Abstract
Currently, there are two medications (i.e., risperidone and aripiprazole) with sufficient established evidence for effectively treating related symptoms (i.e., irritability and hyperactivity) of autism spectrum disorder (ASD). A recent study on the prevalence of psychotropic medication treatment for children with ASD in the USA found that approximately 65% had filled a prescription for at least one psychotropic medication, 35% filled prescriptions across two medication classes, and 15% filled prescriptions across three or more classes concurrently. While these numbers inform rates of psychotropic medication use among this population, little is known about the prescribing practices of practitioners treating ASD symptoms in pediatric populations. There are currently no known empirical studies examining the prescribing practitioner’s perspective and, as a result, it is not known how prescribers are making psychotropic medication management decisions or what factors may influence those decisions. Therefore, the current study sought to evaluate the degree to which prescribers rated the importance of several sources of information when prescribing and managing psychotropic medication for the treatment of core and secondary symptoms of ASD.
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References
Aarons, G. A. (2005). Measuring provider attitudes towards evidence-based practice: Consideration of organizational context and individual differences. Child and Adolescent Psychiatric Clinics, 14(2), 255–267. https://doi.org/10.1016/j.chc.2004.04.008.
Aman, M. G., Singh, N. N., Stewart, A. W., & Field, C. J. (1985). The aberrant behavior checklist: A behavior rating scale for the assessment of treatment effects. American Journal of Mental Deficiency, 89(5), 485–491 Retrieved from http://psycnet.apa.org/record/1985-19035-001.
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(9), 961–973. https://doi.org/10.1097/CHI.0b013e3181ae0a08.
American Academy of Child and Adolescent Psychiatry (2012). A Guide for Public Child Serving Agencies on Psychotropic Medications for Children and Adolescents. Retrieved from http://www.aacap.org/App_Themes/AACAP/docs/press/guide_for_community_child_serving_agencies_on_psychotropic_medications_for_children_and_adolescents_2012.pdf. Accessed 26 Feb 2015.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Barnard-Brak, L., Davis, T. N., Schmidt, M., & Richman, D. M. (2016). Effects associated with on- and off-label stimulant treatment of core autism and ADHD symptoms exhibited by children with autism spectrum disorder. Developmental Neurorehabilitation, 19(1), 46–53 http://dx.doi.org.tcsedsystem.idm.oclc.org/10.3109/17518423.2014.904949.
Bertelli, M. O., Rossi, M., Keller, R., & Lassi, S. (2016). Update on psychopharmacology for autism spectrum disorders. Advances in Mental Health and Intellectual Disabilities, 10(1), 6–26. https://doi.org/10.1108/AMHID-10-2015-0049.
Blydenburg, D. M., & Diller, J. A. (2016). Evaluating components of behavior-analytic training programs. Behavior Analysis in Practice, 9(2), 179–183. https://doi.org/10.1007/s40617-016-0123-2.
Bradley, E. A., Ames, C. S., & Bolton, P. F. (2011). Psychiatric conditions and behavioral problems in adolescents with intellectual disabilities: Correlates with autism. Canadian Journal of Psychiatry, 56(2), 102–109. https://doi.org/10.1177/070674371105600205.
Bramble, D. (2007). Psychotropic drug prescribing in child and adolescent learning disability psychiatry. Journal of Psychopharmacology, 21(5), 486–491. https://doi.org/10.1177/0269881106075642.
Braüner, J. V., Johansen, L. M., Roesbjerg, T., & Pagsberg, A. K. (2016). Off-label prescription of psychopharmacological drugs in child and adolescent psychiatry. Journal of Clinical Psychopharmacology, 36(5), 500–507 http://dx.doi.org.tcsedsystem.idm.oclc.org/10.1097/JCP.0000000000000559.
Frazier, T.W., Shattuck, P.T., Carter Narendorf, S., Cooper, B.P., Wagner, M. & Spitznagel, E.L. (2011). Prevalence and correlates of psychotropic medication use in adolescents with an autism spectrum disorder with and without caregiver-reported attention-deficit hyperactivity disorder. Journal of Child and Adolescent Psychopharmacology, 21(6), 571–579.
