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

Abstract

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.