The effects of a --- on the reduction of self-injurious behavior in children with Autism Spectrum Disorder

The effects of antecedent-based interventions on the reduction of self-injurious behavior (SIB) in a subject with Autism Spectrum Disorder (ASD)

Jamie McMenamin | PSY 521

Autism Spectrum Disorder (ASD)

The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; American Psychiatric Association [APA], 2013) defines Autism Spectrum Disorder (ASD) as a condition marked by chronic deficits in social communication and social interactions, as well as restricted, repetitive behaviors, interests, or activities. While a diagnosis of ASD requires that these deficits begin in early childhood, an individual may not exhibit impairment in current functioning until environmental demands begin to outweigh the individuals capabilities (APA, 2013).

Jamie McMenamin | PSY 5212

Self Injurious Behavior (SIB)

Weiss (2002) explains that the Diagnostic and Statistical Manual historically classified SIB as Stereotypic Movement Disorder in those with MR and not in those with a pervasive developmental disorders.SIB are often placed on a continuum and can vary greatly in severity. Further research and clarification regarding SIB is needed in order to standardize the definition of SIB.Behaviors that cause direct physical harm to ones own body, resulting in physical injury and tissue damage (Richman et al., 2013), and are considered the most chronic forms of challenging behaviors (Waters & Healy, 2012).Common SIB include head banging, self-biting, and/or eye gouging (Anderson & Ernst, 1994).

Jamie McMenamin | PSY 5213

Etiology & Functionsof Self Injurious Behavior

Jamie McMenamin | PSY 5214

Behavior & Functional Analysis

A functional analysis provides a systematic, objective, and measurable way to assess the components involved in maladaptive behaviors. This technique is thought to remove biases, affording an approach that lends itself to appropriate and effective treatment(Weiss, 2002). And pinpoint variables that may be maintaining a maladaptive behavior prior to the implementation of treatment (Iwata, Dorsey, Slifer, Bauman, & Richman, 1994).There are 3 main categories of functional analysis that will be utilized in this study. Jamie McMenamin | PSY 5215

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Methods

Functional AnalysisBehaviorally BasedAntecedent Based InterventionSingle Subject DesignJamie McMenamin | PSY 5216

Methods

Single Subject Research Design & ABAB Design - An AB design is a two part or phase design composed of a baseline with no changes, and a treatment or intervention. If there is a change then the treatment may be said to have had an effect (O'Reilly, Sigafoos, Lancioni, Edrisinha, and Andrews, 2005).ABAB Design: Baseline & Implementing RoutinesIndependent Variable: Implementation of a daily schedule by parents for at home activities including bathing, eating, playing, etc. Dependent Variable: SIB behaviors in frequency, duration & intensity; specifically head-banging.Jamie McMenamin | PSY 5217

Participants

Inclusion criteria: Report from parents that subject has been diagnosed with ASD and engages in common self-injurious behaviors including common ones such as head-banging.Has had limited behavioral treatment & is not enrolled in a school program which maintains a consistent schedule.Parents are willing to implement a schedule at home & remain consistent.Subject is a 4-year-old male, diagnosed with ASD, who engages in self harm on a daily basis under various circumstances including but not limited to transition from one activity to another. N=1Jamie McMenamin | PSY 5218

Results

Over the course of the study, SIB was reduced consistently during intervention & increased when the baseline condition (no visible consistent schedule) was re-introduced. The use of a standard schedule that can be easily understood and is consistent, reduces the frequency and duration of self-harm.There was no impact on the intensity of the SIB. This study confirms research which supports the use of scheduling in order to reduce maladaptive behaviors in ASD subjects with SIB.

Jamie McMenamin | PSY 5219

ResultsJamie McMenamin | PSY 52110

Inter-Observer Agreement

Researchers maintained a safe and consistent distance from the subject at all times; prior research has used the distance of 5 feet which was implemented in this study.3 observers rotated daily sessions sessions with 2 observing at each time; no fatigue was observed or reported by observers. Inter-observer agreement under all conditions was 98%Jamie McMenamin | PSY 52111

Conclusions

Results suggest that implementing a firm schedule of activities with clear transitions can potentially reduce SIB in children with ASD. Limited Sample & Lack of GeneralizabilityAdditional research & repetitive experiments are needed to increase the generalizability of these results. There is potential to complete further research with this client in order to conduct long term studies which are currently lacking.

