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Research has suggested that individuals who engage in self-injurious behavior may have enhanced expressions of pain, which contradicts previous assertions of blunted pain sensitivity in this population. The purpose of this study was to measure expressions of pain among young children being evaluated for autism and other neurodevelopmental disabilities. The frequency of pain-related behaviors was assessed during everyday routines using the Non-Communicating Children's Pain Checklist (NCCPC-R) for 51 children. Significant group differences between children with and without self-injury were found for the NCCPC-R total scores. The frequency and severity of self-injury, aggression, and stereotypy were also highly correlated with the total scores on the NCCPC-R. These results continue to support that individuals with self-injury may have enhanced expressions of pain.

Before the 1990s, research on the early identification and prevention of severe behavior disorders (SBDs), such as aggression, self-injury, and stereotyped behavior, among young children with intellectual and developmental disabilities (IDD), was mostly done with children 3 years or older. More recent work suggests that signs of SBDs may occur as early as 6 months in some infants. The present study combined a cross-sectional and longitudinal approach to examine SBDs in 180 young children aged 4-48 months recruited through mass screening, then receiving an interdisciplinary evaluation and six-month follow-ups for one year. Twelve potential risk factors related to SBDs were examined. Eight of these risk factors, including age, gender, diagnosis, intellectual and communication levels, visual impairment, parent education, family income, were differentially related to scores for Aggression, SIB, and Stereotyped Behavior subscales on the Behavior Problems Inventory (BPI-01) at initial interdisciplinary evaluation. BPI-01 scores decreased over the year for 57% of the children and increased for 43%. The amount of decrease on each BPI-01 subscale varied with age, gender, and diagnosis.

Expanding on Reese et al. [2003], functional behavioral assessment interviews [O'Neill et al., 1997] concerning disruptive behavior were conducted with parents of 23 children with autism (6 females, 17 males, chronological ages [CA] 24-60 months) and 23 controls without autism pair-matched for CA, developmental age and sex. All children exhibited frequent disruptive behavior. The interviews suggested that matched control children's disruptive behavior typically functioned to gain attention or items, or to escape demands in general. This was also true for girls with autism. For boys with autism, disruptive behavior more often functioned to (a) escape demands that interfere with repetitive behavior, (b) retain access to an item used in repetitive routines, or (c) avoid idiosyncratically aversive sensory stimuli (e.g., ordinary household noises). These results emphasize the importance of considering behavioral characteristics that are associated with sex and specific disorders or syndromes when conducting functional behavioral assessments.

Severe behavior problems among people with intellectual and developmental disabilities (IDD) are a major barrier to integration in the community. Recent research suggests that these behaviors often begin very early in life and might be prevented by early identification and intervention (Rojahn, Schroeder, & Hoch, 2008). The current article presents a method of mass screening for early signs of severe behavior problems among infants and toddlers in Peru. A Parental Concerns Questionnaire (PCQ), which asks 15 questions, each related to a risk factor for severe behavior problems, based on past research on IDD, was used by veteran parents to interview 341 new parents who had been solicited by TV, radio, and public service announcements across the country. Of these, 262 were recruited and enrolled in a longitudinal study in which they will be followed for 12 months to see if at-risk children actually will develop severe behavior problems. An extensive initial interdisciplinary evaluation was given to each child. Consumer satisfaction questionnaires were given to the parents as to their attitude toward the screening method. Data from the vaccines contributedEvaluations of the sample suggest a very high hit rate (96%) by the screening instrument (PCQ). Consumer satisfaction was 98%, suggesting that the method was tolerated well by parents. The PCQ is a brief and efficient method to screen infants and toddlers at risk for severe behavior problems. The data also suggest that parents suspect these problems at a very early age. Early intervention thus seems a feasible strategy to intervene before these problems become deeply ingrained as children develop. (Contains 3 tables and 4 figures.)

The efficacy of the atypical antipsychotic risperidone was evaluated in the treatment of aberrant behavior (e.g., aggression, self-injury) in 20 individuals with developmental disabilities. The study, a double-blind crossover design, identified 50 percent of participants as responders. Naturalistic observations of five participants showed that risperidone was effective in reducing aberrant behavior in four individuals. (Contains references.) (Author/DB)

Functional analyses were conducted during a double-blind, placebo-controlled study of the atypical antipsychotic medication risperidone with 13 individuals. Risperidone was effective in reducing destructive behavior (compared to placebo) for 10 participants. For 7 of these responders, an undifferentiated pattern of responding occurred across their baseline functional analysis conditions (i.e., a similar rate of responding across conditions), and risperidone treatment produced nonspecific reductions of their destructive behavior across functional analysis conditions. For the remaining 3 responders, a differentiated pattern of responding occurred across their baseline functional analysis conditions (i.e., an elevated rate of responding occurred in a specific condition), and risperidone treatment produced function-specific reductions of their destructive behavior. [ABSTRACT FROM AUTHOR]

A functional assessment interview (O'Neill et al., 1997) was conducted with the care providers of 100 young (2 to 5 years old) children with autism regarding reinforcement contingencies contributing to maintenance of their child's disruptive behavior. Care providers were interviewed regarding their child's disruptive behavior related to gaining attention and tangibles and escaping demands. In addition, we individualized the interview in more detail to include the possible relationship between their child's disruptive behavior and gaining access to perseverative activities, avoiding demands when engaged in perseverative activities, and avoiding specific types of sensory stimulation. Results of the study suggest that gaining access to perseverative activities and escaping demands while engaged in these activities frequently contribute to disruptive behavior in young children with autism. These findings are discussed in terms of assessment considerations and treatment for children with autism and other types of syndromes and disorders. [ABSTRACT FROM AUTHOR]

A treatment package consisting of a DRO procedure, token fines, and prompted relaxation was used to reduce the agitated-disruptive behavior of a person with autism and mental retardation living in a community group home. The agitated-disruptive behaviors (cursing, hitting, kicking, throwing objects, and verbal threats) were measured during three different activities in a group home. The baseline rates of the agitated-disruptive behavior during one of these activities was relatively low, during another was moderate, and during the third was high. DRO procedures were partially implemented by a peer with Down syndrome and mental retardation during a portion of the study. Effects of the DRO procedures were as follows: During each activity an initial reduction of agitated-disruptive behavior was dependent on choosing an appropriate DRO interval, with shorter DRO intervals required during activities in which the baseline rates of the agitated-disruptive behavior were higher. Once shorter DRO intervals had been used to reduce agitated-disruptive behavior, longer DRO intervals were effective in maintaining those reductions. Reductions were maintained for up to 6 months. [ABSTRACT FROM AUTHOR]