Evaluation of a Treatment Package for Chronic, Stereotypic Hand Mouthing of a Child Diagnosed with Autism

IF 2.1 Q2 PSYCHOLOGY, CLINICAL

Behavior Analysis in Practice Pub Date : 2024-06-25 DOI:10.1007/s40617-024-00956-8

Aarti Thakore, Andrea Kelly, Anna Ingeborg Petursdottir, Morgan Stockdale

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Abstract

We describe the clinical treatment of repetitive, stereotypic hand mouthing in a 7-year old child with severe developmental delay, conducted in the context of center-based autism service. The client’s history included use of mechanical restraint to prevent tissue damage and infection. Prior antecedent- and reinforcement-based interventions were ineffective. Functional analysis results suggested hand mouthing was maintained by automatic reinforcement. Response interruption and redirection (RIRD) initially did not decrease hand mouthing, but the addition of contingent protective equipment, together with modified RIRD, was followed by reduction to near-zero level, which was maintained following withdrawal of the intervention.

• Repetitive hand mouthing may require treatment due to tissue damage and other health consequences.

• Repetitive hand mouthing is typically maintained in the absence of social contingencies and may be resistant to treatment.

• When reinforcement-based interventions are not sufficient, contingent application of nonrestraining protective equipment may produce lasting reduction in hand mouthing.

• Successful intervention in this case freed the client from mechanical (arm band) restraint and was followed by gains in skill acquisition.

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评估针对被诊断为自闭症儿童的慢性、刻板用手抠发音的一揽子治疗方案

我们描述了在中心自闭症服务的背景下，对一名患有严重发育迟缓的 7 岁儿童重复、刻板地用嘴舔手的临床治疗。该患儿的病史包括使用机械束缚以防止组织损伤和感染。之前基于前因和强化的干预无效。功能分析结果表明，用手咀嚼是通过自动强化来维持的。反应中断和重定向（RIRD）最初并没有减少用手舔嘴的行为，但在增加应急保护设备和修改 RIRD 后，用手舔嘴的行为减少到接近零的水平，而且在撤消干预后仍能保持。- 在没有社会应急措施的情况下，重复性用嘴啃咬手的现象通常会持续下去，而且可能会对治疗产生抵触情绪。-当基于强化的干预措施不够充分时，使用非约束性保护设备可能会持久减少用嘴啃咬手的现象。

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来源期刊

Behavior Analysis in Practice PSYCHOLOGY, CLINICAL-

自引率

18.20%

发文量

期刊介绍： Behavior Analysis in Practice, an official journal of the Association for Behavior Analysis International, is a peer-reviewed translational publication designed to provide science-based, best-practice information relevant to service delivery in behavior analysis. The target audience includes front-line service workers and their supervisors, scientist-practitioners, and school personnel. The mission of Behavior Analysis in Practice is to promote empirically validated best practices in an accessible format that describes not only what works, but also the challenges of implementation in practical settings. Types of articles and topics published include empirical reports describing the application and evaluation of behavior-analytic procedures and programs; discussion papers on professional and practice issues; technical articles on methods, data analysis, or instrumentation in the practice of behavior analysis; tutorials on terms, procedures, and theories relevant to best practices in behavior analysis; and critical reviews of books and products that are aimed at practitioners or consumers of behavior analysis.