Jamie McMenamin | PSY 52112

ReferencesAmerican Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.Anderson, L., Ernst M. (1994). Self-injury in Lesch-Nyhan disease. Journal of Autism and Developmental Disorders, 24, 6781Baghdadli, A., Pascal, C., Grisi, S., & Aussilloux, C., (2003). Risk factors for self-injurious behaviours among 222 young children with autistic disorders. Journal of Intellectual Disability Research, 47, 622-627.Danov, S. E., Hartman, E., McComas, J. J., & Symons, F. J. (2010). Evaluation of two communicative response modalities for a child with autism and self-injury. The Journal of Speech-Language Pathology and Applied Behavior Analysis, 5(1), 70.Forgeot d'Arc, B., Dawson, M., Soulires, I., & Mottron, L. (2012). Self-injury in autism is largely unexplained: Now what? Journal of Autism and Developmental Disorders, 42(11), 2513-2514. doi:10.1007/s10803-012-1628-3Hanley, G., Iwata, B., & Mccord, B. (2003). Functional analysis of problem behavior: A review. Journal of Applied Behavior Analysis, 36, 147-185. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1284431/Iwata, B., Dorsey, M., Slifer, K., Bauman, K., & Richman, G. (1994). Toward a functional analysis of self-injury. Journal of Applied Behavior Analysis, 27, 197-209. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1297798/Kurtz, P., Chin, M., Huete, J., Tarbox, R., O'connor, J., Paclawskyj, T., & Rush, K. (2003). Functional analysis and treatment of self-injurious behavior in young children a summary of 30 cases. Journal of Applied Behavior Analysis, 205-219. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1284433/Mahatmya D, Zobel A, Valdovinos M.G (2008). Treatment approaches for self-injurious behavior in individuals with autism: Behavioral and pharmacological methods. Journal of Early and Intensive Behavior Intervention 5, 106-118.Jamie McMenamin | PSY 52113

ReferencesMinshawi, N. F., Hurwitz, S., Fodstad, J. C., Biebl, S., Morriss, D. H., & McDougle, C. J. (2014). The association between self-injurious behaviors and autism spectrum disorders. Psychology Research and Behavior Management, 7, 125.OReilly, M., Sigafoos, J., Lancioni, G., Edrisinha, C., & Andrews, A. (2005). An Examination of the Effects of a Classroom Activity Schedule on Levels of Self-Injury and Engagement for a Child with Severe Autism. Journal of Autism and Developmental Disorders, 33(3), 305-311. Retrieved from http://link.springer.com/article/10.1007/s10803-005-3294-1Richman, D., Barnard-Brak, L., Bosch, A., Thompson, S., Grubb, L., & Abby, L. (2013). Predictors of self-injurious behaviour exhibited by individuals with autism spectrum disorder. Journal of Intellectual Disability Research & Journal Intellectual Disability Research, 429-439.Rogers, S. J. (2009), What are infant siblings teaching us about autism in infancy? Autism Research 2, 125137. doi: 10.1002/aur.81Sautter, R.A. & LeBlanc, L.A. (2006). Empirical applications of Skinners analysis of verbal behavior with humans. Analysis of Verbal Behavior. 22, 2548. Retrieved from http://www.auburn.edu/~lal0011/pub/SL06.pdfSherer, M., & Schreibman, L. (2005). Individual Behavioral Profiles And Predictors Of Treatment Effectiveness For Children With Autism. Journal of Consulting and Clinical Psychology, 73(3), 525-538. Waters, P., & Healy, O. (2012). Investigating the relationship between self-injurious behavior, social deficits, and co-occurring behaviors in children and adolescents with Autism Spectrum Disorder. Autism Research and Treatment, 2012. doi:10.1155/2012/156481Weiss, Jonathan. (2002). Self-Injurious behaviors in autism: A literature review. Journal on Developmental Disabilities, 9(2), 129-144. Retrieved from http://researchautism.net/autism-publications/publications-database/5183/self-injurious-behaviours-in-autism:-a-literature-review.

Jamie McMenamin | PSY 52114

SIB

Sheet1SessionBaselineTreatment19212312415596675859610411131210131314151514165174184195204