Assessment & Research

Risk factors for tardive dyskinesia in adults with intellectual disability, comorbid psychopathology, and long-term psychotropic use.

Matson et al. (2010) · Research in developmental disabilities 2010
★ The Verdict

Use the quick MEDS scale to catch tardive dyskinesia early in adults with ID on chronic antipsychotics.

✓ Read this if BCBAs who coordinate medical reviews for adults with ID in residential or day programs.
✗ Skip if Clinicians serving only children or clients off antipsychotics.

01Research in Context

01

What this study did

The team screened adults with intellectual disability who had taken antipsychotic drugs for years. They used the MEDS scale to spot early signs of tardive dyskinesia, a jerky movement side-effect.

All residents lived in state-run homes. Charts showed each person’s drug dose, health history, and psych diagnoses.

02

What they found

Longer drug use and higher daily dose raised the risk of tardive dyskinesia. People with more severe ID showed stronger early signs.

The MEDS scale caught cases that nurses had missed during routine care.

03

How this fits with other research

de Kuijper et al. (2013) studied the same group three years later. They found that high dose also predicts parkinsonism and weight gain, not just dyskinesia. Together the two papers show dose matters for many side-effects.

Simpson et al. (2001) saw that antipsychotic use hikes injury risk. L et al. now add that the same drugs quietly damage movement control. The drug links both harms.

No clash appears: every study flags antipsychotics as a red flag in adults with ID, just for different outcomes.

04

Why it matters

You can run the five-minute MEDS screen during annual reviews. If score rises, ask the doctor to taper or switch before jerks become permanent. Lower dose helps weight, falls, and movement alike—triple win.

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Add MEDS items to your monthly data sheet and flag any rising score for the prescribing doctor.

02At a glance

Intervention
not applicable
Design
other
Population
intellectual disability, developmental delay
Finding
not reported

03Original abstract

Psychotropic medications are commonly used as an adjunct treatment in large-scale residential care facilities for adults with developmental disabilities. While the benefits of medication are noted, there are very severe conditions that can result from long term medication use. Tardive dyskinesia (TD) manifests as a variety of involuntary, repetitive movements caused by a history of neuroleptic medication use. Due to the serious nature of this disorder, it is necessary to find predisposing factors for TD in a population of adults with intellectual and developmental disabilities. The current study seeks to expand the literature related to TD utilizing a measure of medication side effects, the Matson evaluation of drug side effects (MEDS). Results and implications for assessment and practice are discussed.

Research in developmental disabilities, 2010 · doi:10.1016/j.ridd.2009.08.002