Title: How (Not What) to prescribe: Managing disruptive behaviors in individuals with neurodevelopmental disorders

Abstract

Disruptive behaviors (DBs) are a class of externalizing behaviors that include physical aggression, property destruction, temper outbursts, verbal aggression, and some forms of self-injurious behaviors. DBs are the most frequent reason for behavioral health referrals among individuals with neurodevelopmental disorders (NDDs), including children and adolescents. Unfortunately, the psychopharmacologic management of DBs in individuals with NDDs lacks a strong evidence base. One factor contributing to this short coming is that DBs are complex and poorly understood manifestations of numerous etiological pathways interacting with diverse environmental influences. Further, our current psychopharmacologic approaches frequently disregard the diversity of this patient cohort. Lastly, treatment studies do not address the heterogeneity of DBs in individuals with NDDs. This world of dueling heterogeneity partially explains why the evidence to support any given treatment is sparse. So how does the medical community compensate for the myriad complications in treatment and subsequently develop effective protocols for managing DBs? The answers lie with the best teachers in medicine: our patients. Our objective with this talk is to illustrate best practices for the management of DBs in individuals with NDDs using a case vignette. Audience members will leave with key principles of best prescribing practices and future directions for ongoing research in psychopharmacology for DBs.

Biography

Dr. Gabrielle Hodgins is a second-year Child and Adolescent Psychiatry Fellow at the University of North Carolina, where she graduated from general psychiatry residency in 2022. Dr. Hodgins graduated from The University of Miami Miller School of Medicine in 2018. While there, she co-founded The Debbie Project, a volunteer organization that partnered medical students with preschool classrooms for children with neurodevelopmental disorders. She subsequently conductedresearch examining the impacts of volunteering on biases towards persons with disabilities. Dr. Hodgins’passions for advocacy, patient care, and researchhave continued as a trainee at UNC. Dr. Hodgins graduated from the American Psychiatric Association’s Leadership Fellowship in 2022 and servedas a fellow representative onAPA’s Council for Advocacy and Government Relations from 2020-2022. She wasrecently awarded the American Academy of Child and Adolescent Psychiatry’s Pilot Research Award for Learning Disabilities, supported by AACAP’s Elaine Schlosser Lewis Fund, for ongoing psychopharmacology research.