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| Challenging Behavior Unraveled: Insights Into Psychotropic Medication Impact on Challenging Behavior Informed by Diverse Assessment Modalities |
| Saturday, May 25, 2024 |
| 5:00 PM–5:50 PM |
| Convention Center, 100 Level, 102 AB |
| Area: BPN/DDA; Domain: Applied Research |
| Chair: Monica Peters (Nova Scotia Health) |
| Discussant: Jessica Torelli (University of Georgia) |
| CE Instructor: Jessica Torelli, Ph.D. |
| Abstract: Psychopharmacological interventions are commonly used to treat challenging behaviors in persons with intellectual and developmental disabilities (Lunsky et al., 2018; Valdovinos, 2019). Some demographic research suggests that up to 90% of adults comprising this clinical population are taking some type of psychotropic medication (Lunsky et al., 2018). Persons with intellectual and developmental disabilities often have communication deficits which may be especially problematic when being prescribed these medications, as physicians largely rely on self-report measures to discern how medication changes are impacting their patient (Quinn, 2014). Behavioural researchers continue to be well-suited to explore the behavioural effects of psychotropic medication by leveraging objective measurement systems (Cox & Virues-Ortega, 2016; Valdovinos et al., 2019). The more the field understands whether and how psychotropic medications affect client responding, the better prepared behavior analysts may be to cultivate behavior change and ultimately improve client quality of life. The two studies below use different assessment strategies to monitor the impact of psychotropic medications in persons with intellectual and developmental disabilities who engage in challenging behavior. |
| Instruction Level: Intermediate |
| Target Audience: Intermediate- Some familiarity with introductory statistics content and some familiarity with applied behavioral pharmacology |
| Learning Objectives: (1) The attendees will be able to identify how direct assessments may aid in monitoring changes in behavior function and rate across clinically-indicated medication changes. (2) The attendees will be able to identify what comprises a comprehensive assessment plan to monitor the impact of psychotropic medications in persons with intellectual and developmental disabilities who engage in challenging behavior. (3) The attendees will be able to identify and describe helpful indirect and direct assessment strategies in the context of monitoring psychotropic medication adjustment impacts on challenging behavior |
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Using Functional Analysis to Monitor the Impact of Psychotropic Medication on Challenging
Behavior Function in Persons With Intellectual and Developmental Disabilities |
| ANDREAS DIMOPOULOS (Brock University), Alison Cox (Brock University), Monica Peters (Nova Scotia Health), Tina Vo (Brock University), Victor Enrique Bethencourt (Brock University), Autumn Kozluk (Brock University) |
| Abstract: Demographic research suggests that up to 50% of persons with intellectual and developmental disabilities engage in behavior that can be described as challenging. That is, behaviors that interfere with skills acquisition, access to services, and may increase the risk of injury to self or others (e.g., aggression, self-injury, property destruction). Psychopharmacological interventions represent an oft applied approach to reduce challenging behavior. Unfortunately, efficacy research on this topic is relatively limited, including applied behavioural pharmacology research aimed at evaluating the behavioural effects of psychotropic medication in this clinical population (Cox & Virués-Ortega, 2016). In behavior analysis, challenging behavior is perceived as ‘learned’ behavior. That is, the individual learns the behavior over time because their interaction with the environment produces a ‘desired’ outcome. The challenging behavior, thus, serves a specific purpose (i.e., behavior function). To identify behavior function, behavior analysts often conduct a functional analysis (FA) to systematically examine the relationship between challenging behavior and environmental events (Hanley, 2012). Theory around how psychotropic medications may be affecting behavior suggests that FAs may facilitate uncovering drug-behavior interactions. Thus, the proposed study examined the behavioural effects of clinically-indicated psychotropic medication changes across six adults with IDD who engage in challenging behavior and were taking psychotropic medication as their primary treatment element. Repeat FAs were conducted across psychotropic medication conditions, including psychotropic PRN (as needed medication) conditions, to monitor changes in behavior function and rate. Clinical implications, limitations, and future directions are discussed. |
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A Comparison of Outcomes From Indirect and Direct Assessment of Challenging Behavior in the Context of Psychotropic Medication Monitoring |
| MONICA PETERS (Nova Scotia Health), Andreas Dimopoulos (Brock University), Alison Cox (Brock University), Tina Vo (Brock University), Victor Enrique Bethencourt (Brock University) |
| Abstract: In behavior analysis, experimental functional analysis technology is considered the gold-standard in assessing challenging behavior. However, psychopharmacological research tends to primarily rely on informant-based techniques to evaluate the participant outcomes (e.g., reduced aggression) (Valdeep & Cox, 2020) The Aberrant Behavior Checklist (ABC) (Aman, Singh, Stewart, & Field, 1985) was initially developed to explore medication impact in persons with intellectual and developmental disabilities who engage in challenging behavior. Another commonly used indirect measure is the Behavior Problems Inventory-R (BPI-R) (Rojahn, Matson, Lott, Esbensen & Smalls, 2001). Given their prevalence in psychopharmacology research, as well as the emphasis on enacting functional analyses in the treatment of challenging behavior, it may be important to examine the convergent validity between these indirect and direct assessment strategies. Thus, the purpose of this study is to evaluate the convergent validity of assessment strategies across medication adjustments in persons with intellectual and developmental disabilities who engage in challenging behavior. Preliminary results suggest there is a 55% agreement between direct and indirect outcomes. Clinical implications and next steps will also be discussed. |
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