Treatment of challenging behavior exhibited by children with prenatal drug exposure
Section snippets
Participants and Setting
Participants were two toddlers receiving behavioral assessment and treatment services in a hospital-based intensive outpatient program for individuals with developmental disabilities and severe challenging behavior. Within our clinic, we have seen a subset of patients with prenatal drug exposure who presented with challenging behaviors at a very early age, typically prior to age 2 years. Both participants presented with histories of prenatal exposure to illicit drugs and severe challenging
Results
Results of functional analyses of challenging behavior, indicated as responses per minute (RPM) per session, are presented in Fig. 1. Randy's functional analysis (top panel) revealed high rates of challenging behavior in demand (mean = 2.2 RPM), attention (mean = 2.1 RPM), and tangible (mean = 6.0 RPM) conditions relative to the toy play (control) condition (mean = 0.1 RPM), suggesting that challenging behavior was maintained by access to adult attention, access to preferred items, and escape from ADL's.
Discussion
In this study, two youngsters prenatally exposed to heroin, cocaine and/or alcohol participated in functional analyses of severe challenging behavior. In both cases, challenging behavior was maintained by environmental variables-access to adult attention or preferred activities, or escape from demands. Additionally, behavioral interventions derived from functional analysis results effectively reduced rates of challenging behavior to near zero rate of occurrence for both participants. To our
Acknowledgements
The authors would like to thank Rebecca Heggemeyer and Tara Lieblein for their assistance with data collection.
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A community evaluation of Parent-Child Interaction Therapy for children with prenatal substance exposure
2020, Children and Youth Services ReviewCitation Excerpt :Additionally, some researchers have argued that traditional externalizing behavior treatments do not address attachment disruptions (e.g., Suchman et al., 2004) and focus too much on limit-setting and control, which could already be adequate among parents of PSE children (Peisch et al., 2018). On the other hand, there is evidence that the mechanisms underlying negative behavior in children with PSE are similar to the mechanisms underlying negative behavior in general (Kurtz, Chin, Rush, & Dixon, 2008; McConnel et al., 2002; Heller, Sobel, & Tanaka-Matsumi, 1996), and thus might respond well to existing interventions. Parent-Child Interaction Therapy (Niec, 2018) is an ecologically sensitive and flexible intervention that holds promise for treating the externalizing problems endemic to children with PSE.
Functional analysis and treatment of problem behavior exhibited by children with fragile X syndrome
2015, Research in Developmental DisabilitiesCitation Excerpt :Commonly identified consequences that reinforce and maintain problem behavior in persons with IDD include provision of adult attention, access to tangible items, and escape from non-preferred tasks (Iwata et al., 1994a,b); however, a number of other functions for problem behavior have been identified (Lancioni, Singh, O’Reilly, Sigafoos, & Didden, 2012; Schlichenmeyer, Roscoe, Rooker, Wheeler, & Dube, 2013). Studies reporting on the functional analysis of problem behavior have included sub-populations of IDD such as individuals with ASD (Love, Carr, & LeBlanc, 2009; O’Reilly et al., 2010); prenatal drug exposure (Kurtz, Chin, Rush, & Dixon, 2008); and genetic disorders such as Angelman (Strachan et al., 2009), Cornelia de Lange (Bay, Mauk, Radcliffe, & Kaplan, 1993), Prader-Willi (Hall, Hustyi, Chui, & Hammond, 2014), Rett (Roane, Piazza, Sgro, Volkert, & Anderson, 2001), Soto (Harding et al., 2001), and Williams syndromes (O’Reilly, Lacey, & Lancioni, 2000). In its consensus document on clinical practices regarding behavior problems in FXS, the Fragile X Clinical and Research Consortium recommended using functional analysis to identify potential causes for problem behavior (Picker & Sudhalter, 2012).
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Now at Millersville University, United States.