Using the Diagnostic Assessment of the Severely Handicapped-II (DASH-II) to measure the therapeutic effects of risperidone.
The DASH-II can’t feel risperidone’s effects, so swap it out for the ABC-C when you track behavior in adults with ID.
01Research in Context
What this study did
Researchers gave adults with intellectual disability six months of risperidone. They tracked behavior with two tools: the DASH-II and the ABC-C.
They wanted to see if both scales caught the drug’s effect. A scale that misses change is useless for clinic work.
What they found
At baseline the two scales matched. After six months they did not. The ABC-C picked up shifts; the DASH-II stayed flat.
The team ruled the DASH-II too dull for drug monitoring.
How this fits with other research
Eisenhower et al. (2006) tell a brighter drug story. In their mixed-age group, low-dose risperidone cut irritability at least in half for half the people. The difference: they used an irritability sub-scale, not the DASH-II.
Lennox et al. (2005) zoom out. Their review says the whole risperidone picture for people with ID is still blurry. They include the present study as one weak brick in a shaky wall.
Lancioni et al. (2000) warned us first. When they set up autism drug trials, they had to toss standard tools and build kid-friendly ones. The present paper shows why: old checklists miss change.
Why it matters
If you monitor meds for adults with ID, pick the ABC-C or another scale that has shown change before. Drop the DASH-II for this job. Your data will be sharper and your team can dose or fade the drug with confidence.
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02At a glance
03Original abstract
BACKGROUND: Within the scope of a double-blind, placebo-controlled, crossover medication study, the Diagnostic Assessment of the Severely Handicapped-II (DASH-II) was evaluated as a measurement for determining the effectiveness of the medication risperidone in treating the problem behaviour of 21 people with intellectual disabilities (ID). METHOD: Participants' caregivers completed the DASH-II during the placebo/baseline phase of the study and the maintenance phase of the study, and completed the Aberrant Behavior Checklist - Community (ABC-C) weekly throughout the entire study. The results obtained using the DASH-II were compared to those obtained using the ABC-C, an instrument shown to be well correlated with the DASH-II. RESULTS: Results suggest that while the DASH-II and the ABC-C were well correlated during the placebo/baseline phase of the current study, they were not well correlated at completion of the 6-month maintenance phase of the medication trial. CONCLUSION: The DASH-II, while appropriate for assisting in the diagnosis of psychopathology in people with ID, does not appear to monitor changes in problem behaviour as a result of risperidone use as well as the ABC-C. Differences in the frequency of problem behaviour that each measure evaluated and the applicability of using the DASH-II to measure medication effects on problem behaviour are discussed.
Journal of intellectual disability research : JIDR, 2004 · doi:10.1111/j.1365-2788.2004.00583.x