Interprofessional Roles to Support Psychotropic Medication Prescribing for ASD

  • Cody A. HostutlerEmail author
  • Jeffrey D. Shahidullah
  • Rebecca A. Baum
  • Brigid K. Groves


While developmental and behavioral interventions are the primary treatment methods for youth with ASD, psychotropic medications are often prescribed by psychiatrists, developmental-behavioral pediatricians, and sometimes primary care clinicians (PCCs) to manage co-occurring disorders and symptoms. To maximize the effectiveness of these medications, collaborations across family, medical, community, and school systems are needed. However, there are numerous barriers unique to interprofessional collaboration around psychotropic prescribing for children with ASD. As such, this chapter aims to discuss these unique barriers, outline models of interprofessional care, and describe specific interprofessional and collaborative roles between prescribers and non-prescribers to support effective psychotropic management for children with ASD.


Pediatrics Autism spectrum disorder Neurodevelopmental Autism Management Treatment Interdisciplinary Psychotropic Psychotropic medication Psychopharmacology Pharmacology Medication 


  1. Al-Haidar, F. A. (2008). Parental attitudes toward the prescription of psychotropic medications for their children. Journal of Family and Community Medicine, 15, 35–42.PubMedGoogle Scholar
  2. Aman, M. G., Farmer, C. A., Hollway, J., & Arnold, L. E. (2008). Treatment of inattention, overactivity, and impulsiveness in autism spectrum disorders. Child and Adolescent Psychiatric Clinics of North America, 17, 713–738.CrossRefGoogle Scholar
  3. American Pharmacists Association and the National Association of Chain Drug Stores Foundation. (2008). Medication therapy management in pharmacy practice: core elements of an MTM service model (version 2.0). Journal of the American Pharmacists Association, 48, 341–353.Google Scholar
  4. Brachlow, A. E., Ness, K. K., McPheeters, M. L., & Gurney, J. G. (2007). Comparison of indicators for a primary care medical home between children with autism or asthma and other special health care needs: National Survey of Children’s Health. Archives of Pediatrics and Adolescent Medicine, 161(4), 399–405.CrossRefGoogle Scholar
  5. Carbone, P., Behl, D., Azor, V., & Murphy, N. (2010). The medical home for children with autism spectrum disorders: Parent and pediatrician perspectives. Journal of Autism and Developmental Disorders, 40(3), 317–324.CrossRefGoogle Scholar
  6. Carbone, P., Murphy, N., Norlin, C., Azor, V., Sheng, X., & Young, P. (2013). Parent and pediatrician perspectives regarding the primary care of children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 43, 964–972.CrossRefGoogle Scholar
  7. DuPaul G. J., & Franklin M. K. (2019). Legal, Ethical, and Professional Issues Related to Use of Psychotropic Medications in School-Aged Populations. In J. Carlson & J. Barterian (Eds.), School psychopharmacology. Pediatric school psychology. Cham: Springer.Google Scholar
  8. Frazier, T. W., Shattuck, P. T., Narendorf, S. C., Cooper, B. P., Wagner, M., & Spitznagel, E. L. (2011). Prevalence and correlates of psychotropic medication use in adolescents with an autism spectrum disorder with and without caregiver-reported attention-deficit/hyperactivity disorder. Journal of Child and Adolescent Psychopharmacology, 21(6), 571–579.CrossRefGoogle Scholar
  9. Gureasko-Moore, D., DuPaul, G. J., & Power, T. J. (2005). Stimulant treatment for ADHD: Medication monitoring practices of school psychologists. School Psychology Review, 34, 232–245.Google Scholar
  10. Health Resources and Services Administration/National Center for Health Workforce Analysis; Substance Abuse and Mental Health Services Administration/Office of Policy, Planning, and Innovation. (2015). National Projections of Supply and Demand for Behavioral Health Practitioners: 2013–2025. Rockville, Maryland. Retrieved from
  11. Heneghan, A., Garner, A. S., Storfer-Isser, A., Kortepeter, K., Stein, R. E., & Horwitz, S. M. (2008). Pediatricians’ role in providing mental health care for children and adolescents: Do pediatricians and child and adolescent psychiatrists agree? Journal of Developmental and Behavioral Pediatrics, 29, 262–269.CrossRefGoogle Scholar
  12. Herman, K. C., Cho, E., Marriott, B. R., & Walker, L. Y. (2018). Bridging the gap in psychiatric care for children with a school-based psychiatry program. School Mental Health, 10(2), 181–189.CrossRefGoogle Scholar
  13. Individuals with Disabilities Education Act. (2004). 20 U.S.C. § 1400.Google Scholar
