Assessment and Treatment of Excessive Straightening and Destructive Behavior in an Adolescent Diagnosed With Autism

Abstract

Repetitive behaviors such as excessive straightening are commonly observed among individuals with autism. Attempts to prevent these behaviors may increase the likelihood of other problem behaviors. The present study was designed to assess and treat the excessive straightening and associated destructive behaviors of a 16-year-old boy who had been diagnosed with autism and moderate mental retardation. Following a series of functional analyses, an intervention that incorporated functional communication, extinction of destructive behavior, and blocking of repetitive straightening was demonstrated to be effective in reducing straightening and destructive behavior.

Assessment and Treatment of Obsessions and Compulsions in Individuals with Autism Spectrum Disorders: a Systematic Review

“…By identifying relevant consequences, their associated discriminative stimuli, and establishing operations that control OCD symptoms and alternate behavior, interventions may be developed to reduce those symptoms and increase functionally related alternate behavior (Sturmey 1996(Sturmey , 2007(Sturmey , 2009. Three studies identified consequences maintaining compulsive behavior in ASD (Hsu and Ho 2009;Kuhn et al 2009). …”

“…Kuhn et al (2009) conducted a functional analysis to determine the reinforcers maintaining aggressive behavior related to being blocked from throwing away nontrash items in a 16-year-old boy with autism. Aggression was followed by five contingent consequences presented in a multi-element design: toy play, social attention, tangible, demand, and ignore (Iwata et al 1982).…”

“…Low undifferentiated rates of aggression across were seen across all five conditions. Using an ABAB design, Kuhn et al (2009) then conducted a second functional analysis, with the same participant, which compared contingent access to throwing away nontrash items for aggressive behaviors to noncontingent access. They found that when blocked from placing nontrash items in the waste bin, aggression was more frequent when it produced contingent access to throwing away nontrash items compared with when access to throwing away nontrash items was available noncontingently.…”

“…There were seven case reports, four small N experiments, two uncontrolled group designs, and two RCTs treating anxiety in ASD including OCD symptoms. Thirteen studies evaluated interventions for children and adolescents (<18 years) (El-Ghoroury and Krackow 2011; Handen et al 1984;Kuhn et al 2009;Lehmkuhl et al 2008;Lindly et al 1977;Marchant et al 1974;Ooi et al 2008;Reaven and Hepburn 2003;Rodriguez et al 2012;Rooney et al 2011;Sze and Wood 2009;Sigafoos et al 2009;Sofronoff et al 2005;Wood et al 2009) and one evaluated treatment for adults (Russell et al 2008). Seven reported standardized ASD diagnostic assessments (Lehmkuhl et al 2008;Ooi et al 2008;Reaven and Hepburn 2003;Russell et al 2008;Sigafoos et al 2009;Sofronoff et al 2005;Sze and Wood 2009) and seven reported OCD diagnoses (El-Ghoroury and Krackow 2011; Lehmkuhl et al 2008;Reaven and Hepburn 2003;Rooney et al 2011;Russell et al 2008;Sze and Wood 2009;Wood et al 2009), of which three reported standardized diagnostic assessments (Rooney et al 2011;Sze and Wood 2009;Wood et al 2009).…”

“…Seven reported standardized ASD diagnostic assessments (Lehmkuhl et al 2008;Ooi et al 2008;Reaven and Hepburn 2003;Russell et al 2008;Sigafoos et al 2009;Sofronoff et al 2005;Sze and Wood 2009) and seven reported OCD diagnoses (El-Ghoroury and Krackow 2011; Lehmkuhl et al 2008;Reaven and Hepburn 2003;Rooney et al 2011;Russell et al 2008;Sze and Wood 2009;Wood et al 2009), of which three reported standardized diagnostic assessments (Rooney et al 2011;Sze and Wood 2009;Wood et al 2009). Of the eight remaining studies, three listed compulsions without operational definitions and five included operational definitions of compulsions (Handen et al 1984;Kuhn et al 2009;Lindly et al 1977;Rodriguez et al 2012;Sigafoos et al 2009). …”