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Neurobehavioral Unit (NBU)
Kennedy Krieger Institute • 707 North Broadway • Baltimore, MD 21205
Louis Hagopian, Ph.D., BCBA-D
Lee Wachtel, M.D.
About Our Program:
Established in the 1980s, the Neurobehavioral Unit (NBU) is a unique, 16-bed inpatient unit dedicated to the assessment and treatment of children and young adults with developmental disabilities and intellectual disabilities who have severe behavioral problems. Throughout its history the NBU has served patients from across the country and around the world. The NBU is recognized as one of the leading programs in the nation for providing intensive behavioral treatment to individuals with severe and highly treatment-resistant behavioral disorders and developmental disabilities. We offer unique integrated and targeted applications of behavioral and pharmacological intervention using a data-based approach. The NBU is also known for its research and advanced training in the field of applied behavior analysis (ABA).
Who We Serve:
We primarily serve children, adolescents, and young adults up to age 21; however, we periodically admit individuals over the age of 21.
Common types of behavioral problems treated on the NBU include:
- Self-injurious behavior (SIB)
- Destructive or disruptive behavior
- Restrictive and repetitive behavior
The NBU serves patients with a variety of diagnoses, including: autism spectrum disorder, developmental delay, intellectual disability, sleep disorders, feeding disorders, stereotypic movement disorder with self-injurious behavior, and various genetic, metabolic, and chromosomal disorders.
Our Treatment Approach:
The NBU is known for its interdisciplinary approach to treatment. Our patients are cared for by professionals specializing in the fields of behavioral psychology, psychiatry, pediatrics, neurology, nursing, social work, and speech and language pathology. And because a child’s progress depends on caregiver involvement and participation in the program, the family is also considered a vital member of the team.
Each patient receives intensive assessments, including a functional behavioral assessment, which helps us understand your child’s problem behavior, and preference assessments to identify activities your child likes and can earn as rewards. We try to comprehensively treat the individual using applied behavior analysis (ABA)—considered the best practice for working with patients like ours—and medication, when appropriate.
We maintain a staff-to-patient ratio of 1:1 or higher during all waking hours. Under the supervision of a board-certified behavior analyst, each patient receives behavioral assessment and treatment sessions from a team of 2-3 therapists. We develop behavioral treatments based on our assessment results, and we closely monitor their success. Meanwhile, data-based psychiatric assessments and medication evaluations examine a number of factors, including problem behaviors, mood, and activity level.
Treatment plans are designed around individual needs and focus on decreasing severe problem behaviors, while encouraging appropriate replacement behavior; however, for all patients admission goals include:
- Identifying and assessing the target problem behaviors
- Developing a treatment plan to decrease those behaviors
- Designing a plan to increase desirable behaviors
- Assessing and treating any underlying psychiatric disorders separate from the behavioral disturbance
- Identifying problem behaviors that may respond to medication
- Training parents, school staff, and other care providers to carry out the treatment recommendations or plan
- Assisting parents and other care providers in accessing community support services
Admission length typically varies from three to six months. Our outcomes data supports the effectiveness of our approach. During the last 5 years:
- 85 percent of patients discharged had reduced problem behaviors by at least 80 percent
- 88 percent of patients had maintained their treatment gains at follow-up
- 95 percent of families reported satisfaction with services
- 99 percent of patients were discharged with at least one caregiver prepared to follow and maintain their treatment plans
Application for Admission:
To begin the process for determining if an NBU inpatient admission is right for your child we will need to get some information from you. Once our admissions team has obtained and reviewed the information they will contact you. Click here to start the application process.
To make a referral or request for an international patient:
For additional assistance related to visas, travel, and translation services appointments for international patients, please contact our affiliate, Johns Hopkins International.
Resources for Practitioners:
References: Automatic SIB & Self-Restraint (Hagopian, L. P. (2014). Delineating subtypes of self-injurious behavior. Invited address presented at the 17th Annual Meeting of the Maryland Association for Behavior Analysis, Baltimore, MD.) (PDF)
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