Purpose The purpose of this study is to critically analyse the current research around the impact of management strategies on challenging behaviour in autism. Design/methodology/approach Mixed method analysis. Findings Seven studies were included for discussion. The author found significant heterogeneity in the outcome measures of all the studies and was unable to provide a meta-analysis. The results showed that psychosocial interventions offer the most promise in terms of safety and efficacy. The author was unable to explain what part of their intervention had the most significant effect. Antipsychotic interventions demonstrated the most robust methodologies and therefore, the results are more reliable. Research limitations/implications These studies provide valuable evidence for UK guidelines and suggest that lower doses of medication do not have a therapeutic effect on patients. Furthermore, these studies do not use psychosocial interventions alongside medication reduction, which may have proven valuable to help the author’s understanding of the different management strategies for treating challenging behaviour in autism. Thus, this literature review recommends further studies in the reduction of medication alongside psychosocial interventions with a larger number of participants recruited from a diverse range of backgrounds. Practical implications Gerrard et al. (2019) hope that positive behavioural support will become standard practice for specialist teams following the results of their findings and conclude that in the absence of effective management strategies, there is a greater likelihood of the re-introduction of medication. Admittedly, they do not understand what components of their intervention had the greatest significance on the results and identify this as a limitation of the study. In the single case study by Lee, Rhodes and Gerrard (2019), they claim that medication reduction and discontinuation can be successful if the rate of titration reduction is slowed down. This may offer some insight into the success of the strategy by Gerrard et al. (2019). Social implications Bishop-Fitzpatrick et al. (2013) state that the researchers in their systematic reviews used “creative techniques” to address the core deficits of autism (p. 7). It can be argued that psychosocial interventions are highly individualized, making them difficult to implement in practice and are ungeneralizable. For this purpose, the reduction of medication cannot be implemented consistently as it is not clear what strategies are effective. Originality/value This is the author’s own work, and to the best of the author’s knowledge, it does not infringe upon anyone’s copyright and that any ideas, techniques or any other material are fully acknowledged in accordance with the Harvard referencing guidelines.
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