Skip to main content
SpringerLink
Log in

Psychotropic Drug Treatments for People with Autism and Other Developmental Disorders: A Primer for Practicing Behavior Analysts

  • Published:
Behavior Analysis in Practice Aims and scope Submit manuscript

Abstract

Many people with developmental disabilities receive medications prescribed to improve behavior. This manuscript overviews the psychopharmacology of developmental disabilities and considers how practitioners can assist in improving the quality of the pharmacological treatments that their clients receive.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Allen, K. D., Barone, V. J., & Kuhn, B. R. (1993). A behavioral prescription for promoting applied behavior analysis within pediatrics. Journal of Applied Behavior Analysis, 26, 493–502.

    PubMed  PubMed Central  Google Scholar 

  • Aman, M. G., & Singh, N. N. (1983). Pharmacological interventions. In J. L. Matson & J. A. Mulick (Eds.), Handbook of mental retardation (pp. 317–337). New York: Pergamon.

    Google Scholar 

  • Aman, M. G., De Smedt, G., Derivan, A., Lyons, B., & Fielding, R. L. (2002). Double-blind, placebo-controlled study of risperidone for the treatment of disruptive behavior disorders in children with subaverage intelligence. American Journal of Psychiatry, 159, 1337–1346.

    PubMed  Google Scholar 

  • Aman, M. G., Singh, N. N., Stewart, A. W., & Field, C. J. (1985). Psychometric characteristics of the Aberrant Behavior Checklist. American Journal of Mental Deficiency, 89, 492–502.

    PubMed  Google Scholar 

  • Aman, M. G., Lam, K. S., & Collier-Crespin, A. (2003). Prevalence and patterns of use among individuals with autism in the Autism Society of Ohio. Journal of Autism and Developmental Disorders, 33, 525–534.

    Google Scholar 

  • American Academy of Child and Adolescent Psychiatry. (2009). Practice parameter on the use of psychotropic medication in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 48, 961–973.

    Google Scholar 

  • Arnold, L. E., Aman, M. G., Martin, A., Collier-Crespin, A., Vitello, B., Tierney, E., Asarnow, R., Bell-Bradshaw, F., Freeman, B. J., Gates-Ulanet, P., Klin, A., McCracken, J. T., McDougle, C. J., McGough, J. J., Posey, D. J., Scahill, L., Sieezy, N. b., Ritz, L., & Volkmar, F. (2000). Assessment in multisite randomized clinical trials of patients with autistic disorders: the autism RUPP network. Journal of Autism and Developmental Disorders, 30, 99–113.

    PubMed  Google Scholar 

  • Baumeister, A. A., & Sevin, J. A. (1990). Pharmacological control of aberrant behavior in the mentally retarded: Towards a more rational approach. Neuroscience & Biobehavioral Reviews, 14, 253–262.

    Google Scholar 

  • Bodfish, J. W. (2004). Treating the core features of autism: Are we there yet? Mental Retardation and Developmental Disabilities Research Reviews, 10, 318–326.

    PubMed  Google Scholar 

  • Brylewski, J., & Duggan, L. (1999). Antipsychotic medication for challenging behavior in people with intellectual disability: A systematic review of randomized controlled trials. Journal of Intellectual Disability Research, 43, 360–371.

    PubMed  Google Scholar 

  • Bryson, S. E., Rogers, S. J., & Fombonne, E. (2003). Autism spectrum disorders: Early detection, intervention, education, and psychopharmacological management. Canadian Journal of Psychiatry, 48, 506–516.

    PubMed  Google Scholar 

  • Christian, L., Snycerski, S., Singh, N., & Poling, A. (1999). Direct service staff’s perceptions of psychotropic medication in noninstitutional settings for individuals with developmental disabilities. Journal of Intellectual Disability Research, 43, 88–93.

    PubMed  Google Scholar 

  • Centers for Disease Control and Prevention. (2007). Prevalence of autism spectrum disorders—Autism and Developmental Disabilities Monitoring (ADDM) network, 14 sites, United States, 2002. MMWR Surveillance Summaries, 2007. 56, 12–28.

