Success Stories: Behavior Management Clinic

D.M. was an 8-year-old male diagnosed with attention deficit hyperactivity disorder (combined type), disruptive behavior disorder and mild intellectual disabilities. Presenting concerns at intake included school difficulties, (i.e. disruptive behavior, poor academic achievement), short attention span, hyperactivity, physical aggression, arguing with twin sister, interrupting and noncompliance. At the time of the initial evaluation, D.M.’s attention deficit and mild retardation had not been diagnosed; hence, referrals were initiated to KKI Developmental Pediatrics and Neuropsychology services. The child had a history of in utero drug exposure and removal from biological parent’s care. He and his twin sister were cared for by the maternal great grandmother. Outpatient treatment focused on caregiver training in behavior management and assistance in ADHD diagnosis and education. The caregiver was trained in the use positive reinforcement, planned ignoring, three-step guided compliance and time-out. Following training and mastery of these skills, the caregiver received assistance in developing and implementing a home reinforcement program. Over the course of treatment, D.M. had a 93 percent reduction in aggression, 85 percent reduction in sibling arguing, 80 percent reduction in interrupting and an 80 percent reduction in noncompliance. The family was seen for 19 sessions in all (three devoted to intake, direct observation, and feedback, 12 treatment sessions, four maintenance sessions). Over the course of treatment, D.M. was also started on stimulant medication.

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