The administration of psychotropic and anticonvulsant drugs to children with profound intellectual disability and multiple impairments.
Two-thirds of people with profound ID and multiple impairments are on psychoactive meds, with anticonvulsants prescribed to over half.
01Research in Context
What this study did
A 1992 UK survey asked doctors about children with profound intellectual disability and multiple medical problems.
The team wanted to know how many of these children take mind-altering or seizure drugs.
Parents and caregivers filled in forms listing every daily medicine.
What they found
Two out of three children were on at least one psychoactive drug.
Seizure medicines topped the list, used by more than half of the kids.
The survey gave the first clear picture of heavy medication use in this group.
How this fits with other research
Later studies keep showing high numbers. Scheifes et al. (2013) found nearly one in three institutionalized teens with mild ID on psychotropics.
Heald et al. (2020) moved the lens to adults, reporting 38% on polypharmacy.
Agiovlasitis et al. (2025) recently showed that brief staff training can cut antipsychotic doses in UK community adults, hinting that high use is not fixed.
Together the papers trace a 30-year arc: prevalence stays high, but newer work shows we can reduce doses with better support.
Why it matters
If you serve clients with profound ID, expect most to be on seizure or behavior meds. Use this fact in two ways. First, track side effects like drowsiness or irritability during sessions; small changes can signal drug problems. Second, share data with prescribers and families to prompt regular reviews. Your behavior data can justify tiny dose cuts, improving alertness without extra medication.
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02At a glance
03Original abstract
A national (England and Wales) postal survey of families with a son or daughter with profound intellectual disability and multiple physical and sensory impairments who lived at home was undertaken. A section of the questionnaire dealt with prescription of major tranquillizers, drugs with a sedative function, anticonvulsants and stimulants, while among other variables information was also collected on sex, age, behaviour problems, sleep difficulties and epilepsy. Of children and adults: 5.3 and 7.9%, respectively, were receiving major tranquillizers; 28.5 and 24.5%, respectively, were prescribed drugs with a sedative function; and 53.4 and 52.7% were in receipt of anticonvulsants, with no individuals in receipt of stimulants. Only 1.5% of the total sample received major tranquillizers, drugs with a sedative function and anticonvulsants, though 18.9% were prescribed drugs from two classes, notably drugs with a sedative function and anticonvulsants. In all, 66.3% of the combined child and adult samples received at least one drug from the classes investigated. No sex bias in prescribing was found. Receipt of major tranquillizers bore some relation to reported behaviour problems, while administration of sedatives and anticonvulsants were related respectively to reports of sleep problems and occurrence of epilepsy.
Journal of intellectual disability research : JIDR, 1992 · doi:10.1111/j.1365-2788.1992.tb00567.x