Recognition and Treatment of Tardive Dyskinesia in Individuals with Intellectual Disability

Table 2

TD symptoms and daily functioning in ID individuals before and after treatment with valbenazine.

	TD symptoms/TD-related functional impairment^a
	Before valbenazine	After valbenazine (80 mg)
Case 1; (M, 63 yr)	(i) Constant tongue protrusion and intermittent chewing movements of jaw; severe drooling and difficulty swallowing; (ii) Excessive, pronounced eye blinking; (iii) Bilateral shoulder/hand/finger movement; (iv) Constant left foot tapping; (v) Instability during standing and ambulating; wheelchair assistance required, and caregiver assistance needed with some ADLs	(i) No tongue protrusion or chewing movements of jaw; able to close mouth; reduced drooling and improved swallowing; (ii) Reduced frequency and less pronounced eye blinking; (iii) Minimal shoulder/hand/finger movement; (iv) No foot tapping; (v) Improved stability during standing and ambulating; able to ambulate with walker, and less caregiver assistance needed with ADLs
Case 2; (F, 63 yr)	(i) Repetitive tongue thrusting; lip smacking; chewing movements of mouth/jaw; and unclear speech; (ii) Constant bilateral arm/hand/finger movements; (iii) Instability during ambulation; some wheelchair assistance required	(i) Minimal tongue thrusting and lip and mouth/jaw movements; clearer speech; (ii) Minimal arm/hand/finger movements; (iii) Improved stability during ambulation; less assistance required for some ADLs
Case 3; (M, 28 yr)	(i) Intermittent chewing movement of jaw; (ii) Constant bilateral arm/hand/finger movements; (iii) Repetitive bilateral foot tapping; (iv) Truncal rocking	(i) No jaw movements; (ii) Minimal to no arm/hand/finger movements; (iii) Minimal to no foot tapping; (iv) No truncal rocking
Case 4; (M, 61 yr)	(i) Intermittent tongue thrusting, chewing motion of jaw, and facial grimacing; (ii) Intermittent nodding/forward movement of head/neck; (iii) Frequent eye blinking; (iv) Constant bilateral hand movement	(i) No tongue thrusting or chewing motion of jaw, and minimal facial grimacing; (ii) Minimal head/neck movement; (iii) Normal eye blinking; (iv) No hand movement
Case 5; (M, 45 yr)	(i) Intermittent lip puckering, jaw movements and facial grimacing; unclear speech; (ii) Constant bilateral shoulder/hand/finger movement; (iii) Repetitive bilateral foot tapping; (iv) Truncal rocking; (v) Instability during ambulation; wheelchair assistance required, and caregiver assistance required for some ADLs	(i) Very minimal lip/jaw movements and no facial grimacing; clearer speech; (ii) Minimal shoulder/hand/finger movement; (iii) Minimal foot tapping; (iv) Minimal truncal rocking; (v) Improved stability during ambulation; able to ambulate independently with a cane, and less assistance required for ADLs

^aIn nonverbal or minimally verbal patients, based on caregiver reports and clinician observation during patient visits. Abbreviations: ADLs, activities of daily living; F, female; ID, intellectual disability; M, male; TD, tardive dyskinesia; yr, years.