Freeman, E., & McIntosh, D. E. (2009). Current practice in psychopharmacology for children and adolescents with autism spectrum disorders. Psychology in the Schools, 46, 905–909. https://doi.org/10.1002/pits.20431.
Friedman, M. (1937). The use of ranks to avoid the assumption of normality implicit in the analysis of variance. Journal of the American Statistical Association, 32, 675–701.
Garland, A. F., Kruse, M., & Aarons, G. A. (2003). Clinicians and outcomes measurement: What’s the use? Journal of Behavioral Health Services & Research, 30(4), 393–405. https://doi.org/10.1007/BF02287427.
George, D., & Mallery, M. (2003). Using SPSS for Windows step by step: a simple guide and reference. Boston, MA: Allyn & Bacon.
Gray, K., Keating, C., Taffe, J., Brereton, A., Einfeld, S., & Tonge, B. (2012). Trajectory of behavior and emotional problems in autism. American Journal on Intellectual and Developmental Disabilities, 117(2), 121–133. https://doi.org/10.1352/1944-7588-117-2.121.
Grove, W. M., & Meehl, P. E. (1996). Comparative efficiency in informal (subjective, impressionistic) and formal (mechanical, algorithmic) prediction procedures: The clinical –statistical controversy. Psychology, Public Policy, and Law, 2(2), 293–323. https://doi.org/10.1037/1076-8971.2.2.293.
Guy, W. (Ed.). (1976). Clinical Global Impressions Scale. Rockville: National Institute of Mental Health.
Hatfield, D. R., & Ogles, B. M. (2006). The influence of outcomes in assessing client change and treatment decisions. Journal of Clinical Psychology, 62(3), 325–337. https://doi.org/10.1002/jclp.20235.
Haw, C., & Stubbs, J. (2005). A survey of off-label prescribing for inpatients with mild intellectual disability and mental illness. Journal of Intellectual Disability Research, 49(11), 858–864. https://doi.org/10.1111/j.1365-2788.2005.00723.x.
Hoagwood, K., Burns, B. J., Kiser, L., Ringeisen, H., & Schoenwald, S. K. (2001). Evidence-based practice in child and adolescent mental health services. Psychiatric Services, 52(9), 1179–1189. https://doi.org/10.1176/appi.ps.52.9.1179.
Hughes, S., Narendorf, S., & Lacasse, J. R. (2017). A national survey of graduate education in psychopharmacology: Advancing the social work perspective on psychiatric medication. Journal of Social Work Educations, 53(3), 424–434. https://doi.org/10.1080/10437797.2016.1272513.
Lake, J. A., Denton, D., Lunsky, Y., Shui, A. M., Veenstra-VanderWeele, J., & Anagnostou, E. (2017). Medical conditions and demographic, service, and clinical factors associated with atypical antipsychotic medication use among children with an autism spectrum disorder. Journal of Autism and Developmental Disorders, 47(5), 1391–1402. https://doi.org/10.1007/s10803-017-3058-8.
Lopez De-Fede, A., Vyavaharkar, M., & Bellinger, J. D. (2014). Antipsychotic prescriptions for children aged 5 years or younger; do we need policy oversight standards? SAGE Open, 4(4). https://doi.org/10.1177/2158244014555116.
Lund, A. & Lund, M. (2013). Laerd Statistics Retrieved from https://statistics.laerd.com/aboutus.php.
Madden, J. M., Lakoma, M. D., Lynch, F. L., Rusinak, D., Owen-Smith, A. A., Coleman, K. J., Quinn, V. P., Yau, V. M., Qian, Y. X., & Croen, L. A. (2017). Psychotropic medication use among insured children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 47(1), 144–154. https://doi.org/10.1007/s10803-016-2946-7.
Murray, M. L., Hsia, Y., Glaser, K., Simonoff, E., Murphy, D. G., Asherson, P. J., Eklund, H., & Wong, I. C. J. (2014). Pharmacological treatments prescribed to people with autism spectrum disorder in primary health care. Psychopharmacology, 231(6), 1011–1021 http://dx.doi.org.tcsedsystem.idm.oclc.org/10.1007/s00213-013-3140-7.
Myers, S. M. (2008). Psychopharmacologic approaches to challenging behaviors in individuals with autism. In B. K. Shapiro & P. J. Accardo (Eds.), Autism frontiers: Clinical issues and innovations (pp. 153–175). Baltimore: P. H. Brookes.