    Google Scholar 

  • Crosland, K. A., Zarcone, J. R., Lindauer, S. E., Valdovinos, M. G., Zarcone, T. J., Hellings, J. A., & Schroeder, S. R. (2003). Use of functional analysis methodology in the evaluation of medication effects. Journal of Autism and Developmental Disabilities, 33, 271–279.

    Google Scholar 

  • Fahmie, T. A., & Hanley, G. P. (2008). Progressing toward data intimacy: A review of within-session data analysis. Journal of Applied Behavior Analysis, 41, 319–331.

    PubMed  PubMed Central  Google Scholar 

  • Fisher, W., Piazza, C. C., & Page, T. J. (1989). Assessing independent and interactive effects of behavioral and pharmacological interventions for a client with dual diagnoses. Journal of Behavior Therapy and Experimental Psychiatry, 20, 241–250.

    PubMed  Google Scholar 

  • Flora, R. (2007). Taking America off drugs: Why behavior therapy is more effective for treating ADHD, OCD, depression, and other psychological problems. Albany, NY: State University of New York Press.

    Google Scholar 

  • Francis, K. (2005). Autism interventions: A critical update. Developmental Medicine & Child Neurology, 47, 493–499.

    Google Scholar 

  • Gadow, K. D., & Poling, A. (1988). Pharmacotherapy and mental retardation. Boston: Little, Brown.

    Google Scholar 

  • Garcia, D., & Smith, R. G. (1999). Using analog baselines to assess the effects of naltrexone on self-injurious behavior. Research in Developmental Disabilities, 20, 1–21.

    PubMed  Google Scholar 

  • Ghanizadeh, A., & Kianpoor, M. (2008). Cessation of risperidone-induced incontinency by valproate in a child with pervasive developmental disorder. Primary Psychiatry, 15, 32–34.

    Google Scholar 

  • Goin-Kochler, R. P., Myers, B. J., & Mackintosh, V. H. (2007). Parental reports on the use of treatments and therapies for children with autism spectrum disorders. Research in Autism Spectrum Disorders, 1, 195–209.

    Google Scholar 

  • Green, V. A., Pituch, K. A., Itchen, J., Choi, A., O’Reilly, M., & Sigafoos, J. (2006). Internet survey of treatments used by parents of children with autism. Research in Developmental Disabilities, 27, 70–84.

    PubMed  Google Scholar 

  • Greiner, T. (1958). Problems in methodology in research with drugs. American Journal of Mental Deficiency, 64, 346–352.

    Google Scholar 

  • Gringras, P. (2000). Practical pediatric psychopharmacological prescribing in autism: The potential and the pitfalls. Autism, 4, 229–247.

    Google Scholar 

  • Gualtieri, C. T., & Schroeder, S. R. (1989). Pharmacotherapy for self-injurious behavior: Preliminary tests of the D1 hypothesis. Psychopharmacology Bulletin, 25, 264–271.

    Google Scholar 

  • Guy, W. (1976). ECDEU assessment manual for psychopharmacology (Revised) U.S. Department of Health, Education, and Welfare Publication ADM, pp. 76–338). Rockville, MD: National Institute of Mental Health.

    Google Scholar 

  • Hagopian, L. P., & Anderson, M. E. (2010). Integrating behavioral and pharmacological interventions for severe problem behavior displayed by children with neurogenetic and developmental disorders. In B. K. Shapiro & P. J. Accardo (Eds.), Neurobehavioral disorders: Behavioral issues and their treatment (pp. 2319–239). New York: Brookes.

    Google Scholar 

  • Israel, M. (2009). Primer on psychotropic drugs (volume 38). Retrieved January 29, 2010 from http://www.judgerc.org/DrugPrimer.pdf.

  • Iwata, B. A., Dorsey, M. F., Slifer, K. J., Bauman, K. E., & Richman, G. S. (1994). Toward a functional analysis of self-injury. Journal of Applied Behavior Analysis, 27, 197–209. (Reprinted from Analysis and Intervention in Developmental Disabilities, 2, 3–20, 1982).

