Behavioral Approaches to Managing Severe Problem Behaviors in Children with Autism Spectrum and Related Developmental Disorders

Doehring, Peter; Reichow, Brian; Palka, Tamara; Phillips, Cara; Hagopian, Louis P.

doi:10.1016/j.chc.2013.08.001

Cited by 71 publications

(39 citation statements)

References 38 publications

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“…This relates to the fact that the major focus of previous reviews has been on a wide range of problem behaviors displayed by children with ASD rather than on SIB alone. Specifically, the authors of the reviews listed previously discussed their findings within the context of a broad category of problem behaviors, including verbal and physical aggression, property destruction, tantrums, and stereotypies and the behavioral interventions used to address these behaviors in the school setting (Machalicek et al 2007), across multiple environments (Conroy et al 2005;Horner et al 2002), or for children and adolescents with ASD and related disorders (Doehring et al 2014).…”

Section: Introductionmentioning

confidence: 99%

Current Perspectives on Interventions for Self-Injurious Behavior of Children with Autism Spectrum Disorder: A Systematic Review of the Literature

et al. 2017

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Our purpose in this systematic review was to identify, evaluate, and summarize the single-case research design studies examining behavioral interventions to address self-injurious behavior for young children with autism spectrum disorder. We identified 24 studies published between 2000 and 2016 that met the inclusion criteria. We reviewed and coded each study across five content areas using systematic procedures. These content areas consisted of the methodological quality of single-case research designs, children's demographic information, conditions under which the intervention was implemented, characteristics of intervention, and outcomes. Our findings indicate that procedural integrity data were reported for only one study and social validity for two studies. The majority of studies were implemented by researchers or therapists in the school setting. For 24 of 30 children included in the studies reviewed, the authors taught a replacement behavior selected on the basis of an assessment conducted prior to intervention. All authors reported a decrease in the self-injurious behavior post-intervention. A limited number of authors examined generalization and maintenance of low rates of self-injurious behavior. Limitations of the present review and future directions and implications for research and practice are discussed.

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Section: Introductionmentioning

confidence: 99%

Current Perspectives on Interventions for Self-Injurious Behavior of Children with Autism Spectrum Disorder: A Systematic Review of the Literature

et al. 2017

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“…Recent reviews have found that behavioral interventions based on understanding of the function of I/ PB are highly effective in producing a consistent decrease in aggressive or self-injurious behavior in ASD. 49,51 Even without changing the response to the behavior itself, specific events and antecedents that commonly precede I/PB, such as unstructured times or transition from preferred to nonpreferred activity, can often be addressed by using environmental supports and introducing structure such as visual schedules or predictable routines. Additional detail on functional behavior analysis and treatment is provided at http:// www.…”

Section: Step 5d Assess and Address Any Maladaptive Reinforcement Pamentioning

confidence: 99%

“…This behavior might then become reinforced if the care provider gives the patient a break or redirects him to a different activity. Functional behavioral assessment of I/PB is designed to identify variables that occasion and maintain I/PB symptoms (as reviewed 4,[49][50][51] ). The most commonly reported behavioral functions for I/PB include access to attention, access to tangible rewards, escape from tasks or demands, and apparent sensory reinforcement (inferred when these behaviors occur across situations independent of consequences).…”

Section: Step 5d Assess and Address Any Maladaptive Reinforcement Pamentioning

confidence: 99%

Irritability and Problem Behavior in Autism Spectrum Disorder: A Practice Pathway for Pediatric Primary Care

