SLPCase SeriesDevelopmental neurorehabilitation2022

Descriptive Longitudinal Analysis of Stereotypy and Corresponding Changes in Psychotropic Medication.

Drew Piersma, Marisela Aguilar, Haley Seibert and 3 others

PMID 34865596

WHAT IT FOUND

In three adults with ASD and intellectual disability, body rocking, air holding, and grunting did not change predictably when psychotropic medications were adjusted.

Some changes occurred, but they were inconsistent, so medication changes cannot be assumed to reduce stereotypy.

Key findings

01In three participants, weekly home observations showed variable stereotypy, but there were no significant overall increases or decreases over time.

02Across medication-regimen comparisons, some stereotypy changes were significant and some were not.

03In the functional analyses, stereotypy in control and ignore conditions sometimes tracked weekly home observations and sometimes did not.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

Only three participants were studied, and they were selected because they already showed stereotypy. All participants were taking multiple psychotropic medications at the same time. The treatment team, not the researchers, decided medication changes, so the study did not control which medication changed or when. The stereotypy topographies differed across participants: body rocking was gross motor, while air holding and grunting were more subtle. Functional analyses were designed for challenging behavior, and consequences were not delivered for stereotypy. The authors could not determine whether medication changed the automatic reinforcement maintaining stereotypy.

The easy way to misread this

Do not conclude that changing psychotropic medication reliably reduces stereotypy. This involved three participants only, all were taking multiple medications at once, and the authors state that any medication influence was not predictable or consistent.

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