The Use of Psychotropic Medication for People with Severe Disabilities and Challenging Behavior: Current Status and Future Directions

Abstract

People with severe disabilities who engage in challenging behavior are often prescribed psychotropic medication as a form of intervention. Although the goal of the medication is to reduce challenging behavior, limited empirical evidence is available to support the use of psychotropic intervention for people with severe disabilities. However, across a range of drug classes basic research suggests that many psychotropic medications selectively affect dimensions of behavior that could be of benefit in reducing challenging behavior. Currently, researchers cannot demonstrate whether most drugs prescribed to reduce challenging behavior are effective or predict when adverse side effects will emerge from their use. In this article we review the basic literature on behavioral pharmacology and integrate those findings with existing applied research to update JASH readers regarding the status of psychotropic medication. From this review, we present a set of suggestions that include: (a) improving research practices, (b) increasing the diversity of individuals involved in decision-making processes regarding medication use, and (c) developing consumer-friendly strategies for monitoring drug effects.

His brain is totally different: An analysisof care‐staff explanations of aggressive challenging behaviour and the impactof gendered discourses

“…For example, referrals are made for an individual client, and referral systems are often designed to encourage this, case files are kept for individual clients and the IP system, which currently dominates in care systems, focuses attention on the individual rather than the context. In addition, medication is the most common response to challenging behaviour, even though there is actually little empirical evidence which supports its efficacy (Brylewski & Duggan, 1999; Kennedy & Meyer, 1998). Institutional structures and practices are both supported by, and give support to, an individualized discourse of the needs of people with learning disabilities.…”

Clinical Pearls to Manage Cyberchondriacs

“…The use of the same stimulus in relation to the same response, but under distinct contingency arrangements, may prove a useful approach that could improve the success of functional analysis outcomes. 12,13 This technique is the first functional analysis of obsessive-compulsive verbalizations in a patient with OCD. Future research will be needed to know (a) if such an approach is necessary in analyzing OCD-related behaviors, (b) whether it is more efficacious than other functional behavioral assessment approaches, and (c) whether the differential contingency approach can be extended to other behaviors and populations of interest.…”

“…[12][13][14] It seems that although rTMS is effective, a greater number of sessions or sessions of longer durations than those reported in previous studies are needed to produce significant results. On the other hand, rTMS given at intervals may be useful to improve and maintain the mood.…”

Applied behavior analysis, social validation, and the psychopharmacology of mental retardation

“…Several authors have proposed that the strategies and tactics characteristic of applied behavior analysis are valuable in clinical psychopharmacology [e.g., Barlow and Hersen, 1984;Kennedy and Meyer, 1998;Kollins et al, in press;Poling and Cleary, 1986a,b;Schroeder, 1985;Singh and Beale, 1986;Wysocki and Fuqua, 1982]. It is beyond the scope of this article to discuss this approach to research in detail [for such information see Barlow and Hersen, 1984;Cooper et al, 1987;.…”