Treating obsessive compulsive behavior and enhancing peer engagement in a preschooler with intellectual disability

Abstract

Intellectual disability (ID) is a neurodevelopmental disorder characterized by impairments in cognitive and adaptive functioning in social, practical, or conceptual domains. Individuals with ID present with higher-order repetitive behaviors such as a need for sameness, ritualistic, and compulsive behaviors.Often referred to as obsessive compulsive behaviors (OCBs), these behaviors increase in prevalence between 2 and 5 years of age. The present study evaluated an exposure-based behavioral intervention for decreasing OCBs and concomitantly increasing play skills in a 4-year-old boy with mild ID in an inclusive preschool setting. Using a multiple baseline across behaviors design, the intervention was associated with a decrease in target behaviors and an increase in the duration of peer social engagement, with results maintained at 3-week follow-up.The intervention consisted of exposure and response prevention with function-based components. Procedures including prompting and reinforcement were generalized to parent and teacher mediators. This study provides preliminary support for the use of an exposure-based behavioral intervention to treat OCBs in children of preschool age with ID. KEYWORDS exposure and response prevention, functional behavioral assessment, intellectual disability, obsessive compulsive behavior, school-based interventionThe researchers would like to thank the participating preschool, teachers, and family for their contribution to the project. This research was supported by a graduate fellowship and Match of Minds scholarship from Brock University.

Considering efficacy and effectiveness trials of cognitive behavioral therapy among youth with autism: A systematic review

“…The field of implementation science has evolved to help bridge this gap and to better understand the barriers and facilitators that exist in translating evidence-based innovations into practice such that successful efficacy trials do become eventual successful effectiveness trials where interventions are delivered with fidelity in an economical and sustainable way in the community worldwide (Wood, McLeod, et al, 2015). In our review, about half of the efficacy studies identified (Ehrenreich-May et al, 2014; Fujii et al, 2013; Reaven et al, 2012b; Storch et al, 2013; Vause et al, 2017; Weiss et al, 2015; White et al, 2013; Wood et al, 2009; Wood, Ehrenreich-May, et al, 2015) went on to become eventual effectiveness studies (Ames & Weiss, 2013; Beidas et al, 2010; Floor & Lane, 2018; Guertin et al, 2019; Ireri et al, 2019; Kester & Lucyshyn, 2019; Wise et al, 2019; Wood et al, 2014). These studies occurred using a number of different CBT programs (e.g.…”

Obsessive–compulsive behaviors in autism spectrum disorder: Behavior analytic conceptual frameworks.

“…Repetitive behaviors in ASD and similar developmental disorders can also occur due to social positive reinforcement (e.g., providing attention or items to the individual) or social negative reinforcement (e.g., delaying or terminating aversive events; Guertin et al, 2019;Neil et al, 2017;Vause et al, 2014Vause et al, , 2017. Establishing operations can increase after periods of deprivation for social positive reinforcement or prolonged presentation of aversive stimuli for negative reinforcement.…”

“…Studies have used established indirect measures such as the Questions About Behavioral Function (QABF; Matson & Vollmer, 1995) to assess the functions of OCBs (Vause et al, 2014; Vause, Jaksic, et al, 2020); however, no interview has yet been established for assessing the function of OCBs specifically. In response to the paucity of measures available, Guertin et al (2016) developed and piloted the Parent Interview for Assessing Function—Obsessive-Compulsive Behavior, a structured interview assessment to determine the functions of OCBs with a caregiver as an informant (Guertin et al, 2019).…”