Examining the influence of social‐environmental variables on self‐injurious behaviour in adolescent boys with fragile X syndrome

Hall, Scott S.; Hustyi, Kristin M.; Barnett, Ross

doi:10.1111/jir.12489

Cited by 14 publications

(20 citation statements)

References 44 publications

(102 reference statements)

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“…The prevalence of behavior problems observed in this review is in general agreement with previous findings for different behavior problems. This is the case for the prevalence of attention and ADHD-related problems [ 114 ], and clinical range [ 115 ], although even higher scores were found in boys (77%) in other studies [ 116 ]; for the prevalence of aggression and severity rates [ 117 , 118 ], and self-injurious behavior [ 118 , 119 , 120 , 121 ], although higher prevalence has been found in studies with functional analyses [ 122 ]; and for the prevalence of thought problems in the clinical range [ 116 ]. Low percentages in the clinical range for delinquent behavior align with studies finding scores for this behavior in the normal range [ 123 ].…”

Section: Discussionmentioning

confidence: 99%

Behavior Problems and Social Competence in Fragile X Syndrome: A Systematic Review

Cregenzán-Royo

Gasca

Fornieles

2022

Genes

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Fragile X syndrome (FXS) causes intellectual disability and is the known leading cause of autism. Common problems in FXS include behavior and social problems. Along with syndromic characteristics and autism comorbidity, environmental factors might influence these difficulties. This systematic review focuses on the last 20 years of studies concerning behavior and social problems in FXS, considering environmental and personal variables that might influence both problems. Three databases were reviewed, leading to fifty-one studies meeting the inclusion criteria. Attention deficit hyperactivity disorder (ADHD) problems remain the greatest behavior problems, with behavioral problems and social competence being stable during the 20 years. Some developmental trajectories might have changed due to higher methodological control, such as aggressive behavior and attention problems. The socialization trajectory from childhood to adolescence remains unclear. Comorbidity with autism in individuals with FXS increased behavior problems and worsened social competence profiles. At the same time, comparisons between individuals with comorbid FXS and autism and individuals with autism might help define the comorbid phenotype. Environmental factors and parental characteristics influenced behavior problems and social competence. Higher methodological control is needed in studies including autism symptomatology and parental characteristics. More studies comparing autism in FXS with idiopathic autism are needed to discern differences between conditions.

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Section: Discussionmentioning

confidence: 99%

Behavior Problems and Social Competence in Fragile X Syndrome: A Systematic Review

Cregenzán-Royo

Gasca

Fornieles

2022

Genes

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“…The two raters independently classified cases without obvious trends and large response reductions in the conditions of interest (i.e., clear cases) with 100% agreement and came to a consensus on cases of low‐to‐moderate response reductions in the conditions of interest or with trends (i.e., unclear cases), which were selected for further discussion. Overall, 31 (25%) unclear cases required discussion among the raters (Ava, Bobby1, Brian1, Chad2, Charlene, Charlie, Christie, Dexter, Jack, Jamie1, Jamie2, Joey, Laura, Libby, Marc, Mark, P1 [Woods et al, 2013], P10, P17 & P22 [Healy et al, 2013], P8 [Hall et al, 2018], Peter1, Peter3, Rob, Ross, Sharon, Timmy1, Timmy2, Tina, Wyatt). The final consensus corrected the logically derived outcome of 15 (12%) datasets (Ava, Brian1, Chad2, Charlie, Christie, Jack, Janey, Joey, Laura, Mark, P1 [Woods et al, 2013], P8 [Hall et al, 2018], Timmy2, Tina, Wyatt).…”

Section: Methodsmentioning

confidence: 99%

“…Overall, 31 (25%) unclear cases required discussion among the raters (Ava, Bobby1, Brian1, Chad2, Charlene, Charlie, Christie, Dexter, Jack, Jamie1, Jamie2, Joey, Laura, Libby, Marc, Mark, P1 [Woods et al, 2013], P10, P17 & P22 [Healy et al, 2013], P8 [Hall et al, 2018], Peter1, Peter3, Rob, Ross, Sharon, Timmy1, Timmy2, Tina, Wyatt). The final consensus corrected the logically derived outcome of 15 (12%) datasets (Ava, Brian1, Chad2, Charlie, Christie, Jack, Janey, Joey, Laura, Mark, P1 [Woods et al, 2013], P8 [Hall et al, 2018], Timmy2, Tina, Wyatt). Datasets that could not be identified with any of the three proposed patterns were assigned to the other category.…”

Section: Methodsmentioning

confidence: 99%

Functional analysis patterns of automatic reinforcement: A review and component analysis of treatment effects

