Exploring the relationship between challenging behaviour and mental health disorder in autistic individuals with intellectual disabilities

Kildahl, Arvid Nikolai; Ludvigsen, Linn Beate; Hove, Oddbjørn; Helverschou, Sissel Berge

doi:10.1016/j.rasd.2023.102147

Cited by 5 publications

(1 citation statement)

References 60 publications

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“…In addition, the negative impacts researchers have reported to result from problem behavior that is not a direct effect of the behavior itself, such as limiting autistic children's access to education, contributing to unemployment, causing teacher burnout, and causing significant parental stress and depression (summarized in Conroy et al, 2005;Machalicek et al, 2007;Zaidman-Zait et al, 2014), have been demonstrated in correlational research. This means that the actual associations between problem behavior and these outcomes may not be causal, could be in the reverse direction or bidirectional, or could be more complex than a simple bivariate association (Kildahl et al, 2023;Zaidman-Zait et al, 2014). For example, there may be associations between autistic children's "inappropriate" social behavior and unsatisfying social relationships, but this could be explained by ableism and stigma on the part of potential friends and may not necessarily mean that autistic children whose conduct is non-normative are incapable of developing social relationships-or that enforcing normative behavior will improve their relationships.…”

Section: Study Featuresmentioning

confidence: 99%

Problems with “problem behavior”: A secondary systematic review of intervention research on transition-age autistic youth

Bottema-Beutel,

McKinnon,

Mohiuddin

et al. 2024

Autism

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In this secondary systematic review of single-case and controlled group design intervention studies conducted with transition-age autistic youth, we examined features of 48 studies with 273 participants that measured at least one “problem behavior” outcome (Prospero registration number: 231764). We searched 11 databases for relevant studies, and the final search date was November 2022. Our primary aims were to determine how problem behaviors were defined and selected for reduction, how functions were determined, and the interventions used to address them. Studies were coded and codes were tabulated and converted to percentages to answer each research question. Thirty-eight percent of studies defined problem behavior, and 88% of studies implemented behavioral strategies to reduce problem behaviors. Behaviors with low potential for harm constituted the majority of the 67 outcome variables (61%), while behaviors with high potential for harm were a minority (39%). The most common intervention target was stereotypic behavior. Fewer than half of studies: reported procedures for selecting behaviors, reported procedures to determine behavior function, or ascribed functions to behaviors. We were unable to report on some demographic features of participants (e.g. race/ethnicity) because they were rarely reported in primary studies. We conclude that problem behavior is poorly conceptualized in this research. Lay abstract In a previous study, we looked at research done on strategies to support autistic people who were between 14 and 22 years old. For this study, we looked at all of the studies in our previous study that tried to decrease or stop autistic people from doing certain things—many researchers call these things “problem behavior.” There were 48 studies that tried to reduce problem behavior, and most of them used strategies like prompting and reinforcement to try get autistic people to change their behavior. We found many things wrong with these studies. Most of them did not define the group of behaviors they were trying to stop autistic people from doing. None of the studies looked at whether any side effects happened when they tried the strategy they were studying. Also, most of the studies tried to stop autistic people from doing behaviors that probably were not harmful, like stereotypic behavior. Most of the studies did not say how they decided that the behaviors they tried to stop were a problem for the autistic people in the study, and most studies did not try to figure out why the autistic people in the study did the behaviors the researchers were trying to stop them from doing.

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Section: Study Featuresmentioning

confidence: 99%

Problems with “problem behavior”: A secondary systematic review of intervention research on transition-age autistic youth

Bottema-Beutel,

McKinnon,

Mohiuddin

et al. 2024

Autism

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Mental Health in People with Intellectual and Developmental Disabilities

Halvorsen,

Kildahl,

Helverschou

2024

Contemporary Clinical Neuroscience

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Schizophrenia in Autistic People with Intellectual Disabilities. Treatment and Interventions

Bakken,

Askeland Hellerud,

Kildahl

et al. 2024

J Autism Dev Disord

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Autistic people with intellectual disabilities appear to be at increased risk of schizophrenia. While current recommendations emphasize adapting interventions used for people with schizophrenia in general, few studies to date have investigated treatment of co-occurring schizophrenia in this specific population. To explore what interventions are provided to autistic people with intellectual disabilities and co-occurring schizophrenia in specialized mental health services, and to investigate whether changes in mental health symptoms and challenging behavior occurred during treatment. Using data from a longitudinal, national multicenter study, interventions provided to 26 autistic individuals with intellectual disabilities and co-occurring schizophrenia were explored. Symptoms were measured using the Psychopathology in Autism Checklist (PAC) and the Aberrant Behavior Checklist ABC) at referral (T1), at the end of treatment (T2), and at follow-up 12 months after T2 (T3). A broad range of interventions were provided to the participants, including inpatient admission, psychopharmacological treatment, various psychosocial interventions, and supportive interventions. Scores on the PAC and ABC were significantly lower at T2 than T1 for most scales, and no significant change was found from T2 to T3.Treatment of co-occurring schizophrenia appears feasible and effective in autistic people with intellectual disabilities.

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Exploring the relationship between challenging behaviour and mental health disorder in autistic individuals with intellectual disabilities

Cited by 5 publications

References 60 publications

Problems with “problem behavior”: A secondary systematic review of intervention research on transition-age autistic youth

Problems with “problem behavior”: A secondary systematic review of intervention research on transition-age autistic youth

Mental Health in People with Intellectual and Developmental Disabilities

Schizophrenia in Autistic People with Intellectual Disabilities. Treatment and Interventions

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