  14. Joint Commission of Pharmacy Practitioners. (2014). Pharmacists’ patient care process. Accessed 26 Jan 2020.
  15. Katon, W., Von Korff, M., Lin, E., Walker, E., Simon, G. E., Bush, T., … & Russo, J. (1995). Collaborative management to achieve treatment guidelines: impact on depression in primary care. JAMA, 273(13), 1026–1031.Google Scholar
  16. Koegel, L. K., Krasno, A. M., Taras, H., Koegel, R. L., & Frea, W. (2013). Is medication information for children with autism spectrum disorder monitored and coordinated across professionals? findings from a teacher survey. School Mental Health, 5(1), 48–57.CrossRefGoogle Scholar
  17. Kogan, M. D., Strickland, B. B., Blumberg, S. J., Singh, G. K., Perrin, J. M., & van Dyck, P. C. (2008). A national profile of the health care experiences and family impact of autism spectrum disorder among children in the United States, 2005–2006. Pediatrics, 122(6), e1149–e1158.CrossRefGoogle Scholar
  18. Kozminski, M., Busby, R., McGivney, M. S., Klatt, P. M., Hackett, S. R., & Merenstein, J. H. (2011). Pharmacist integration into the medical-home: Qualitative analysis. Journal of the American Pharmacists Association, 51(2), 173–183.CrossRefGoogle Scholar
  19. Kirsch, A. C., Huebner, A. R. S., Mehta, S. Q., Howie, F. R., Weaver, A. L., Myers, S. M., ….& Katusic, S. K. (2020). Association of comorbid mood and anxiety disorders with autism spectrum disorder. JAMA Pediatrics, 174, 63–70.Google Scholar
  20. Logan, S. L., Nicholas, J. S., Carpenter, L. A., King, L. B., Garrett-Mayer, E., & Charles, J. M. (2012). High prescription drug use and associated costs among Medicaid-eligible children with autism spectrum disorders identified by a population-based surveillance network. Annals of Epidemiology, 22(1), 1–8.CrossRefGoogle Scholar
  21. Madden, J. M., Lakoma, M. D., Lynch, F. L., Rusinak, D., Owen-Smith, A. A., Coleman, K. J., … & Croen, L. A. (2018). Psychotropic medication use among insured children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 47, 144–154.Google Scholar
  22. Mazurek, M. O., Brown, R., Curran, A., & Sohl, K. (2017). ECHO autism: A new model for training primary care providers in best-practice care for children with autism. Clinical Pediatrics, 56(3), 247–256.CrossRefGoogle Scholar
  23. Meadows, T., Valleley, R., Haack, M. K., Thorson, R., & Evans, J. (2011). Physician “costs” in providing behavioral health in primary care. Clinical Pediatrics, 50, 447–455.CrossRefGoogle Scholar
  24. Myers, S. M., & Johnson, C. P. (2007). Management of children with autism spectrum disorders. Pediatrics, 120(5), 1162–1182.CrossRefGoogle Scholar
  25. Njoroge, W. F., Hostutler, C. A., Schwartz, B. S., & Mautone, J. A. (2016). Integrated behavioral health in pediatric primary care. Current Psychiatry Reports, 18(12), 106.CrossRefGoogle Scholar
  26. Plax, K., & Garwood, S. (2018). Integrating Behavioral Health into a School Based Health Center. Pediatrics, 141(1 MeetingAbstract), 187–187.
  27. Polaha, J., Dalton, W. T., & Allen, S. (2011). The prevalence of emotional and behavior problems in pediatric care serving rural children. Journal of Pediatric Psychology, 36, 652–660.CrossRefGoogle Scholar
  28. Power, T. J., DuPaul, G. J., Shapiro, E. S., & Kazak, A. E. (2003). Promoting children’s health: Integrating health, school, family, and community systems. Guilford.Google Scholar
  29. Power, T. J., Michel, J., Mayne, S., Miller, J., Blum, N. J., Grundmeier, R. W., … & Fiks, A. G. (2016). Coordinating systems of care using health information technology: Development of the ADHD care assistant. Advances in School Mental Health Promotion, 9(3–4), 201–218.Google Scholar
  30. Riley, A. R., Paternostro, J. K., Walker, B. L., & Wagner, D. V. (2019). The impact of behavioral health consultations on medical encounter duration in pediatric primary care: A retrospective match-controlled study. Families, Systems, & Health, 37(2), 162.CrossRefGoogle Scholar
  31. Ryan, J. B., Katsiyannis, A., Losinski, M., Reid, R., & Ellis, C. (2014). Review of state medication policies/guidelines regarding psychotropic medications in public schools. Journal of Child and Family Studies, 23(4), 704–715.
  32. Sarvet, B., Gold, J., Bostic, J. Q., Masek, B. J., Prince, J. B., Jeffers-Terry, M., et al. (2010). Improving access to mental health care for children: The Massachusetts Child Psychiatry Access Project. Pediatrics, 126, 1191–1200.CrossRefGoogle Scholar
  33. Santosh, P. J., Bell, L., Fiori, F., & Singh, J. (2017). Pediatric antipsychotic use and outcomes monitoring. Journal of Child and Adolescent Psychopharmacology, 27(6), 546–554.CrossRefGoogle Scholar
