Evaluating Preference Stability Across Psychotropic Medication Changes in Persons with Intellectual and Developmental Disabilities

Abstract

Research in applied behaviour analysis evaluating psychotropic medication impact on persons with intellectual and developmental disabilities (IDD) is relatively limited (Cox & Virués-Ortega, 2016). Even though evidence supporting the efficacy of psychotropic medication in treating challenging behaviour has been described as controversial, an Ontario study reported between 39% to 56% of adults with IDD are prescribed at least one psychotropic medication (Lunksy et al., 2018). The overall prevalence of medication use within this population, combined with the lack of research showcasing efficacious outcomes, suggests that further evaluation of psychotropic medication impacts is required. Behaviour analytic researchers have hypothesized that psychotropic medications may function as motivating operations (Conine & Vollmer, 2019). Therefore, it may be important to systematically monitor clinically indicated medication changes for their effect on an individuals preference stability, as well as on stimulus class displacement. Two participants with IDD who engage in challenging behaviour and were undergoing medication changes (e.g., medication increases, decreases, addition, and removal) took part in repeated weekly preference assessments (edible-item, leisure-item, and combined-class). Analysis included a Spearman rank correlation analysis, a non-parametric partial correlation analyses, and visual analysis to these data. Results indicated that psychotropic medication changes appeared to affect non-selection, preference stability, and class displacement differentially across the two participants. Clinical implications, limitations, and future directions are discussed.