Stopping inappropriate medication of children with intellectual disability, autism or both: the STOMP–STAMP initiative

Abstract

SUMMARY Children with intellectual disability are often prescribed psychotropic medication to manage behaviours that challenge. Unfortunately, many receive medication with potentially serious long-term side-effects that has been prescribed inappropriately or for longer than is necessary. NHS England launched STOMP (stopping the over-medication of people with intellectual disability, autism or both with psychotropic medicines) in 2016 to reduce the inappropriate prescribing in adults. This was broadened to include children in 2018 by the addition of STAMP (supporting treatment and appropriate medication in paediatrics). In this article we review the rationale for STOMP–STAMP, highlight the Royal College of Psychiatrists’ position statement on STOMP–STAMP and give clinical advice for psychiatrists who treat children with intellectual disability, autism and/or attention-deficit hyperactivity disorder (ADHD). Importantly, it is essential to consider that ADHD may have been missed and that by diagnosing and treating it, the need for inappropriate antipsychotic medication may be reduced.

Neurodevelopmental disorders including intellectual disability: a clinical toolkit for mental health professionals (part 2)

“…Children in both groups can present with overlapping symptoms and diagnostic overshadowing, leading to misdiagnosis, missed diagnoses or overdiagnosis. Swanepoel & Lovell (2023), in their article on the STOMP-STAMP initiative and appropriate medication for children with neurodevelopmental disorders, highlight inappropriate antipsychotic prescribing for behaviour that challenges, as well as appropriate use of psychotropic medication in, for example, improving concentration in children with ADHD. Judicious and appropriate use of pharmacotherapy will enhance the engagement of the child with behavioural and communication strategies.…”