The Clinical Application of Applied Behavior Analysis in a Child With Partial Fetal Alcohol Syndrome

Abstract

The current case study describes the longitudinal assessment of a young child diagnosed with Partial Fetal Alcohol Syndrome and pervasive developmental disorder-not otherwise specified. The patient participated in an applied behavior analysis (ABA)-based Verbal Behavior treatment program to target communication impairments and functional skill deficits. Because ABA-based interventions have demonstrated efficacy in improving levels of functioning across various developmental disabilities, it was reasonable to assess the clinical utility of these same strategies when applied to a patient presenting with fetal alcohol spectrum disorder and associated developmental delays. The current study relied on quasi-experimental single-subject design methods to measure treatment outcomes and to inform clinical decision making. Dependent measures in the study included standardized, norm-referenced assessments of cognitive and adaptive functioning, as well as behavioral data collected throughout treatment to measure gains across skill areas. Outcomes included rapid skill acquisition across several areas of functioning (e.g., expressive and receptive language, visual-performance, and adaptive emotional/behavioral functioning). The impact of treatment on global areas of functioning will be reported. Keywords applied behavior analysis, fetal alcohol syndrome 1 Theoretical and Research Basis for Treatment Early and intensive intervention rooted in applied behavior analysis (ABA) is a widely utilized and researched area in the treatment of individuals with developmental disabilities. Defined as the scientific study of the effects of environmental variables on socially significant behavior, the field of ABA is devoted to assessing and treating socially significant behaviors to produce behavioral and developmental improvements (Cooper, Heron, & Heward, 2007).

A Systematic Review of Interventions to Improve Mental Health and Substance Use Outcomes for Individuals with Prenatal Alcohol Exposure and Fetal Alcohol Spectrum Disorder

“…in which behavioral interventions were delivered in various settings to children with FASD (ranging in age from 3 to 11 years), and findings were predominantly positive. In Connolly and colleagues’ (2016) study, a long‐term, intensive, and multidisciplinary applied‐behavior analysis‐based treatment led to posttreatment improvements in functional communication, adaptive behavior, and emotional–behavioral functioning for a young girl with FASD. Griffin and Copeland (2018) reported on an in‐home behavior therapy delivered to an 11‐year‐oldboy with FASD and his caregiver, which resulted in increased task completion and reduced argumentativeness over the course of treatment.…”

“…• One-on-one treatment to improve child functional communication, adaptive behavior, and emotional-behavioral functioning (Connolly et al, 2016) • Group program to improve rule following and appropriate behavior (Wiskow et al, 2018) Self-regulation…”

“…Behavioral Skills-Five studies were identified where children with PAE/FASD were taught skills and strategies to improve behavioral functioning. Three of these were case studies (Connolly et al, 2016;Griffin and Copeland, 2018;Wiskow et al, 2018). in which behavioral interventions were delivered in various settings to children with FASD (ranging in age from 3 to 11 years), and findings were predominantly positive.…”

The Distribution of Available Prevention and Management Interventions for Fetal Alcohol Spectrum Disorder (2007 to 2017): Implications for Collaborative Actions

“…We identified 13 facility-based management interventions [70,71,72,73,74,76,77,78,79,80,81,82] aimed at managing the FASD. Five of the facility-based management interventions were pharmacological interventions [70,72,73,76,82].…”

“…In another study, the use of an early intervention program for drug and alcohol addicted mothers and their young children (Breaking the Cycle) was effective to mitigate some of the well-described damages caused by heavy in utero alcohol exposure [75]. A different study reported that verbal behavior treatment program (applied behavior analysis) resulted in rapid skill acquisition across several areas of functioning (communication and functional skills) in a child with FASD [77]. Furthermore, physical activity program for children with FASD showed differences in cortisol levels in children with FASD compared to Controls [80].…”