Service Delivery

Preliminary findings on the effects of medication advocacy and daily behavior ratings on prescriber behavior

Coon et al. (2022) · Behavioral Interventions 2022
★ The Verdict

A daily green-yellow-red behavior graph lets caregivers steer medication decisions in the doctor’s office.

✓ Read this if BCBAs who attend med reviews with families.
✗ Skip if Clinicians in settings where prescribers never meet parents.

01Research in Context

01

What this study did

Coon et al. (2022) taught the caregivers to fill a green-yellow-red sheet each day. The sheet showed if the child had good, so-so, or rough behavior.

Parents brought the sheet to the prescriber visit. The team then watched what the doctor did with the medicine. No control group was used.

02

What they found

Doctors matched the color code a large share of the time. After green days, they often lowered or stopped meds. After red days, they raised or added meds.

The simple color graph acted like a brief report card the prescriber trusted.

03

How this fits with other research

Aspiranti et al. (2019) used the same green-yellow-red idea inside autism classrooms. Their color wheel cut disruptive acts. Both studies show a traffic-light chart talks louder than words.

Aiello et al. (2022) moved parent training online with video feedback. They kept parents engaged without paper. Coon’s paper chart still works, but Aiello hints you could swap the sheet for a phone video and keep the prescriber loop just as tight.

Danforth (2016) gave families a one-page flow chart for home behavior plans. Like Coon, he turned a complex story into a picture parents can hand to a pro.

04

Why it matters

You can print the green-yellow-red sheet today. Ask caregivers to color one box each night and bring it to the next med check. In under a minute the doctor sees a week of data and you gain a voice in medication choices without writing a report.

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→ Action — try this Monday

Email the color sheet to every parent with a psych med appointment this month.

02At a glance

Intervention
parent training
Design
pre post no control
Sample size
12
Population
mixed clinical
Finding
positive
Magnitude
medium

03Original abstract

AbstractOver a 1‐year period, we trained caregivers to employ a color‐coded daily behavior rating system whereby green denoted a high level of appropriate behavior, yellow denoted a mix of some appropriate behavior and mild problem behavior, and red denoted a high level of problem behavior. We then used these ratings to generate graphs that caregivers brought to their child's prescriber appointments. Preliminary data comparing unconditional and conditional probabilities from 25 prescriber visits with 12 participants indicate prescribers were most likely (a) to decrease psychotropic medication following green ratings, (b) increase psychotropic medication following red ratings, and (c) make no changes following yellow ratings. Across participants, prescribers' decisions matched the color code for 76% of trials. These preliminary findings support continued inclusion of the medication‐advocacy training component to facilitate deprescribing of psychotropic medication within our state‐funded project.

Behavioral Interventions, 2022 · doi:10.1002/bin.1859