How often are we given a new medication to “try out” and then when we attend a follow-up appointment, the doctor says, “How’s that medication working?” We say something like “Um, it seems to be helping?”
Unfortunately, we parents rarely collect objective behavioral data following medication changes. This is a concern not just for people diagnosed with autism, but everyone. How do we know a medication is helping? There are some simple things you can do to gain a better picture of the efficacy of medications.
Take some data! Wait, hear me out! I know that sentence can be overwhelming or even annoying. It does not have to be a complicated collection procedure that you then graph and follow up with a written summary. (Leave that to us behavior analyst nerds!)
How to measure
Simply make a note of the start date of a new medication. You can do this on a document in your computer, the notes on your phone, a piece of paper, etc. (An app that our iPad guru likes is called Birdhouse for Autism.) Decide (with the doctor) what behavior/symptom the medication is targeted to treat. And finally, decide how you could measure that (e.g., frequency, duration, intensity, amount, etc.). In some cases, it may be helpful to develop a simple scale (e.g., 1-5) that allows you or others – such as teachers from whom you need information about performance at school – to subjectively rate the severity of a behavior or symptom.
Looking to increase sleep or decrease drowsiness? Write down the duration of sleep (time falling asleep until wakeup time).
Want to decrease a problem behavior? First, objectively define the behavior (e.g., aggression = hitting, kicking, biting; self-injury = hitting with open hand or closed hand to head; irritability = crying, yelling, verbal refusals). Then, keep a record of the number of times your loved one engages in that specific behavior.
Looking to increase or decrease appetite? Note which foods were eaten that day, the number of times the person asked for food, and the amount of liquid intake.
Do you or your loved one have an as-needed (PRN) medication for intense behavior concerns? Keep a log of when this medication is administered and some of the details surrounding how it is administered. What happened right before the escalation of behavior? Who was there? Where did it occur? How long and/or how intense was the behavior? What happened right after the behavior?
Collect data often, at least daily. Try to write the data down in real time or as close to it as possible. Collect some data on behavior prior to starting the medication so you have a baseline for comparison.
Impress your doctor
Then prepare to “wow” the doctor with your objective data! You will be able to provide a much clearer answer, something like, “Yes, doc, since taking that medication, my child’s amount of sleep has increased by 2 hours each night.” If you have any further questions about data collection, graphing, analyzing, all things behavior analytic, ASNC’s Clinical Department is here for you!
Ryan Sayre, MA, LPC, BCBA, is a member of ASNC’s Clinical Department in the Wilmington region and can be reached at rsayre@autismsociety-nc.org.
ASNC’s Clinical Department staff is composed of PhD and master’s-level licensed psychologists, Board Certified Behavior Analysts, and former special education teachers. We provide individualized intensive consultation using evidence-based practices to support children and adults across the spectrum in home, school, employment, residential and other community-based contexts. We also deliver workshops to professionals on a wide range of topics including but not limited to, strategies to prevent and respond to challenging behaviors, best practices in early intervention, functional communication training, and evidence-based practices in instruction for K-12 students with autism.
To find out more, contact us at 919-390-7242 or clinical@autismsociety-nc.org.
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