Diagnostic-based pharmacological treatment of behavior disorders in persons with developmental disabilities: a review and a decision-making typology.

Sturmey (1995) looked at every earlier worry about giving strong mind drugs to people with developmental disabilities.

The author built a simple map: pick the drug only after you name the real behavioral diagnosis, not just the surface behavior.

The paper is a narrative review, so it tells the story of past mistakes and then hands the reader a decision checklist.

No new numbers were run. Instead, the review shows that most old prescriptions were written for ‘aggression’ or ‘self-injury’ without asking why the behavior happened.

The payoff is the typology: a one-page chart that links each behavioral diagnosis (for example, stereotypy linked to anxiety) to the drug class that actually fits that diagnosis.

Dall et al. (1997) took the 1995 idea and turned it into 21 international consensus reports. The field moved from ‘here is a good idea’ to ‘here is the agreed manual.’

Patton et al. (2020) gives a dark sequel: adults who entered crisis services while loaded with four or five psychotropics and showing tremors, drooling, and sedation. Their data say the 1995 typology is still not used enough.

Li et al. (2018) surveyed BCBAs and found the same gap: most supervise clients on these drugs but were never trained on how the drugs work or how to join the prescribing meeting. Together, the three papers show the typology was welcomed, then forgotten at the front line.

If you write behavior plans for people on psychotropic meds, pin the 1995 typology to your team board. Use it in the next interdisciplinary meeting: ask, ‘What is the behavioral diagnosis behind the aggression?’ Push for one drug that matches that diagnosis instead of a cocktail that only sedates. Your question can cut side effects and keep behavior analytic work in the lead.