Professional staff in four state facilities for individuals with mental retardation were surveyed to determine their perceptions, knowledge and opinions regarding the use of psychotropic medication. A large majority of the 377 respondents indicated that the physicians in their facilities were primarily responsible for medication-related decisions. Under ideal conditions, however, all professional staff and parents were seen as having a greater influence in the decision-making process. Aggression, delusions and hallucinations, self-injury, other psychiatric disorders, and anxiety were rated as disorders most likely to result in medication therapy. Behaviour modification was viewed as a suitable alternative to drug treatment for acting out and aggression. The professionals indicated that behavioural observation was the most influential assessment technique in current usage, followed by global impressions and informal diaries. Over 80% of the respondents perceived their preservice and inservice training on issues related to the use of psychotropic medication to treat behaviour problems as inadequate, with 96% of them desiring continuing education. These findings were compared to data from similar studies of populations with other disabilities, and suggestions for modifications in the current decision-making processes related to the use of psychotropic medication in institutionalized individuals with mental retardation are discussed.
Five cases involving the treatment oflongstanding, severe, and previously unmanageable self-injurious behavior are presented. In each case, the behavior was forceful contact with the head or face, and treatment consisted of mild and brief contingent electrical stimulation, delivered automatically or by a therapist, via the Self-Injurious Behavior Inhibiting System. Results of reversal and/or multiple baseline designs, in which sessions ranged in duration from 10 min to all day across a variety of settings, showed that the effects of the system were immediate and produced almost complete elimination of the self-injurious behavior. Controlled and anecdotal follow-up data for four of the five cases suggest continuing benefits and the absence of detrimental side effects associated with treatment. Potential applications of the device, as well as extensions and limitations, are discussed.DESCRIPTORS: self-injurious behavior, electrical stimulation, punishmentWe express our deepest appreciation to the parents and guardians of those who participated as subjects in this study for their support and cooperation. We also thank the following individuals for their invaluable work on the development of SIBIS (Robert Fischell, Leslie and Mooza Grant, Arnold Newman, and Gary Pace) and their assistance in conducting various aspects of the research
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.