Virués‐Ortega

Clayton

Pérez‐Bustamante

et al. 2022

J of App Behav Analysis

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Functional analysis (FA) conditions include different antecedent or consequent events that may disrupt responding. Thus, varying patterns of FA differentiation may predict treatment outcomes of problem behavior maintained by automatic reinforcement. These patterns could be used to inform the development of individualized interventions. An approach to classifying these patterns is to categorize FA outcomes as attention condition lowest, demand condition lowest, and play condition lowest, according to the condition in which problem behavior is most disrupted. In Study 1, we applied this criterion to 120 datasets finding that 60% could be classified using this method, whereas 89% of datasets showed a disruption of 50% or higher. In Study 2, we conducted a treatment component analyses for 3 individuals whose FAs each exhibited one of the 3 distinct patterns. The results indicated that specific elements of the FA conditions could reduce problem behavior. The predictive utility of these disruption patterns is discussed.

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“…Prior to initiation of treatment, a member of the study team, who was a Board Certified Behavior Analyst (BCBA), traveled to the child’s home to conduct a functional analysis (FA) of the child’s problem behavior [ 60 ]. Briefly, six FA test conditions (i.e., ignore , attention , tangible , social escape , academic escape , and transition escape ) and one control condition ( play ) were conducted at least 4 to 6 times over 2 days in the child’s home [ 33 , 60 ]. In the ignore condition, the child was observed with no leisure items (e.g., toys) in the room, and caregivers were coached to ignore the child’s problem behavior.…”

Section: Methodsmentioning

confidence: 99%

“…Although treatments for FXS are often considered from a medical perspective, several studies have shown that problem behaviors displayed by children with FXS may be shaped and maintained by operant learning processes such as positive and/or negative reinforcement [ 30 – 33 ]. For example, if a child typically receives attention from others when he/she engages in problem behavior, the child’s problem behavior may be positively reinforced by attention.…”

Section: Introductionmentioning

confidence: 99%

Telehealth-enabled behavioral treatment for problem behaviors in boys with fragile X syndrome: a randomized controlled trial

Hall

Monlux

Rodriguez

et al. 2020

J Neurodevelop Disord

Self Cite

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Background Children with fragile X syndrome (FXS) are at increased risk for exhibiting problem behaviors such as aggression and self-injury. However, many children with FXS have limited access to behavioral treatments that have known efficacy due to the low availability of treatment providers and the wide geographical dispersion of families with FXS across the country. Telehealth may offer a cost-effective and practical solution to overcome these significant barriers. We examined the effect of administering an established behavior analytic intervention called functional communication training (FCT) via telehealth on levels of problem behaviors exhibited by boys with FXS. We also examined treatment acceptability, as well as the effect of the treatment on levels of parenting stress. Methods Boys with FXS, aged 3 to 10 years, who displayed problem behaviors daily, were randomized to receive FCT via telehealth (n = 30) or treatment as usual (n = 27) over 12 weeks. Outcome measures included in-session observations of problem behavior, the Aberrant Behavior Checklist—Community (ABC-C), the Treatment Acceptability Rating Form—Revised (TARF-R), and the Parenting Stress Index, 4th edition (PSI-4). Results Intention-to-treat analyses indicated that scores on the irritability subscale of the ABC-C, our primary outcome measure, decreased significantly for boys who received FCT via telehealth compared to boys who received treatment as usual (p < .001, Cohen’s d = 0.65). In-session observations conducted for those who received treatment showed that levels of problem behavior decreased by 91% from baseline. Levels of parenting stress related to child behavioral problems were also lower following FCT treatment, and caregivers reported that the intervention was acceptable. Conclusions These findings support telehealth-enabled FCT as a framework for expanding access to behavioral treatments for problem behaviors in children with FXS. Expanded delivery of behavior analytic treatment via telehealth also has the potential to lower healthcare costs, improve child and family quality of life, and lead to advances in the treatment of problem behavior in the broader population of individuals with neurodevelopmental disorders. Trial registration ClinicalTrials.gov, NCT03510156. Registered 27 April 2018

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Examining the influence of social‐environmental variables on self‐injurious behaviour in adolescent boys with fragile X syndrome

Cited by 14 publications

References 44 publications

Behavior Problems and Social Competence in Fragile X Syndrome: A Systematic Review

Behavior Problems and Social Competence in Fragile X Syndrome: A Systematic Review

Functional analysis patterns of automatic reinforcement: A review and component analysis of treatment effects

Telehealth-enabled behavioral treatment for problem behaviors in boys with fragile X syndrome: a randomized controlled trial

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