    PubMed  PubMed Central  Google Scholar 

  • Jesner, O. S., Aref-Adib, M., & Coren, E. (2007). Risperidone for autism spectrum disorders. Cochrane Database of Systematic Reviews (1):CD005040.

  • Kalachnik, J. E. (1988). Medication monitoring procedures. In K. D. Gadow & A. Poling (Eds.), Pharmacology and mental retardation (pp. 231–268). Boston: Little, Brown.

    Google Scholar 

  • Kollins, S., Ehrhardt, K., & Poling, A. (2000). Clinical drug assessment. In A. Poling & T. Byrne (Eds.), Introduction to behavioral pharmacology (pp. 191–218). Reno, NV: Context Press.

    Google Scholar 

  • Langworthy-Lam, K. S., Aman, M. G., & Van Bourgondien, M. E. (2002). Prevalence and patterns of use of psychoactive medicines in individuals with autism in the Autism Society of North Carolina. Journal of Child and Adolescent Psychopharmacology, 12, 311–321.

    PubMed  Google Scholar 

  • Laraway, S., Snycerski, S., Michael, J., & Poling, A. (2003). Motivating operations and terms to describe them: Some further refinements. Journal of Applied Behavior Analysis, 36, 407–414.

    PubMed  PubMed Central  Google Scholar 

  • Mandell, D. S., Morales, K. H., Marcus, S. C., Stahmer, A. C., Doshi, J., & Polsky, D. E. (2008). Psychotropic medication use among Medicaid-enrolled children with autism spectrum disorders. Pediatrics, 121, 441–448.

    Google Scholar 

  • Matson, J. L., & Nebel-Schwalm, M. (2007). Assessing challenging behavior in children with autism spectrum disorders: A review. Research in Developmental Disabilities, 28, 567–579.

    PubMed  Google Scholar 

  • Matson, J. L., Bamburg, J. W., Mayville, E. A., Pinkston, J., Bielecki, J., Kuhn, D., Smalls, Y., & Logan, J. R. (2000). Psychopharmacology and mental retardation: A 10 year review (1990–1999). Research in Developmental Disabilities, 21, 263–296.

    PubMed  Google Scholar 

  • Mayhew, M. (2009). Off-label prescribing. Journal for Nurse Practitioners, 5, 122–123.

    Google Scholar 

  • McCracken, J. T. (2005). Safety issues with drug therapies for autism spectrum disorders. Journal of Clinical Psychiatry, 66, 32–37.

    PubMed  Google Scholar 

  • McDougle, C. J., & Posey, D. J. (2002). Autistic and other pervasive developmental disorders. In A. Martin, L. Scahill, D. S. Charney, & J. F. Leckman (Eds.), Paediatric psychopharmacology: Principles and practices (pp. 563–579). Oxford: Oxford University Press.

    Google Scholar 

  • McDougle, C. J., Scahill, L., McCracken, J. T., Aman, M. G., Tierney, E., Arnold, L. E., Freeman, B. J., Martin, A., McGough, J. J., Cronin, P., Posey, D. J., Riddle, M. A., Ritz, L., Swiezy, N. B., Vitiello, B., Volkmar, F. R., Votolato, N. A., & Walson, P. (2000). Research units on pediatric psychopharmacology (RUPP) Autism Network: Background and rationale for an initial controlled study of risperidone. Child and Adolescent Psychiatry Clinics of North America, 9, 201–224.

    Google Scholar 

  • Moussavand, S., & Findling, R. L. (2007). Recent advances in the pharmacological treatment of pervasive developmental disorders. Current Pediatric Reviews, 3, 79–91.

    Google Scholar 

  • MTA Cooperative Group. (1999). A 14-month randomized clinical trial of treatment strategies for attention-deficit hyperactivity disorder (ADHD). Archives of General Psychiatry, 56, 1073–1086.

    Google Scholar 

  • Myers, S. M. (2007). The status of pharmacotherapy for autism spectrum disorders. Expert Opinion on Pharmacotherapy, 8, 1579–1603.

