model between behavior analysts and psychiatry for individuals with challenging behavior, including how data is collected on behavior change and medication side effects. Dr. Tracy Kettering will serve as the discussant for these talks. |
| Instruction Level: Intermediate |
| Keyword(s): challenging behavior, delay discounting, psychiatry, psychotropic medication |
| Target Audience: Intermediate Audience: Audience should have an understanding of pharmacological intervention. |
Learning Objectives: 1. Describe how behavior analysts can support monitoring of psychotropic medications.
2. Identify methods for evaluating the use and effects of psychotropic medications.
3. Determine how behavior analysts may work with prescribers to provide an integrated approach to biobehavioral assessment and intervention. |
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| The Effects of Stimulants on Delay Discounting in Humans |
| COLLIN GLAZEK (University of Iowa), Matthew O'Brien (The University of Iowa), Alex Pauls (The University of Iowa) |
| Abstract: In behavioral economics, delay discounting refers to the devaluation of a reward due to a time delay. Those who prefer immediate, smaller rewards over delayed, larger rewards are considered more impulsive than their counterparts. Research indicates that individuals with higher levels of discounting are more likely to engage in risky behaviors such as illegal drug use and pathological gambling. Levels of discounting are relatively stable and unlikely to change over time, which highlights the need for effective interventions. Stimulant medications are considered an effective treatment for impulsivity associated with ADHD; however, the effect of stimulants on delay discounting has not been heavily researched. This talk will highlight the results of a systematic literature review of studies that evaluated the effects of stimulants on delay discounting and provide preliminary results from a pilot trial evaluating the effects of prescription stimulants on discounting in children with ADHD. Implications for clinical practice and future research will be discussed. |
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| Examination of Psychotropic Medication Use Following Outpatient Behavioral Assessments |
| MARIA G. VALDOVINOS (Drake University), Melissa Trites (Heartland Area Education Agency), Janelle Ausenhus (Florida State University - Panama City) |
| Abstract: Psychotropic medications are often prescribed to treat challenging behavior in children with developmental disabilities. This study examined patterns of psychotropic medication use following outpatient behavioral assessment in children ages 2-16 years. Specifically, medication use at the time of behavioral assessments, six months after the assessment, and a follow-up sometime after six months (mean 25 months post-six months, range 1 month to 41 months) were evaluated via a chart review. Medication use was categorized into eight categories and grouped according to the type of medication change experienced. Caregivers also completed a social validity survey rating their satisfaction with the assessment and interventions developed. This retrospective study revealed that children were more likely to experience similar changes in the six months following assessment when compared to later time points with few children remaining on the same medication as when they were first seen. Additionally, although caregivers generally rated their experiences as favorable, additions and increases to psychotropic medication regimens still occurred. |
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| Relations Between Consumption of Functional and Arbitrary Reinforcers Following Cannabidiol or Placebo Administration |
| LEONORA RYLAND (Children's Hospital Colorado), Patrick Romani (University of Colorado, Anschutz Medical Campus), Rebecca Rochowiak (Neuroscience Institute, Children’s Hospital Colorado), Nicole Tartaglia (University of Colorado School of Medicine) |
| Abstract: Abstract: Autistic youth exhibit challenging and aggressive behaviors at a higher rate than their neurotypical peers. Although preliminary data suggests that cannabidiol (CBD) may reduce problem behaviors among autistic children, the effects of this medication on ancillary behaviors have yet to be investigated. The purpose of the current study was to evaluate child consumption of reinforcement (e.g., attention) following CBD or placebo administration. We will present data from 25 children enrolled in a double-blinded modified cross-over study with 3 arms, including 2 traditional placebo-controlled cross-over arms (12 weeks per treatment/3-week wash-out) plus a third arm in which participants received CBD for the entire 27 weeks. Randomized participants were titrated to a dose of 10 mg/kg/day of CBD or placebo (provided by Jazz Pharmaceuticals). We analyzed data from three administrations of a functional analysis of problem behavior conducted before the study began and then two more times when the participant took CBD or placebo. Data suggest that CBD administration reduced consumption of escape and delivery of placebo medication reduced consumption of tangible. We hypothesize changes in quality of parent attention led to these differences. These data support previous suppositions that attention should be given to both functional and arbitrary classes of reinforcement. |
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| Collaborative Intervention Approach: Integrating Behavior Analysis and Psychiatry to Provide Interdisciplinary Care |
| KACIE MCGARRY (University of Florida), Yumi Kovic (Tallahassee Health Care), Kerri P. Peters (University of Florida), Justin Boyan Han (University of Florida), Takahiro Soda (University of Florida), Timothy R. Vollmer (University of Florida) |
| Abstract: There are a variety of medications that are prescribed with the intention of reducing symptoms that are associated with an autism diagnosis, such as self-injury and aggression (Aishworiya et al., 2022). Additionally, co-occurring diagnoses are highly prevalent in the autistic community (Simonoff et al., 2008), increasing the likelihood and complexity of medication trials. This project presents a collaborative intervention model that combines the expertise of behavior analysts and psychiatrists to comprehensively address dangerous or destructive behavior in adolescents. By integrating behavioral analysis with psychiatric interventions, this approach aims to provide tailored solutions for individuals facing complex behavioral challenges. The presentation will review the process for collecting data on the target behaviors and potential side effects of medications being evaluated. Moreover, it offers valuable insights into the development of integrated systems that streamline communication and coordination between behavioral and psychiatric professionals, ultimately fostering a more effective treatment for improved patient outcomes. |
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