Often times when we meet with parents to discuss their child’s behavior one of the topics that is touched upon is what medications they may be taking in order to help treat the behaviors. While we are behavior analysts, not psychiatrists or doctors, and do not make specific recommendations about starting, stopping, or changing medications, we do try to account for them and how their modifications paired with behavioral interventions may be affecting the behaviors we are tracking.
When we ask parents if they feel the medication has made any difference a common response is that they are unsure. One reason may be that multiple medications were introduced at once so if the parent does notice a difference, they may not be sure which of the medications has made the difference. Also, many medications may take 4-6 weeks to have an effect so the parent may feel they have to wait longer to judge it. Also, often times the medication may be started at a low dose initially to assess tolerance, which may not show a therapeutic effect.
When we look at starting a behavioral intervention, we may not be sure if the medication is helping to reduce the behaviors, or if it is dosed correctly. There may also be adverse side effects the parent may not be aware of that could be making the child more uncomfortable and in turn increasing the behaviors. Since many of the children who receive these medications have communication deficits, they are not always able to effectively communicate any adverse effects they may be experiencing.
As behavior analysts an important technique we employ is always going to be tracking antecedents and consequences in order to determine function of behavior; however we still want to account for other variables such as medication and medication changes. So how do we do this and how can parents also use the same methods at home?
The most effective way to know how variables are affecting behavior is to take data. At our clinics, when we are made aware of a change we introduce a phase change line into the data. This line lets us know of a change in conditions and gives us a quick visual way to track how such a change is going to have an effect on the behavior if any.
We can see in this hypothetical data that Medication A & B plus the behavioral intervention is having the most effect in this case. You would also want to track the dosage of medication being used. Parents at home would have to take data, a frequency count in this case and then note the dates of medication changes. While taking data at home for parents is often difficult, given everything else going on in their life, it is the most effective and accurate way to know how these changes are truly impacting behavior.
While these are some guidelines on how to track medication variables in relation to behavior, there are other ways to ensure that your individual child is getting the most effective interventions. If you have any questions or are interested in services in order to help with this process, please leave a comment or contact Behavioral Consulting of Tampa Bay at 813-814-2000.