Melissa L. González

The Behavioral Treatment of an 11-Year-Old Girl With Autism and Aggressive Behaviors

The authors describe the assessment and treatment of an 11-year-old girl who presented with autism and aggressive behaviors. Based on a functional analysis and review of relevant literature, differential reinforcement of other behaviors (DRO), compliance training, extinction, and functional communication were used as the primary intervention strategies. This case also illustrates the importance of creating a plan for generalization and the challenges parents face when trying to incorporate treatment strategies into the home environment. The importance of an accurate diagnosis and appropriate behavioral treatment are emphasized as a protection against the misuse of psychotropic medications and psychological interventions.

A functional assessment of handmouthing among persons with severe and profound intellectual disability

Abstract Background The behavioural function of handmouthing has been assessed across various studies utilising analogue functional analyses. The aim of the current study was to expand upon research on this relatively understudied behaviour by examining the relationship between handmouthing and Gastro‐Esophageal Reflux Disorder (GERD), and the potential variables maintaining this challenging behaviour in 30 individuals with intellectual disability. Method First, the relationship of GERD to handmouthing was examined. Second, the behavioural function of handmouthing was assessed with an indirect functional assessment, the Questions About Behavioral Function (QABF). Results We found that a diagnosis of GERD was present with greater frequency among individuals with handmouthing than among matched peers who did not engage in handmouthing. Non‐social reinforcement was most frequently endorsed as a behavioural function of this challenging behaviour. Discussion Although individuals with handmouthing exhibited more GERD than those who did not handmouth, the findings suggest that handmouthing was most often maintained by non‐social reinforcement. The importance of utilising functional assessment methodology for the assessment and treatment of handmouthing is discussed.

The relationship between food refusal and social skills in persons with intellectual disabilities

Abstract Background Feeding problems are common among individuals with intellectual disabilities. The aim of the current study was to determine the relationship between food refusal and social skills in people with intellectual disability. Method The Screening Tool of Feeding Problems (STEP) was administered to all residents of a large developmental centre. This screening tool identified 82 residents who exhibited food refusal, and 81 residents who did not exhibit food refusal. The Matson Evaluation of Social Skills in Persons with Severe Retardation (MESSIER) was administered to the 163 participants. Results People who exhibited food refusal displayed significantly more negative nonverbal and general negative social skills when compared to controls. Food refusal was prevalent across all ages, genders, and levels of intellectual disability. Conclusions As social skill deficits are associated with deficits in feeding skills, social skills training should be considered as a major component of behavioural interventions targeting food refusal in people with intellectual disability.

Assessment of Self‐Injurious and Aggressive Behavior

Publisher Summary This chapter describes the structural and functional assessment methodologies relevant for self-injurious behavior (SIB) and aggressive behavior in individuals with intellectual disability. Structural and functional assessment techniques are not mutually exclusive and can complement each other. Psychometric weaknesses are in the nature of problem behavior in persons with intellectual disabilities. Low incidence skewed-distribution phenomena create technical challenges for the construction of assessment instruments and for statistical data analysis. For instance, it is an axiom of classical test theory that scales with fewer items, which have lower reliability than scales with more items. Inferential statistics require normal distribution of variables, an assumption that tends to be violated in group based on such instruments. There is an ongoing debate over the best, most accurate, and the most feasible strategy to identify functional properties of target behaviors. However, the precision, cost, and potential risk of an experimental functional analysis (EFA) must be carefully weighted against the lessened immediate risk and cost.