    PubMed  Google Scholar 

  • Myers, S. M., & Johnson, C. P. (2007). Management of children with autism spectrum disorders. Pediatrics, 120, 1162–1182.

    PubMed  Google Scholar 

  • Napolitano, D. A., Jack, S. L., Sheldon, J. B., Willaims, D. C., McAdam, D. B., & Schroeder, S. R. (1999). Drug-behavior interactions in persons with mental retardation and developmental disabilities. Mental Retardation and Developmental Disabilities Research Reviews, 5, 322–344.

    Google Scholar 

  • Northup, J., Fusilier, I., Swanson, V., Huete, J., Bruce, T., Freeland, J., Gulley, V., & Edwards, S. (1999). Further analysis of the separate and interactive effects of methylphenidate and common classroom contingencies. Journal of Applied Behavior Analysis, 32, 35–50.

    PubMed  PubMed Central  Google Scholar 

  • Northup, J., Fusilier, I., Swanson, V., Roane, H., & Borrero, J. (1997). An evaluation of methylphenidate as a potential establishing operation for some common classroom reinforcers. Journal of Applied Behavior Analysis, 30, 615–625.

    PubMed  PubMed Central  Google Scholar 

  • Physicians’ Desk Reference 2010. (2010). Montvale, NJ: Author.

  • Poling, A. (1994). Pharmacological treatment of behavioral problems in people with mental retardation: Some ethical considerations. In L. J. Hayes, G. J. Hayes, S. C. Moore, & P. M. Ghezzi (Ed.), Ethical issues in developmental disabilities (pp. 149–177). Reno, NV: Context Press.

    Google Scholar 

  • Poling, A., & Ehrhardt, K. (1999). Applied behavior analysis, social validation, and the psychopharmacology of mental retardation. Mental Retardation and Developmental Disabilities Research Reviews, 5, 342–347.

    Google Scholar 

  • Poling, A., Ehrhardt, K., Wood, A., & Bowerman, R. (in press). Psychopharmacology and behavior analysis in autism treatment. In J. A. Matson & E. A. Mayville (Eds.), Behavioral foundations of effective autism treatment. New York: Sloan.

  • Poling, A., Laraway, S., Ehrhardt, K., Jennings, L., & Turner, L. (2004). Pharmaceutical interventions and developmental disabilities. In W. L. Williams (Eds.), Developmental disabilities: Etiology, assessment, intervention, and integration (pp. 105–124). Reno: Context Press.

    Google Scholar 

  • Poling, A., Laraway, S., Ehrhardt, K., Jennings, L., & Turner, L. (2004). Pharmaceutical interventions and developmental disabilities. In W. L. Williams (Eds.), Developmental disabilities: Etiology, assessment, intervention, and integration (pp. 105–124). Reno: Context Press.

    Google Scholar 

  • Pyles, D. A. M., Muniz, K., Cade, A., & Silva, R. (1997). A behavioral diagnostic paradigm for integrating behavior-analytic and psychopharmacological interventions for people with a dual diagnosis. Research in Developmental Disabilities, 18, 185–214.

    PubMed  Google Scholar 

  • Research Units on Pediatric Psychopharmacology Autism Network. (2002). Risperidone in children with autism and serious behavioral problems. New England Journal of Medicine, 347, 314–321.

    Google Scholar 

  • Scahill, L., Koenig, K., Carroll, D. H., & Pachler, M. (2007). Risperidone approved for the treatment of serious behavioral problems in children with autism. Journal of Child and Adolescent Psychiatric Nursing: Official Publication of the Association of Child and Adolescent Psychiatric Nurses, Inc, 20, 188–190.

    Google Scholar 

  • Schroeder, S. R., Lewis, M. H., & Lipton, M. A. (1983). Interaction of pharmacotherapy and behavior therapy among with learning and behavior disorders. Advances in Learning and Behavior Disabilities, 2, 179–225.

    Google Scholar 

  • Snyder, R., Turgay, A., Aman, M., Binder, C., Fisman, S., & Carroll, A. (2002). Effects of risperidone on conduct and disruptive behavior disorders in children with subaverage IQs. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 1026–1046.

