Demonstration of Parent Training to Address Early Self-Injury in Young Children with Intellectual and Developmental Delays
Individuals with intellectual and developmental disabilities (IDD) are at a high risk for engaging in self-injurious behavior (SIB). Prognosis is poor when SIB emerges early. Limited research exists on interventions teaching parents how to manage their young child’s SIB. This investigation assessed the feasibility of adapting an applied behavior analytic parent training program with 11 parents of children 1–5 years of age with IDD and SIB. Quantitative and observational measures were used to assess outcomes; semi-structured interviews assessed caregiver satisfaction. Outcomes yielded preliminary data suggesting the adapted curriculum was feasible and acceptable to parents. Initial efficacy outcomes yielded decreases in SIB and observed negative parent–child interactions on pre- and post-measures. Qualitative data provided areas for further curriculum refinement.
KeywordsSelf-injury Parent training Applied behavior analysis Developmental delay Young child
We would like to thank Alexia Cathala, BA with assistance in data management, and Noha Minshawi, PhD with feedback on initial study design.
JF conceived the study, conducted analyses, drafted the manuscript. AK conducted supplementary analyses, assisted with drafting/providing feedback on manuscript drafts. MF conducted data collection, assisted with drafting/providing feedback on manuscript drafts. NB provided feedback on study design and provided feedback on manuscript drafts. All authors read and approved the final manuscript.
This research is supported by the Indiana Clinical and Translational Sciences Institute Young Investigator Award funded in part by National Institutes of Health grant # UL1TR001108 (A. Shekhar, PI), 9/26/2013–4/30/2018, and the Indiana University Strategic Research Initiative (SRI). Its contents are solely the responsibility of the authors and do not necessarily represent the official view of the Indiana CTSI or NIH.
Compliance with Ethical Standards
Conflict of interest
All authors have no other conflicts of interest to report.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all caregiver participants included in the study for themselves as well for their child.
- Abidin, R. R. (1990). Parenting stress index-short form. Charlottesville, VA: Pediatric Psychology Press.Google Scholar
- Aman, M. G., Singh, N. N., Stewart, A. W., & Field, C. J. (1985). Psychometric characteristics of the aberrant behavior checklist. American Journal of Mental Deficiency, 89, 492–502Google Scholar
- Bearss, K., Johnson, C., Handen, B., Butter, E., Lecavalier, L., Smith, T., & Scahill, L. (2015a). RUBI Autism Network: Parent training for disruptive behavior [a treatment manual]. Publisher: Authors. Retrieved from http://www.rubinetwork.org.
- Dimian, A. F., Botteron, K. N., Dager, S. R., Elison, J. T., Estes, A. M., Pruett, J. R., et al. (2017). Potential risk factors for the development of self-injurious behavior among infants at risk for Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 47(5), 1403–1415.CrossRefGoogle Scholar
- Feldman, M. A., & Werner, S. E. (2002). Collateral effects of behavioral parent training on families of children with developmental disabilities and behavior disorders. Behavioral Interventions, 17(2), 75–83.Google Scholar
- Forehand, R. L., & McMahon, R. J. (1981). Helping the noncompliant child: A clinician’s guide to parent training. New York: Guilford Press.Google Scholar
- Furniss, F., & Biswas, A. B. (2012). Recent research on aetiology, development and phenomenology of self-injurious behaviour in people with intellectual disabilities: A systematic review and implications for treatment. Journal of Intellectual Disability Research, 56(5), 453–475.CrossRefGoogle Scholar
- Guy, W. B. R. R. (1976). CGI clinical global impressions. EC-DEU Assessment Manual for Psychopharmacology, Rockville, 76-338.Google Scholar
- Johnson, C. R., Butter, E. M., Handen, B. L., Sukhodolsky, D. G., Mulick, J., Lecavalier, L., et al. (2009). Standardised Observation Analogue Procedure (SOAP) for assessing parent and child behaviours in clinical trials. Journal of Intellectual and Developmental Disability, 34(3), 230–238.CrossRefGoogle Scholar
- Mitchell, E. S., Bearss, K., & Scahill, L. (2014, August). The use of parent nominated target problems to assess outcomes in psychosocial interventions for young children with Autism Spectrum Disorder. In Poster session presented at the Annual Convention of the American Psychological Association, Washington, DCGoogle Scholar
- Rojahn, J., Matson, J. L., Lott, D., Esbensen, A. J., & Smalls, Y. (2001). The Behavior Problems Inventory: An instrument for the assessment of self-injury, stereotyped behavior, and aggression/destruction in individuals with developmental disabilities. Journal of Autism and Developmental Disorders, 31(6), 577–588.CrossRefGoogle Scholar
- Rojahn, J., Schroeder, S. R., & Hoch, T. A. (2007). Self-injurious behavior in intellectual disabilities (Vol. 2). Amsterdam: Elsevier.Google Scholar
- Rojahn, J., Schroeder, S. R., Mayo-Ortega, L., Oyama-Ganiko, R., LeBlanc, J., Marquis, J., & Berke, E. (2013). Validity and reliability of the Behavior Problems Inventory, the Aberrant Behavior Checklist, and the Repetitive Behavior Scale-Revised among infants and toddlers at risk for intellectual or developmental disabilities: A multi-method assessment approach. Research in Developmental Disabilities, 34(5), 1804–1814.CrossRefGoogle Scholar
- Schroeder, S. R., Marquis, J. G., Reese, R. M., Richman, D. M., Mayo-Ortega, L., Oyama-Ganiko, R., et al. (2014). Risk factors for self-injury, aggression, and stereotyped behavior among young children at risk for intellectual and developmental disabilities. American Journal on Intellectual and Developmental Disabilities, 119(4), 351–370.CrossRefGoogle Scholar
- Schroeder, S. R., Reese, R. M., Hellings, J., Loupe, P., & Tessel, R. (1999). The causes of self-injurious behavior and their clinical implications. In N. Wieseler & R. Hanson (Eds.), Challenging behavior (pp. 249–261). Washington, DC: American Association on Mental Retardation.Google Scholar
- Seale, C., Gobo, G., Gubrium, J. F., & Silverman, D. (Eds.). (2004). Qualitative research practice. London: Sage.Google Scholar
- Tabachnick, B. G., & Fidell, L. S. (2013). Using multivariate statistics (6th ed.). Boston: Pearson.Google Scholar
- Webster-Stratton, C., & Reid, M. J. (2010). The incredible years parents, teachers, and children training series: A multifaceted treatment approach for young children with conduct disorders. New York: Guilford Press.Google Scholar