Response patterns for individuals receiving contingent skin shock aversion intervention to treat violent self-injurious and assaultive behaviours.

BMJ Case Reports
Golnaz YadollahikhalesMiles Cunningham

Abstract

A small proportion of patients with intellectual disabilities (IDs) and/or autism spectrum disorder (ASD) exhibit extraordinarily dangerous self-injurious and assaultive behaviours that persist despite long-term multidisciplinary interventions. These uncontrolled behaviours result in physical and emotional trauma to the patients, care providers and family members. A graduated electronic decelerator (GED) is an aversive therapy device that has been shown to reduce the frequency of severe problem behaviours by 97%. Within a cohort of 173 patients, we have identified the four most common patterns of response: (1) on removal of GED, behaviours immediately return, and GED is reinstated; (2) GED is removed for periods of time (faded) and reinstated if and when behaviours return; (3) a low frequency of GED applications maintains very low rates of problem behaviours; and (4) GED is removed permanently after cessation of problem behaviours. GED is intended as a therapeutic option only for violent, treatment-resistant patients with ID and ASD.

References

May 1, 1993·Research in Developmental Disabilities·D E WilliamsB A Iwata
Mar 1, 1993·Journal of Behavior Therapy and Experimental Psychiatry·R W RickettsM Matese
Jan 31, 2003·Journal of Applied Behavior Analysis·Dorothea C Lerman, Christina M Vorndran
Jun 13, 2006·Research in Developmental Disabilities·Johnny L Matson, Marie S Nebel-Schwalm
Feb 10, 2009·European Child & Adolescent Psychiatry·Lee E WachtelIrving M Reti
Feb 28, 2014·Autism : the International Journal of Research and Practice·Benjamin A AdlerCraig A Erickson

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