Monitoring Psychotropic Medication Influence on Disruptive Behaviour in Persons with Intellectual and Developmental Disabilities

Abstract

Demographic research suggests that up to 50% of persons with intellectual and developmental disabilities engage in disruptive behaviour (Sheehan et al., 2015). Psychopharmacological interventions are an oft applied treatment approach. Unfortunately, efficacy research on this topic is relatively limited, especially applied behavioural pharmacology research aimed at monitoring and evaluating the behavioural effects of psychotropic medication in this clinical population (Khokhar et al., 2023). Behaviour analysts often conduct a functional analysis to uncover behaviour function as this assessment approach permits the systematic examination of the relationship between disruptive behaviour and environmental events. Theory around how psychotropic medications may be affecting behaviour suggests that functional analyses may facilitate revealing drug-behaviour interactions. Thus, the proposed study explored the behavioural effects of clinically-indicated psychotropic medication changes in 10 adults with intellectual and developmental disabilities who engaged in disruptive behaviour and were prescribed psychotropic medication. Repeat functional analyses were conducted across regular and PRN phases to monitor changes in behaviour function and rate. Evidently, 47.82% of the regular medication phase comparisons were associated with function stability, while 36.36% of the PRN phase comparisons were associated with function stability. An odds ratio coefficient of 0.62 (95% CI: 0.14-2.73) indicated function changes across PRN medication phases were more likely. Effect sizes were generated to examine the magnitude of change in disruptive behaviour. Mean absolute effect size results for the PRN and regular medication phases (0.32 and 0.67, respectively) suggest there may be a noteworthy difference across the two conditions. Clinical implications, study strengths and limitations are discussed.