hi I'm Samantha sarin a board certified behavior analyst with Brett DiNovio and
associates and we're going to be talking about ethical considerations for
interdisciplinary collaboration with prescribing professionals regardless of
how long you've been working in the field as a behavior analyst chances are
that you've probably worked with a client that's prescribed psychiatric
medications various studies indicate that the percentage of individuals with
autism who are prescribed psychiatric medications is around 29 to 34 percent
in other words one out of every three learners that we work with is probably
taking a psychiatric medication one of the reasons that this collaboration with
prescribing professionals is so important is because we have to consider
medication as of course an intervention and we know that anytime we introduce or
modify or discontinue an intervention that it's important to consider how that
intervention can potentially affect other interventions that are already in
place so if we're looking at adding a medication how does that impact what
else we're doing with with overall programming or if we're looking at
changing or discontinuing a medication we have to ask the same kind of question
and that's it's important to have those kinds of discussions with the
prescribing professional so that we're able to better isolate which
intervention is having potentially which effect with that said let's talk about
our role as behavior analysts when collaborating with prescribing
professionals I'm going to provide three tips for successful collaboration first
one is to educate yourself understand that medications are prescribed for
symptoms not secure condition in other words a medication may be prescribed to
help manage irritability due to autism not to cure autism or a medication may
be prescribed to help to increase ability to focus not secure attention
deficit hyperactivity disorder the FDA currently only has two approved
antipsychotics that are prescribed for the treatment of the symptom of
irritability associated with autism so familiarize yourself with common classes
of medications such as sleep medications it's like Oh stimulants antipsychotics
and antidepressants as those classes are the most commonly prescribed for our
individuals with autism also if you're able to learn some of the expectant
associated side-effects this can be especially useful when it comes to how
we may be able to help as far as monitoring a symptom or taking data on a
targeted behavior once a medication is prescribed or changed moving forward
alright tip to seek the expertise of a prescribing professional from 3.02
medical consultation and the BAC B's professional and ethical Compliance code
for behavior analysts behavior analysts recommend seeking a medical consultation
if there is any reasonable possibility that our fir'd behavior is influenced by
medical or biological variables in other words we might look for the expertise of
a psychiatrist when we've identified that a challenging behavior has an
automatic function since this would indicate that something internally
regulated is reinforcing that challenging behavior and the third tip
stay in your lane so from 1.02 boundaries of competence in the BAC be
professional and ethical compliance code for behavior analysts all behavior
analysts provide services teach and conduct research only within the
boundaries of their competence defined as being commensurate with their
education training and supervised experience basically this means that
paver analysts collaborating with prescribing professionals are not doing
things like suggesting which medication be prescribed that would be far beyond
our scope of competence but what we can absolutely do is offer
to take data on a targeted behavior or symptom or even on a particular
side-effect and we can of course summarize and present that data in a
concise and meaningful way there's not a lot of research on the direct comparison
of using only medication versus only APA versus the combination of both there are
studies that compare medications to placebos to cognitive behavioral therapy
and then to the combination because cognitive behavioral therapy or CBT
often contains components of ABA we should consider this research what those
studies show is that participants usually have the greatest effects from
combination treatments meaning both medication and CBT in the in the
earliest stages of treatment those differences sort of taper off the
further that treatment continues we're no longer that treatment continues so
that there's not really significant differences noted in later stages of
treatment if we're going to look at studies that look at only medication for
autism there is some evidence for risperidone and era papers all
decreasing challenging and repetitive behaviors associated with autism those
are just two psychiatric medications and we're talking about behavior reduction
in contrast we know there's a wide body of research supporting sustained
improvements for symptoms of autism using applied behavior analysis as the
treatment and with ABA we're of course talking about targeting behavior
reduction but also skill acquisition if you'd like to hear more on other
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