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| Collaboration of Psychiatry and Applied Behavior Analysis: Systematic Evaluation of Treatment Packages, Medication Packages, and Emotional States |
| Sunday, May 24, 2015 |
| 11:00 AM–11:50 AM |
| 214D (CC) |
| Area: DDA/BPH; Domain: Applied Research |
| Chair: James Chok (Melmark Pennsylvania) |
| Abstract: In the behavioral health field, medication and clinical changes are often made independently of each other. To determine the best combination of services, collaborative efforts between psychiatry and applied behavior analysis should be utilized. Articles systematically evaluating the effects of medications in comparison or conjunction with research methods of Applied Behavior Analysis are conspicuously absent from the current research (Weeden, Erhardt, & Poling, 2009). Within an interdisciplinary model, clinical decisions about treatment packages are determined based on the individuals current clinical and medical profiles. Systematically evaluating behavioral level changes prior, during, and following medication changes have allowed clinical teams to determine what the best combination of services for an individual is. Assessments such as functional analyses and treatment analyses can serve as systematic tools to evaluate behavioral changes across medication changes and emotional states. Systematic, experimental evaluations of psychiatric and behavior analytic interventions can help clinicians can gain a larger, more comprehensive view of the individuals current needs. |
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| Integrating Behavior Analysis and Psychiatry: Effecting Behavioral Level Changes Through Collaboration |
| JENNIFER HANSON (Melmark), Anna DiPietro (Melmark), Lauren Davison (Hogan Learning Academy), Elizabeth Dayton (Melmark) |
| Abstract: Behavior analysts and psychiatric practitioners frequently are involved in the same cases concurrently without working directly together to make changes to the individuals program. Examples of integrated efforts in the fields of psychiatry and behavior analysis are sparse in both the research literature and applied settings. The variety of potential benefits of this collaboration include more complete designs to evaluate treatment effect and more in-depth measures of behavioral changes and side effects (Blum et al., 1996). The current study examined the behavioral levels of ritualistic behavior and aggression for an individual across medication discontinuation and reintroduction, and in the presence of a behavior analytic treatment package. Changes in level trends were observed across both challenging behavior and targeted precursor behavior in correlation with the medication dosage changes implemented. Observation of level changes associated with medication variations led to the tracking of relevant precursor behavior to capture changes in rigidity of behavior. Systematic manipulation of medication dosage changes with frequent review and collaboration between clinicians and psychiatric practitioners led to a decrease in challenging behavior and a more effective data tracking system of relevant targeted behaviors. |
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| Psychotropic Medications and Neurocognitive Disorder: The Impact of Medication on Behavioral Assessment and Treatment Among Older Adults |
| Jonathan C. Baker (Southern Illinois University), DAWN SEEFELDT (Southern Illinois University) |
| Abstract: In 1986 the Nursing Home Reform Act, as part of the Omnibus Budget Reconciliation Act (OBRA 1986), mandated that behavioral interventions be used prior to chemical or physical restraints for older adult populations. Despite this legislation, as well as several black box warnings from the Food and Drug Administration (FDA), psychotropic medication continues to be a main approach for addressing behavioral changes among older adults (Baker & LeBlanc, 2011). Given that many psychotropic medications are still being used for older adults, it is important for behavior analysts working with older adults to understand the impact that such medications can have. This presentation will include data from several clinical applications from our lab in which individuals were already on psychotropic medication or medications were added (e.g., Hadol, Xanax, Ativan). Data from functional analyses, as well as intervention analyses, will be presented and we discuss the impact of psychotropic medication in the context of assessment and treatment. |
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| Varying Results of Functional Analyses across Mood States of an Individual with Autism and Intellectual Disability |
| ELIZABETH DAYTON (Melmark), Anna DiPietro (Melmark), Lauren Davison (Hogan Learning Academy), Jennifer Hanson (Melmark), Jennie England (Melmark) |
| Abstract: Functional analysis results are essential for guiding the development of an individual's behavioral plan. There are multiple variables that may affect the results of functional analysis. One of these variables is the introduction or change in medication. Research has demonstrated that medications can have differential effects on functions (Crosland et al., 2003) or topographies of behaviors (Garcia & Smith, 1999). Psychotropic medications are frequently prescribed to individuals with autism and intellectual disabilities to treat common psychiatric symptoms including irritability and anxiety. It is possible that functional analysis results differ based on an individual's mood state at the time of the analysis. The current study examined the possible evocative effect the symptoms of mania, including elevated mood, had on rates of challenging behavior for a child diagnosed with bipolar disorder and autism spectrum disorder. Although the presented data suggest elevated mood states enhanced the reinforcer value for challenging behavior, further investigation is warranted. The preliminary results have led to further discussion with the medical and behavioral team to identify measurements of mood and possible implications on functional analysis results and altering interventions based upon mood states. |
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