McGuire

Fung

Hagopian³

et al. 2016

Pediatrics

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OBJECTIVE: Pediatric primary care providers (PCPs) caring for patients with autism spectrum disorder (ASD) often encounter irritability (vocal or motoric outbursts expressive of anger, frustration, or distress) and problem behavior (directed acts of aggression toward other people, self, or property). The Autism Intervention Research Network on Physical Health and Autism Speaks Autism Treatment Network charged a multidisciplinary workgroup with developing a practice pathway to assist PCPs in the evaluation and treatment of irritability and problem behavior (I/PB). METHODS:The workgroup reviewed the literature on the evaluation and treatment of contributory factors for I/PB in ASD. The workgroup then achieved consensus on the content and sequence of each step in the pathway. RESULTS:The practice pathway is designed to help the PCP generate individualized treatment plans based on contributing factors identified in each patient. These factors may include medical conditions, which the PCP is in a key position to address; functional communication challenges that can be addressed at school or at home; psychosocial stressors that may be ameliorated; inadvertent reinforcement of I/PB; and co-occurring psychiatric conditions that can be treated. The pathway provides guidance on psychotropic medication use, when indicated, within an individualized treatment plan. In addition to guidance on assessment, referral, and initial treatment, the pathway includes monitoring of treatment response and periodic reassessment. CONCLUSIONS:The pediatric PCP caring for the patient with ASD is in a unique position to help generate an individualized treatment plan that targets factors contributing to I/PB and to implement this plan in collaboration with parents, schools, and other providers. Dr McGuire contributed to the design of the practice pathway, played a leading role in drafting the initial manuscript, and revised the manuscript; Drs Fung, Hagopian, Vasa, Mahajan, Bernal, and Coury and Ms Silberman and Ms Wolfe contributed to the design of the practice pathway and reviewed and revised the manuscript; Drs Hardan and Veenstra-VanderWeele contributed to the conceptualization and design of the practice pathway and reviewed and revised the manuscript; Dr Whitaker played a leading role in conceptualizing and designing the practice pathway, drafted portions of the initial manuscript, and reviewed and revised the manuscript; and all authors approved the fi nal manuscript as submitted.

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“…Additional behaviours including self-injury and aggression can complicate integration into their school or community for children with ASD, placing additional stress on their families (Carroll et al 2014;Doehring et al, 2014). Though parents have reported feeling shock and grief on receiving a diagnosis of ASD for their child, receiving a diagnosis has also provided a sense of relief for some bringing acceptance and understanding of their child's particular difficulties (Mount and Dillon 2014).…”

Section: Introductionmentioning

confidence: 99%

Distress and Psychological Growth in Parenting an Adult Child with Autism Spectrum Disorder and Aggression

Swaab

McCormack

Campbell

2017

Adv Neurodev Disord

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Parenting an adult child with autism spectrum disorder (ASD) who has intermittent outbursts of aggression may expose parents and other family members to potential physical threat and psychological distress including chronic hypervigilance. However, no known studies have explored the 'lived' experience of parenting an adult child diagnosed with ASD who displays aggression. Therefore, this phenomenological study sought both negative and positive subjective interpretations of three parents of adult sons with ASD (aged between 20 and 30) displaying intermittent and unpredictable aggressive behaviours. Data was collected through semi-structured interviews, transcribed and analysed using interpretative phenomenological analysis (IPA). One main theme emerged: Complex parental distress and growth overarching six subordinate themes. Themes describe the psychological and emotional unpredictability that was relentless in daily life whilst parenting a child diagnosed with ASD complicated by outbursts of aggressive behaviour. Anticipation of potentially traumatic events was expressed as constant. The powerful emotions of frustration, empathy, pity and an intense need to protect the child with ASD who displays aggression were in contrast with felt stigma and societal criticism. In time, they developed their own pragmatic survival strategies for functioning as a family that could accommodate each family member's needs as much as possible. Psychological well-being became a balance of striving for personal psychological growth despite the constancy of anticipatory traumatic events. Future research and implications are discussed.

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Behavioral Approaches to Managing Severe Problem Behaviors in Children with Autism Spectrum and Related Developmental Disorders

Cited by 71 publications

References 38 publications

Current Perspectives on Interventions for Self-Injurious Behavior of Children with Autism Spectrum Disorder: A Systematic Review of the Literature

Current Perspectives on Interventions for Self-Injurious Behavior of Children with Autism Spectrum Disorder: A Systematic Review of the Literature

Irritability and Problem Behavior in Autism Spectrum Disorder: A Practice Pathway for Pediatric Primary Care

Distress and Psychological Growth in Parenting an Adult Child with Autism Spectrum Disorder and Aggression

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