    PubMed  Google Scholar 

  • Sprague, R. L., & Werry, J. L. (1971). Methodology of psychopharmacological studies with the retarded. In N. R. Ellis (Ed.), International review of research in mental retardation (Vol. 5, pp. 147–219). New York: Academic Press.

    Google Scholar 

  • Thompson, T. (2007). Making sense of autism. Baltimore, MD: Brookes.

    Google Scholar 

  • Thompson, T., Moore, T., & Symons, F. (2007). Psychotherapeutic medications for positive behavior support. In S. Odom, R. Horner, M. Snell, & J. Blacher (Eds.), Handbook on developmental disabilities (pp. 501–527). New York: Guilford.

    Google Scholar 

  • Tsai, L. V. (2001). Taking the mystery out of medications in autism/Asperger’s syndrome. Arlington, TX: Future Horizons.

    Google Scholar 

  • U.S. Food and Drug Administration. (2006). FDA approves the first drug to treat irritability associated with autism, Risperdal http://www.fda.gov/bbs/topics/NEWS/2006/NEW01485.html accessed May 28, 2009

  • Valdovinos, M. G., Ellringer, N. P., & Alexander, M. L. (2007). Changes in the rate of problem behavior associated with the discontinuation of the antipsychotic medication quetiapine. Mental Health Aspects of Developmental Disabilities, 10, 64–67.

    Google Scholar 

  • Valdovinos, M. G., Napolitano, D. A., Zarcone, J. R., Hellings, J. A., Williams, D. G., & Schroeder, S. R. (2002). Multimodal evaluation of risperidone for destructive behavior: Functional analysis, direct observations, rating scales, and psychiatric impressions. Experimental and Clinical Psychopharmacology, 10, 268–275.

    PubMed  Google Scholar 

  • Ventola, C. L. (2009). Off-label drug information: Regulation, distribution, evaluation, and related controversies. Pharmacy and Therapeutics, 34, 428–432.

    PubMed  PubMed Central  Google Scholar 

  • Weeden, M., Ehrhardt, K., & Poling, A. (2009). Conspicuous by their absence: Studies comparing and combining risperidone and applied behavior analysis to reduce challenging behavior in children with autism. Research in Autism Spectrum Disorders, 3, 905–912.

    Google Scholar 

  • Witwer, A., & Lecavalier, L. (2005). Treatment incidence and patterns in children and adolescents with autism spectrum disorders. Journal of Child and Adolescent Psychopharmacology, 15, 671–681.

    PubMed  Google Scholar 

  • Wyatt v. Stickney. (1972). 325 F. Supp. 387 (filed 1972).

  • Zarcone, J. R., Hollings, J. A., Crandall, K., Reese, R. M., Marquis, J., Fleming, K., Shores, R., Williams, D., & Schroeder, S. R. (2001). Effects of risperidone on aberrant behavior of persons with developmental disabilities: I. A double-blind crossover study using multiple measures. American Journal on Mental Retardation, 106, 525–538.

    PubMed  Google Scholar 

  • Zarcone, J. R., Lindauer, S. E., Morse, P. S., Crosland, K. A., Valdovinos, M. G., McKerchar, T. L., Reese, R. M., Hellings, J. A., & Schroeder, S. R. (2004). Effects of risperidone on destructive behavior of persons with developmental disabilities: III. Functional analysis. American Journal on Mental Retardation, 109, 310–321.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychology, Western Michigan University, Kalamazoo, MI, 49008, USA

    Marc Weeden M.S., BCBA, Kristal Ehrhardt Ph.D. & Alan Poling Ph. D., BCBA-D

Authors
  1. Marc Weeden M.S., BCBA
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kristal Ehrhardt Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alan Poling Ph. D., BCBA-D
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marc Weeden M.S., BCBA.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Weeden, M., Ehrhardt, K. & Poling, A. Psychotropic Drug Treatments for People with Autism and Other Developmental Disorders: A Primer for Practicing Behavior Analysts. Behav Analysis Practice 3, 4–12 (2010). https://doi.org/10.1007/BF03391753

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03391753

Keywords

Search

Navigation