The challenging behavior of people with intellectual and developmental disabilities (IDD) represents a major obstacle to the habilitation of this population, as well as one of the most erosive components for caretakers working with this population. The controlled multi-sensory approach (Snoezelen), which includes an adapted multisensory environment and an enabling therapist, is becoming increasingly popular in healthcare facilities for individuals with IDD, and considered to enable positive changes in an array of maladaptive behaviors in this population. However, reliable scientific evidence of Snoezelen efficacy is as yet relatively limited, which could be attributed to the non-structured format of traditional Snoezelen intervention that does not lend itself easily to quantitative research approaches. The Snoezelen Therapeutic Intervention (STI) presented here is a structured representation of the Snoezelen treatment framework, which maintains the original characteristics of the Snoezelen experience, while allowing for structured and scientifically valid research. The present study participants included ten adults with severe to moderate IDD, who exhibited a variety of challenging behaviors. Single-subject design with washout periods revealed measurable reduction in challenging behaviors, observed through significant long-standing change in behavior throughout the patient's daily routine. The controlled multi-sensory approach was found to be a useful tool in dealing with severe behavioral problems for individuals with severe to moderate intellectual disabilities.
INTRODUCTIONChallenging behaviors, such as self mutilation, physical or verbal aggression, property destruction, inappropriate sexual behaviors, nutrient rejection, or deliberate urination and defecation, are apparent in 10% to 15% of people with intellectual and developmental disabilities (IDD) (1). Such behaviors represent a major obstacle to the habilitation of individuals with severe handicaps (2), might negatively influence the acceptance of individuals with IDD within society (3) and were found to be a major cause for re-institutionalization (5-7). Furthermore, such behaviors were found to be associated with high level tension, reduced work satisfaction, and enhancement of levels of anxiety and emotional exhaustion among caregivers and special education professionals working with this population (8-12). People with challenging behavior are at times congregated together on special wards or units, which may present problems of staff turnover and quality of care (13-16).