Predicting the persistence of severe self-injurious behavior

Emerson, Eric; Kiernan, Chris; Alborz, Alison; Reeves, David; Mason, Heidi; Swarbrick, Rebecca; Mason, Linda; Hatton, Chris

doi:10.1016/s0891-4222(00)00062-7

Cited by 110 publications

(141 citation statements)

References 18 publications

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“…However, the findings were later contradicted by a series of other studies of self-injury, using better methodology, all of which reported high chronicity rates (Emerson et al, 2001;Griffin, 1984;Murphy et al, 1993;Schroeder et al, 1986;Windahl, 1988). In a small study of 34 families with children with intellectual disabilities, Kiernan and Alborz (1996) also found high chronicity rates for a broad range of challenging behaviours.…”

Section: Introductionmentioning

confidence: 94%

Chronicity of Challenging Behaviours in People with Severe Intellectual Disabilities and/or Autism: A Total Population Sample

Murphy

Beadle‐Brown

Wing

et al. 2005

J Autism Dev Disord

205

123

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The skills, social impairments and challenging behaviours of a total population of 166 children, with severe intellectual disabilities and/or autism, were assessed through interview with the main carers, when the children were under 15 years old (time 1). Twelve years later, 141 of these individuals were re-assessed, using the same measures (time 2). "Abnormal" behaviours tended to reduce with age and were associated with poorer language skills and poorer quality of social interaction. Individuals with most abnormal behaviours at time 1, tended to have most at time 2. Abnormal behaviour at time 2 was predicted by the presence of abnormal behaviour at time 1, poor expressive language at time 1, poor quality of social interaction at time 1 and a diagnosis of autism/autistic continuum at time 1.

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Section: Introductionmentioning

confidence: 94%

Chronicity of Challenging Behaviours in People with Severe Intellectual Disabilities and/or Autism: A Total Population Sample

Murphy

Beadle‐Brown

Wing

et al. 2005

J Autism Dev Disord

205

123

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“…Physical consequences may be apparent in the form of physical injury to themselves, staff or others around them. Emerson et al, (2001b) describe the physical outcomes of SIB as including secondary infections, physical malformation of the face or limbs, loss of sight or hearing, additional neurological damage and even death. Such risks for the physical well-being of the individual, and those around them, impact on the individual's socialization and integration potential.…”

mentioning

confidence: 99%

“…Such risks for the physical well-being of the individual, and those around them, impact on the individual's socialization and integration potential. Emerson et al, (2001b) regard those with challenging behavior as at risk of social exclusion. Academic, developmental and adaptive behavior may also be affected, in that challenging behaviors interfere with learning and development (Holden & Gitlesen, 2006).…”

mentioning

confidence: 99%

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Analysis of risk factors and early predictors of challenging behavior for children with autism spectrum disorder

McTiernan

Leader

Healy

et al. 2011

Research in Autism Spectrum Disorders

129

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“…Studies suggest that PBs are not only prevalent but also persistent in people with ID (17)(18)(19). Totsika et al (20) found that serious physical attacks, self-injury and stereotypy were the most likely types of PBs to persist over time.…”

mentioning

confidence: 99%

International guide to prescribing psychotropic medication for the management of problem behaviours in adults with intellectual disabilities

et al. 2009

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Intellectual disability (ID) or mental retardation or learning disability is a lifelong condition included in the group of mental disorders in all the international classification systems. It is a syndrome grouping (meta-syndrome) including a heterogeneous range of clinical conditions characterized by a deficit in cognitive functioning prior to the acquisition of skills through learning (1). Over 30% of people with ID have a comorbid psychiatric disorder, which often has its onset in childhood and persists through adolescence and adulthood (2,3).In spite of this evidence, ID and related conditions are still considered a marginal area of psychiatry. In many countries there is little or no training provision on ID during undergraduate medical training or psychiatric specialization. The World Health Organization (WHO) has recently highlighted the unmet care needs of persons with ID (4). Psychiatrists are the first health professionals in contact with this population group and there is a global gap in training and guidelines on mental health issues related to ID.Within the ID field, the assessment, differential diagnosis and treatment of problem behaviours (PBs) deserve special attention. The rate of PBs in people with ID is high (5) and their presentation is determined by many complex factors. The pathogenic contribution of organic conditions, psychiatric disorders, environmental influences, or a combination of these has to be carefully established for every single case.The prevalence of PBs in people with ID seems to be sufficiently high (5,6) to constitute a major concern in this population. Depending on the definition and methodology, rates have been reported to vary from 5.7 to 17% (7-10). Using the Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities (DC-LD) (11), Cooper et al (12,13) aggression and self-injurious behaviour to be 9.8% and 4.9%, respectively, among adults (16 years and over) with ID in a community setting.It has been reported that 20-45% of people with ID are receiving psychotropic medication and 14-30% are receiving psychotropic medication to manage PBs such as aggression or self-injurious behaviours (14,15) in the absence of a diagnosed psychiatric disorder. Examples of psychotropic medications used for adults with ID are antipsychotics, antidepressants, anti-anxiety drugs (benzodiazepines, buspirone, beta-blockers), mood stabilizers (lithium, anticonvulsants), psychostimulants, and opioid antagonists. Spreat et al (16) reported that as many as two thirds of psychotropic medications prescribed to people with ID are antipsychotics.Studies suggest that PBs are not only prevalent but also persistent in people with . Totsika et al (20) found that serious physical attacks, self-injury and stereotypy were the most likely types of PBs to persist over time. It is therefore suggested that it may be necessary to start interventions as early as possible to prevent the behaviours from becoming more serious and to reduce the number of emergent behaviours. It has...

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Predicting the persistence of severe self-injurious behavior

Cited by 110 publications

References 18 publications

Chronicity of Challenging Behaviours in People with Severe Intellectual Disabilities and/or Autism: A Total Population Sample

Chronicity of Challenging Behaviours in People with Severe Intellectual Disabilities and/or Autism: A Total Population Sample

Analysis of risk factors and early predictors of challenging behavior for children with autism spectrum disorder

International guide to prescribing psychotropic medication for the management of problem behaviours in adults with intellectual disabilities

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