4.21 MEASURES TO ASSESS OUTCOMES IN ROUTINE PSYCHOTROPIC MEDICATION TREATMENT OF YOUTH WITH AUTISM OR INTELLECTUAL DISABILITIES

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Objectives

Psychotropic medications are used frequently in populations of youth with intellectual disabilities (ID) and/or ASD who are demonstrating significant mental health problems. However, systematic outcome monitoring may not be routinely used during such treatment. This study aimed to identify psychometrically sound instruments that have been used frequently in clinical trials with youth with ID and/or ASD to identify candidate measures for outcome monitoring for routine practice.

Methods

Peer-reviewed articles of randomized controlled trials of psychotropic medications involving youth with ID and/or ASD were identified through a systematic review. Outcome measures of mental health problems in each study were identified, and articles reporting on their psychometric properties were summarized. The final list was restricted to English language measures that had at least one peer-reviewed report on psychometric properties.

Results

A total of 11 primary outcome measures were considered, with multiple additional measures identified as secondary. The irritability subscale of the Aberrant Behavior Checklist (ABC-I) was the most frequently used measure, followed by the Clinical Global Impression scales. Other frequently used instruments included other subscales of the ABC, the Nisonger Child Behavior Rating Form, and the Child Yale-Brown Obsessive Compulsive Scale. Data supporting acceptable psychometric properties were

Conclusions

The ABC-I may be a leading candidate measure that could be used in routine services that include medication treatment of youth with ID and/or ASD. Change scores from multiple studies using this instrument could facilitate benchmarking to help evaluate routine services. However, additional studies are required to further evaluate its sensitivity to capture change as a function of other interventions (i.e., nonmedication) and to identify what complementary measures best capture other dimensions.

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