Some guidelines for conducting research in applied behavioral pharmacology

A Systematic Review of Direct Assessments to Evaluate Psychotropic Medication Effects for Children With Disabilities

To evaluate effects of psychotropic medication for children with disabilities, direct assessments may offer a valuable supplement to caregiver reports. Relative to indirect assessment, direct measures of behavior can increase objectivity and sensitivity, and some have potential to isolate distinct behavioral and learning processes. We conducted a systematic, narrative literature review to identify and describe the types and qualities of direct assessment methods that have been used to evaluate effects of non-stimulant psychotropic medication for children with disabilities. We identified 50 studies and 78 direct assessments, which we organized and described using seven assessment categories. Only one study met all three direct assessment quality indicators. We use our descriptive results to highlight research trends and gaps that warrant further study.

Effects of Dexmethylphenidate on Targeted and Non-Targeted Behaviours during Functional Analyses: A Brief Report

Objective: This study evaluated the effects of dexmethylphenidate on problem behavior during functional analyses conducted across dexmethylphenidate and placebo conditions for a child with multiple disabilities. Methods: We conducted functional analyses in a multielement format embedded in a withdrawal design and collected data on the frequency of disruptive behavior and duration of crying. Results: Results suggest disruptive behaviour was maintained by attention when DMPH was absent, but not when it was present. Results also suggest DMPH may have had collateral effects on the probability of non-targeted behaviour (crying). Consistent with previous research, functional analyses exhibited a change in disruptive behaviour's function between medication and placebo conditions. Conclusion: These findings provide further support that stimulant medication may change the function of disruptive behavior and highlight the need to investigate the effects of stimulants on non-targeted behaviors.

Board Certified Behavior Analysts and Psychotropic Medications: Slipshod Training, Inconsistent Involvement, and Reason for Hope

People with autism spectrum disorder often receive psychotropic medications and two drugs, risperidone and aripiprazole, are approved for treating "irritability" in this population. A number of authors have suggested that behavior analysts can contribute to the prudent use of such drugs, but little is known regarding Board Certified Behavior Analysts' involvement in practices relevant to the use of psychotropic drugs. We e-mailed Board Certified Behavior Analysts an anonymous web-based survey regarding such practices. A majority of respondents work with individuals with autism spectrum disorder who take at least one psychotropic medication but respondents' training relevant to psychotropic medications is inconsistent. Many report that their training is inadequate, they do not regularly work as part of interdisciplinary teams concerned with medication, and behavior-analytic interventions are not typically evaluated before drugs are prescribed. Nonetheless, the majority of respondents reported that medications sometimes produce beneficial effects. Those involved in training behavior analysts should consider the competencies needed for graduates to work effectively as members of teams concerned with the optimal use of medications and how to foster and assess those competencies. Behavior analysts should also work to develop and implement strategies that foster collaboration with psychiatrists and other physicians. • Psychotropic drugs are often prescribed for people with autism, and both risperidone and aripiprazole are approved for reducing "irritability," which comprises self-injury, aggression, tantrums, and other challenging responses. • Respondents are not consistently involved in monitoring the effects of psychotropic drugs, which are often administered prior to evaluating an alternative, less restrictive, intervention. • Respondents are not trained consistently with respect to matters relevant to psychotropic drugs, and many apparently are not trained adequately. • People involved in training behavior analysts should consider the competencies needed for graduates to work effectively as members of teams concerned with the optimal use of medications and how to foster and assess those competencies. • Behavior analysts should also work to develop and implement strategies that foster collaboration with psychiatrists and other physicians.