Park, S. Y., Cervesi, C., Galling, B., Molteni, S., Walyzada, F., Ameis, S. H., et al. (2016). Antipsychotic use trends in youth with autism spectrum disorder and/or intellectual disability: A meta-analysis. Journal of the American Academy of Child & Adolescent Psychiatry, 55(6), 456–468 http://dx.doi.org.tcsedsystem.idm.oclc.org/10.1016/j.jaac.2016.03.012.
Paul, A. R., Mckechanie, A. G., Johnstone, E. C., Cunningham Owens, D. G., & Stanfield, A. C. (2015). Brief report: The association of autistic traits and behavioral patterns in adolescents receiving special educational assistance. Journal of Autism and Developmental Disorders, 45(9), 3055–3060 http://dx.doi.org.tcsedsystem.idm.oclc.org/10.1007/s10803-015-2445-2.
Poling, A. D., Ehrhardt, K., & Li, A. (2017). Pharmacotherapy. In J. L. Matson (Ed.), Handbook of treatments for autism (pp. 459476). New York: Springer.
Rivard, M., Forget, J., Giroux, N., Mello, C., Kerr, K., & Regli, G. (2016). Observation of socially appropriate and inappropriate behaviors among children with autism spectrum disorder during an early behavioral intervention program. Journal on Developmental Disabilities, 22(1), 52–67 Retrieved from https://tcsedsystem.idm.oclc.org/login?url=http://search.proquest.com.tcsedsystem.idm.oclc.org/docview/1823375716?accountid=34120.
Rosenberg, R., Mandell, D. S., Farmer, J. E., Kiely Law, J., Marvin, A. R., & Law, P. A. (2010). Psychotropic medication use among children with autism spectrum disorders enrolled in a national registry, 2007-2008. Journal of Autism and Developmental Disorders, 40(3), 342–351. https://doi.org/10.1007/s10803-009-0878-1.
Scahill, L., Riddle, M. A., McSwiggin-Hardin, M., Ort, S. I., King, R. A., Goodman, W. K., et al. (1997). Children’s Yale-Brown obsessive compulsive scale: Reliability and validity. Journal of the American Academy of Child & Adolescent Psychiatry, 36(6), 844–852. https://doi.org/10.1097/00004583-199706000-00023.
Shireman, T. I., Reichard, A., & Rigler, S. K. (2005). Psychotropic medication use among Kansas medicaid youths with disabilities. Journal of Child and Adolescent Psychopharmacology, 15(1), 107–115. https://doi.org/10.1089/cap.2005.15.107.
Siegel, M., & Beaulieu, A. A. (2011). Psychotropic medications in children with autism spectrum disorders: A systematic review and synthesis for evidence-based practice. Journal of Autism and Developmental Disorders, 42(8), 1592–1605. https://doi.org/10.1007/s10803-011-1399-2.
Spencer, D., Marshall, J., Post, B., Kulakodlu, M., Newschaffer, C., Dennen, T., Azocar, F., & Jain, A. (2013). Psychotropic medication use and polypharmacy in children with autism spectrum disorders. Pediatrics, 132(5), 833–840. https://doi.org/10.1542/peds.2012-3774.
Zonfrillo, M. R., Penn, J. V., & Leonard, H. L. (2005). Pediatric psychotropic polypharmacy. Psychiatry, 2(8), 14–19.
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This research involved human participants, and was approved by the Institutional Review Board at the site at which it was conducted. Informed consent was obtained from all participants.
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Chrystal Jansz Rieken is now at The Chicago School of Professional Psychology
Jacqueline Huscroft D’Angelo is now at The University of Nebraska- Lincoln
Tyler Re is now at The Chicago School of Professional Psychology
The authors would like to thank Wesley H. Dotson and Stacy L. Carter for their contributions.
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Rieken, C.J., Griffith, A.K., D’Angelo, J.H. et al. Psychotropic Medication Prescription for Autism: Data Sources for Decision Making. Adv Neurodev Disord 3, 1–7 (2019). https://doi.org/10.1007/s41252-018-0078-0
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DOI: https://doi.org/10.1007/s41252-018-0078-0