  34. Scott, M. A., Hitch, B., Ray, L., & Colvin, G. (2011). Integration of pharmacists into a patient-centered medical home. Journal of the American Pharmacists Association, 51(2), 161–166.CrossRefGoogle Scholar
  35. Section 504 of the Rehabilitation Act of 1973, 34. C.F.R. Part 104.Google Scholar
  36. Shahidullah, J. D., & Carlson, J. S. (2014). Survey of Nationally Certified School Psychologists’ roles and training in psychopharmacology. Psychology in the Schools, 51, 705–721.CrossRefGoogle Scholar
  37. Shahidullah, J., Hostutler, C. A., & Stancin, T. (2018a). Collaborative medication-related roles for pediatric primary care psychologists. Clinical Practice in Pediatric Psychology, 6(1), 61–72.CrossRefGoogle Scholar
  38. Shahidullah, J. D., Kettlewell, P. W., Palejwala, M. H., Forman, S. G., Billups, A., Anismatta, S. L., et al. (2018b). Behavioral health training in pediatric residency programs: a national survey of training directors. Journal of Developmental and Behavioral Pediatrics, 39(4), 292–302.CrossRefGoogle Scholar
  39. Shahidullah, J. D., Hostutler, C. A., & Forman, S. G. (2019). Ethical considerations in medication-related roles for pediatric primary care psychologists. Clinical Practice in Pediatric Psychology, 7(4), 405.CrossRefGoogle Scholar
  40. Sharma, V., Stranieri, A., Burstein, F., Warren, J., Daly, S., Patterson, L., … & Wolff, A. (2016). Group decision making in health care: A case study of multidisciplinary meetings. Journal of Decision Systems, 25(sup1), 476–485.Google Scholar
  41. Shaw, S. R., Glaser, S. E., & Ouimet, T. (2011). Developing the medical liaison role in school settings. Journal of Educational and Psychological Consultation, 21, 106–117.CrossRefGoogle Scholar
  42. Sohl, K., Mazurek, M. O., & Brown, R. (2017). ECHO autism: Using technology and mentorship to bridge gaps, increase access to care, and bring best practice autism care to primary care. Clinical Pediatrics, 56, 509–511.CrossRefGoogle Scholar
  43. Smyer, M. A., Balster, R. L., Egli, D., Johnson, D. L., Kilbey, M. M., Leith, N. J., et al. (1993). Summary of the report of the ad hoc task force on psychopharmacology of the American Psychological Association. Professional Psychology: Research and Practice, 2, 394–403.CrossRefGoogle Scholar
  44. Straus, J. H., & Sarvet, B. (2014). Behavioral health care for children: The Massachusetts Child Psychiatry Access Project. Health Affairs, 33, 2153–2161.CrossRefGoogle Scholar
  45. Strunk, J. A. (2009). School nurses’ knowledge of autism spectrum disorders. The Journal of School Nursing, 25(6), 445–452.CrossRefGoogle Scholar
  46. Swiezy, N., Stuart, M., & Korzekwa, P. (2008). Bridging for success in autism: Training and collaboration across medical, educational, and community systems. Child and Adolescent Psychiatric Clinics of North America, 17(4), 907–922.CrossRefGoogle Scholar
  47. Towbin, K. E. (2003). Strategies for pharmacologic treatment of high functioning autism and Asperger syndrome. Child and Adolescent Psychiatric Clinics of North America, 12, 23–45.CrossRefGoogle Scholar
  48. Van Cleave, J., Holifield, C., Neumeyer, A. M., Perrin, J. M., Powers, E., Van, L., et al. (2018). Expanding the capacity of primary care to treat co-morbidities in children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 48(12), 4222–4230.CrossRefGoogle Scholar
  49. Wegner, S. E., Humble, C. G., Feaganes, J., & Stiles, A. D. (2008). Estimated savings from paid telephone consultations between subspecialists and primary care physicians. Pediatrics, 122, e1136–e1140.CrossRefGoogle Scholar
  50. Wongpakaran, R., Suansanae, T., Tan-khum, T., Kraivichian, C., Ongarjsakulman, R., & Suthisisang, C. (2017). Impact of providing psychiatry specialty pharmacist intervention on reducing drug-related problems among children with autism spectrum disorder related to disruptive behavioural symptoms: A prospective randomized open-label study. Journal of Clinical Pharmacy and Therapeutics, 42(3), 329–336.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Cody A. Hostutler
    • 1
    • 2
    Email author
  • Jeffrey D. Shahidullah
    • 3
  • Rebecca A. Baum
    • 2
    • 4
  • Brigid K. Groves
    • 5
  1. 1.Pediatric Psychology and NeuropsychologyColumbusUSA
  2. 2.Department of PediatricsThe Ohio State University College of MedicineColumbusUSA
  3. 3.Department of PsychiatryUniversity of Texas at Austin Dell Medical SchoolAustinUSA
  4. 4.Department of Developmental Behavioral PediatricsColumbusUSA
  5. 5.Department of PharmacyColumbusUSA

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