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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.

A plethora of literature suggests that collaborative partnerships among families, educators, and outside service providers are necessary and beneficial to address behavior problems, but there continues to be a lack of coordination among these stakeholders. The current study used conjoint behavioral consultation (CBC) to facilitate the development and implementation of collaborative intervention plans. Parents, teachers, and an outside mental health provider worked together to create and support behavioral intervention plans that were implemented at home and school. The results of this multiple baseline study indicate that collaborative interventions developed through the CBC process were effective in improving behavior at home and school. More specifically, visual analysis of the data, along with calculated effect sizes, showed an increase in the percentage of time that all 3 participants complied with expectations during problematic routines at home and school. Implications, limitations, and future research directions are discussed.

Children living in rural and underserved areas experience decreased access to health care services and are often diagnosed with autism at a later age compared to those living in urban or suburban areas. This study examines the utility and validity of an ASD assessment protocol conducted via video conferencing (VC). Participants (n = 17) included families with young children (2.5-6 years) requesting an evaluation for ASD in an interdisciplinary clinic. We randomly assigned families to complete an additional evaluation either in-person or via VC prior to their clinic appointment and compared diagnostic impressions to their interdisciplinary clinic evaluation. Results demonstrate excellent inter-rater agreement on diagnoses between clinicians in the VC setting and the interdisciplinary team, which suggests VC may be a viable method to increase access to autism diagnostic services, and ultimately early intervention, for families in rural and underserved areas.

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.

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.)

Risperidone has shown safety and efficacy for aggressive and destructive behaviors in short-term studies. This longer-duration study includes a broad sample. Forty subjects, aged 8-56 years (mean=22), all with mental retardation and 36 with autism spectrum disorders participated in this 22-week crossover study, with 24 weeks of open maintenance thereafter. Of 40 subjects, 23 (57.5%) responded fully (50% decrease in Aberrant Behavior Checklist-Community Irritability subscale score), while 35 subjects (87.5%) showed a 25% decrease. Gender, mood disorder, and antiseizure medications did not alter response. Increased appetite and weight gain were common. Low dose risperidone was effective for aggressive behavior in persons with MR. More long-term studies are needed, incorporating weight control interventions.

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.

A functional assessment interview was conducted with care providers of 100 children (ages 2-5) with autism regarding reinforcement contingencies contributing to maintenance of disruptive behavior. Gaining access to perseverative activities and escaping demands while engaged in these activities frequently contributed to disruptive behavior in the children with autism. (Contains references.) (Author/CR)

A study involving 11 non-medical professionals and 17 parents of children with autism resulted in the following guidelines for sharing a diagnosis of autism, including establish a family-friendly setting, understand the family's needs, use good communication skills, provide a list of resources and interventions, discuss prognosis, provide hope, and follow-up. (Contains references.) (CR)

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)

Standardized assessment instruments and direct observation data were collected pre- and post-administration (2 weeks after administration) on the effects of secretin on a 4-year-old boy with autism. No changes in communication functioning, occurrences of stereotypic behavior, or social interaction were observed. A 3-month follow-up indicated no substantial behavioral changes. (Contains references.) (Author/CR)

A treatment package consisting of differential reinforcement of other behavior (DRO), token fines, and prompted relaxation was used to reduce the agitated-disruptive behavior of a young adult with autism and mental retardation living in a community group home. DRO procedures were partially implemented by a peer with Down syndrome. Baseline rates of target behaviors determined effective DRO intervals. (DB)

The article suggests a role for Human Rights Committees in monitoring programs for mentally retarded persons in terms of whether the goals and objectives are adequate and whether the habilitation procedures represent a reasonable balance between intrusiveness and effectiveness and are being employed as indicated in the habilitation plan. (Author/CL)

Rather than questioning equal educational opportunities for disabled students, the authors suggest that research and curriculum development should focus on three areas: criteria of educational validity to demonstrate appropriateness; variance in learning associated with specific student characteristics and interventions; and valid curricular approaches for efficiency and cost-effectiveness. (Author/CL)

The authors argue that standardized group training of parents, without provision of individualization, is not likely to be fully successful. Individualized Education Plans in parent-training programs are suggested. (Author/CL)

Agitated-disruptive behavior from three mentally retarded adults in community group homes was reduced using procedures that included a self-recorded differential reinforcement of other behavior point fines for agitated-disruptive behavior, social skills training, and relaxation training. (Author/CL)

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. [ABSTRACT FROM AUTHOR]

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]

Objective: The aim of this study was to study valproate efficacy and safety for aggression in children and adolescents with pervasive developmental disorders (PDD)., Methods: In this prospective double-blind, placebo-controlled study, 30 subjects (20 boys, 10 girls) 6-20 years of age with PDD and significant aggression were randomized and received treatment with valproate (VPA) or placebo (PBO) for 8 weeks as outpatients. Mean VPA trough blood levels were 75.5 mcg/mL at week 4 and 77.8 mcg/mL at week 8., Results: No treatment difference was observed statistically between VPA and PBO groups. The Aberrant Behavior Checklist--Community Scale (ABC-C) Irritability subscale was the primary outcome measure (p = 0.65), and CGI--Improvement (p = 0.16) and OAS (p = 0.96) were secondary outcome measures. Increased appetite and skin rash were significant side effects. Only 1 subject was dropped from the study owing to side effects, notably a spreading skin rash, which then resolved spontaneously. Two subjects receiving VPA developed increased serum ammonia levels, one with an associated parent report of slurred speech and mild cognitive slowing. Poststudy, of 16 VPA and PBO subjects receiving VPA, 10 subjects demonstrated sustained response, 4 of whom later attempted taper, with significant relapse of aggression., Conclusion: The present negative findings cannot be viewed as conclusive, partly owing to the large placebo response, subject heterogeneity, and size of the groups. Larger studies are needed to expand upon these findings.