Flexible arm splints in the control of a Lesch-Nyhan victim's finger biting and a profoundly retarded client's finger sucking

Ball, Thomas S.; Datta, Purna C.; Rios, Manuel; Constantine, Cherri

doi:10.1007/bf01531603

Cited by 17 publications

(9 citation statements)

References 6 publications

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“…Mental retardation was regarded as a cardinal feature of Lesch-Nyhan disease (LND) when the syndrome was first identified (Lesch & Nyhan, 1964). This has been challenged by reports of individual cases with IQ scores in the borderline to average range of intelligence (Ball et al, 1985;Bull & LaVecchio, 1978;Christie et al, 1982;Scherzer & Ilson, 1969). Arguing that their movement disorder, dysarthria, and limited formal education make standardized cognitive testing of patients with LND "almost impossible," Anderson et al (1992) developed a parent0caregiver questionnaire of everyday functioning to estimate general cognitive ability.…”

Section: Introductionmentioning

confidence: 99%

Neurocognitive functioning in Lesch-Nyhan disease and partial hypoxanthine-guanine phosphoribosyltransferase deficiency

Schretlen

Harris

Park

et al. 2001

J Int Neuropsychol Soc

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Lesch-Nyhan disease (LND) is a rare, X-linked genetic disorder that involves the nearly complete absence of an enzyme (hypoxanthine-guanine phosphoribosyltransferase, or HPRT) that is essential for purine salvage. In addition to hyperuricemia, all patients with classic LND suffer from movement disorder and compulsive self-injury, and most have mental retardation. Patients with partial HPRT deficiency (variants) always have hyperuricemia and often have neurologic abnormalities, but do not self-injure and usually are described as having normal intelligence. Here we compare 15 patients with LND to 9 variants and 13 normal adolescents and adults. Testing revealed unambiguous and qualitatively similar cognitive deficits in both patient groups. The variants produced scores that were intermediate between those of patients with LND and normal participants on nearly every cognitive measure. We discuss these findings in terms of what is known about the neuropathology of LND. (JINS, 2001, 7, 805–812.)

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Section: Introductionmentioning

confidence: 99%

Neurocognitive functioning in Lesch-Nyhan disease and partial hypoxanthine-guanine phosphoribosyltransferase deficiency

Schretlen

Harris

Park

et al. 2001

J Int Neuropsychol Soc

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“…One tactic used by researchers and practitioners to mitigate the negative side effects of mechanical restraints, while capitalizing on the beneficial aspects, is restraint fading (Fisher, Piazza, Bowman, Hanley, & Adelinis, 1997). Although the term restraint fading is sometimes used to describe the process of systematically decreasing the time in which an individual wears restraint devices throughout the day (Obi, 1997), it typically refers to a process in which the restrictiveness of a restraint device is systematically decreased (Ball et al, 1980(Ball et al, , 1985Fisher et al, 1997;Kahng, Abt, & Wilder, 2001;Oliver et al, 1998;Paul & Romanczyk, 1973).…”

mentioning

confidence: 99%

“…Some variations of arm splints are designed specifically for the purpose of restraint fading (Ball et al, 1980(Ball et al, , 1985Fisher et al 1997;Oliver et al, 1998;Paul & Romanczyk, 1973). Fisher et al (1997) evaluated the effectiveness of a canvas variation of arm splints designed to prevent hand-to-head SIB.…”

mentioning

confidence: 99%

Further investigation of a rapid restraint analysis

Deshais

Fisher

Hausman

et al. 2015

J of App Behav Analysis

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Research related to the use of mechanical restraint devices (e.g., arm splints) has been limited despite the frequency with which they are used in the clinical treatment of severe and dangerous self-injurious behavior (SIB). Wallace, Iwata, Zhou, and Goff () used a rapid restraint analysis (RRA) to evaluate the effects of different levels of arm-splint flexion on rates of hand-to-head SIB and adaptive behavior. The goal of the current study was 3-fold: (a) to extend previous research on RRA by reporting RRA results for 10 participants and investigating post-RRA outcomes, (b) to investigate whether the RRA might have the potential to eliminate the need for restraint fading altogether for some individuals, and (c) to investigate whether the RRA might help to identify a starting point for restraint fading for individuals for whom fading is necessary. Results suggested that the RRA helped to eliminate the need for restraint fading for 6 participants. With respect to the identification of a starting point for restraint fading, results were mixed. Overall, 8 of the 10 participants were discharged from the inpatient unit at a less restrictive level of flexion or at the same level of flexion identified by the RRA. Implications for adoption of the RRA are discussed.

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“…Other authors have noted that some individuals appear to have a preference for restraint, as evidenced by the use of the term "addiction" (Corbett, 1975;Kinnel, 1984), the observation of negative emotion in response to restraint termination (Ball et al, 1975;Lovaas & Simmons, 1969;Myers & Diebert, 1971;Shear et al, 1971) and the use of restraint as positive reinforcement in operant conditioning paradigms (Favell, McGimsey & Jones, 1978;Foxx & Defrense, 1984). Negative response to restraint removal and restraint seeking behaviors are also commonly reported in Lesch-Nyhan syndrome in which self-injury is severe and the term self-restraint is frequently used (Anderson, Dancis & Alpert, 1978;Ball et al, 1985;Buzas, Ayllon & Collins, 1981;Christie et al, 1982;Dizmang & Cheatham, 1970;Duker, 1975;Gilbert, Spellacy & Watts, 1979;Wurtele et al, 1984).…”

Section: The Phenomenology Of Self-restraintmentioning

confidence: 99%

Phenomenology of Self-Restraint

Oliver

Murphy²,

Hall³

et al. 2003

Am J Mental Retard

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Self-restraint is often reported in individuals with mental retardation who show self-injurious behavior (SIB). In this study, the phenomenology and prevalence of self-restraint in individuals showing self-injury and wearing protective devices and those showing self-injury but not wearing protective devices were compared. A high prevalence of self-restraint in the whole sample of individuals showing self-injury was identified (67/88, 76.1%), and self-restraint was more prevalent in a group showing self-injury but not wearing protective devices (43/47, 91.5%) than in a group showing self-injury and wearing protective devices (24/41, 58.5%). Individuals not wearing protective devices showed a greater number of topographies of self-restraint than those who did wear them. Results are discussed with reference to the purely topographical definition of self-restraint employed and the potential equivalence of protective devices and self-restraint.

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Flexible arm splints in the control of a Lesch-Nyhan victim's finger biting and a profoundly retarded client's finger sucking

Cited by 17 publications

References 6 publications

Neurocognitive functioning in Lesch-Nyhan disease and partial hypoxanthine-guanine phosphoribosyltransferase deficiency

Neurocognitive functioning in Lesch-Nyhan disease and partial hypoxanthine-guanine phosphoribosyltransferase deficiency

Further investigation of a rapid restraint analysis

Phenomenology of Self-Restraint

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