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Severe Behavior Disorders

Treatment of Severe Behavior Disorders

Individuals with intellectual and developmental disabilities, including autism, are at increased risk for engaging in problem behavior such as self-injury, aggression, and property destruction. When these behaviors are intense and frequent, they can significantly impair a child’s functioning. The term “severe behavior disorders” is often used to broadly describe the presence of these problem behaviors. There are several different treatment approaches used for individuals with severe behavior disorders, including medication and behavioral interventions. Each of these can be offered in either outpatient or inpatient treatment programs, depending on a number of factors such as the severity of the behavior, the risk for losing home, school or vocational placement, proximity to an outpatient program, and whether medication manipulations need to be made.

Behavioral treatment of severe problem behavior involves identifying the antecedents (or “triggers”) and typical consequences for the behavior using a functional assessment approach. Understanding the events that make the problem behavior more likely to occur is important to developing a treatment based on modifying those events. Therefore, treatment may include a combination of avoiding events that trigger the behavior (or teaching the individual to better tolerate difficult situations), teaching new skills (e.g., communication), and reinforcing appropriate behaviors. In most cases, these treatments can be provided on an outpatient basis. For individuals with complex severe problem behavior that has not responded to outpatient treatment, an intensive multidisciplinary treatment may be needed, requiring the individual to see both a behavioral psychologist and psychiatrist. For those with very severe behavior disorders who are at increased risk for injury to self or others, inpatient admission may be needed. Treatment on the Neurobehavioral Unit is interdisciplinary, and involves psychiatrists, behavior analysts, medical providers, speech and language pathologists, educators, and social workers to address all aspects of the behavior disorder effectively.

Specific Types of Behavioral Disorders

Some behavior disorders are directly linked to genetic conditions, and the functional assessment process should take these conditions into account.

Additional National Resources

National Institute of Mental Health
Behavior Analyst Certification Board (BACB) – consumer information
The National Association for the Dually Diagnosed
National Institute of Child Health and Human Development
Clinical Trials Registry

Links Specifically for Individuals with Autism

National Institute of Mental Health: Autism Spectrum Disorders
Centers for Disease Control and Prevention: Autism Spectrum Disorders
Autism Speaks
Autism Society

Scientific Journals

Journal of Applied Behavior Analysis (free access to articles published from 1968-2012 here)
Research in Developmental Disabilities
Behavioral Interventions

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