Antipsychotic medication, psychiatric diagnosis and children with intellectual disability: a 12-year follow-up study.
Children with both intellectual disability and autism are more likely to be placed on antipsychotics, but the drugs do not erase challenging behavior.
01Research in Context
What this study did
The team tracked antipsychotic prescriptions for children with intellectual disability for 12 years.
They asked whether having an autism label changed the odds of getting these drugs.
What they found
Kids who had both ID and autism were more likely to receive antipsychotics during the 12-year window.
The study did not report dose sizes or behavior changes—only that the prescription link held steady.
How this fits with other research
Ono (1998) looked at the same year and same population. They found that residents already on antipsychotics showed worse challenging behavior and higher hyperactivity scores. Together the two papers paint a loop: autism predicts prescribing, yet the medicine does not erase behavior.
Heald et al. (2020) widened the lens to Australian adults. Over 16 years, psychotropic use rose from 43 % to 54 % and challenging behavior remained the top reason. The adult trend matches the child signal—once the prescription starts, it tends to continue.
Silverman et al. (1994) offers a safety footnote. When doctors kept doses inside British guidelines, movement side-effects looked no worse than in unmedicated peers. So proper monitoring can lower risk even when use is high.
Why it matters
You will meet many clients who take antipsychotics before you see a single behavior graph. These papers tell you the drug is often a response to diagnosis plus behavior, not a cure. Start by measuring the behavior yourself. Share clear data with the prescriber each quarter. Good numbers can justify dose cuts or safer switches.
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02At a glance
03Original abstract
This study is a follow-up to an original survey carried out in the early 1980s of all children with an identified intellectual disability in Cornwall, England. The purpose of this second study was to review the use of antipsychotic medication in these children and to relate it to their various diagnoses. This is a relatively under-researched area, and the few comparable studies in children have not been designed to specify diagnoses, psychiatric or otherwise. A positive relationship between the diagnosis of autistic spectrum disorders in children and the use of antipsychotic medication was one of the important findings which emerged from the research. The possible reasons for this association are discussed.
Journal of intellectual disability research : JIDR, 1998 · doi:10.1046/j.1365-2788.1998.00097.x