Interactions between behavior function and psychotropic medication.

The authors pulled 37 published cases where kids got both a functional analysis and a new psychotropic med. They re-examined the data to see if the drug changed the behavior's function.

The group was mixed: autism, ID, ADHD, and other diagnoses. All had severe problem behavior like SIB or aggression.

In 29 of the 37 cases the med lowered problem behavior but kept the same function. Escape, attention, or tangible control still drove the behavior, just less of it.

In 4 cases the function itself shifted. For example, escape-maintained SIB became attention-maintained. That means your old FCT plan could miss the mark.

Simó-Pinatella et al. (2013) showed that changing a motivating operation (like giving free attention) usually keeps the same function but alters strength. Spriggs et al. (2016) find the same pattern with meds: most of the time the function stays, only the volume drops.

Spackman et al. (2025) and Schieltz et al. (2022) ran telehealth FAs and got clean functions before starting FCT. Their success hinges on a stable function. D et al. warn that a new prescription could flip that function and wreck the treatment plan.

Hake et al. (1983) mixed Dexedrine with self-control training and saw added benefits. D et al. agree meds can help, but add a caution: rerun your FA after any dose change so your behavioral program still matches the real function.

Before you write a behavior plan, ask the family if meds have changed in the last month. If they have, run a brief re-analysis or at least probe the old conditions. A five-minute attention test could save you weeks of ineffective intervention.