Skip to main content

Behavioral Treatment of Problem Behavior for an Adult with Autism Spectrum Disorder and Misophonia

Abstract

Misophonia is characterized by an autonomic response (e.g., increased heart rate) that is elicited by certain innocuous or repetitive sounds, and individuals with misophonia may display an extreme, overt response commonly associated with rage, hatred, and a loss of self-control. In this investigation, we used a combined respondent and operant approach to treat problem behavior evoked by bodily sounds (i.e., coughing, sneezing, sniffling, and clearing throat) for an adult with autism spectrum disorder. The intervention produced immediate reductions of problem behavior and the effects of treatment maintained during progressively lean schedules of reinforcement. The results of this study will be discussed in light of past research, along with limitations, and future directions for research and clinical practice.

This is a preview of subscription content, access via your institution.

Fig. 1

References

  1. Baer, D. M., Wolf, M. M., & Risley, T. R. (1968). Some current dimensions of applied behavior analysis. Journal of Applied Behavior Analysis, 1, 91–97. https://doi.org/10.1901/jaba.1968.1-91.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Bernstein, R. E., Angell, K. L., & Dehle, C. M. (2013). A brief course of cognitive behavioural therapy for the treatment of misophonia: A case example. The Cognitive Behaviour Therapist, 10, 1–13. https://doi.org/10.1017/S1754470X13000172.

    Article  Google Scholar 

  3. Brout, J. J., Edelstein, M., Erfanian, M., Mannino, M., Miller, L. J., Rouw, R., et al. (2018). Investigating misophonia: A review of the empirical literature, clinical implications, and a research agenda. Frontiers in Neuroscience, 12, 1–13. https://doi.org/10.3389/frnins.2018.00036.

    Article  Google Scholar 

  4. Bruxner, G. (2016). “Mastication rage”: A review of misophonia – An under-recognized symptom of psychiatric relevance? Australian Psychiatry, 24, 195–197. https://doi.org/10.1177/1039856215613010.

    Article  Google Scholar 

  5. Dozier, T. H. (2015). Counterconditioning treatment for misophonia. Clinical Case Studies, 14, 374–387. https://doi.org/10.1177/1534650114566924.

    Article  Google Scholar 

  6. Dozier, T., & Morrison, K. L. (2017). Phenomenology of misophonia: Initial physical and emotional responses. The American Journal of Psychology, 130, 431–438. https://doi.org/10.5406/amerjpsyc.130.4.0431.

    Article  Google Scholar 

  7. Fisher, W. W., Piazza, C. C., Bowman, L. G., Hagopian, L. P., Owens, J. C., & Slevin, I. (1992). A comparison of two approaches for identifying reinforcers for persons with severe and profound disabilities. Journal of Applied Behavior Analysis, 25, 491–498.

    Article  Google Scholar 

  8. Hill, T. L., Saulnier, C. A., Cicchetti, D., Gray, S. A. O., & Carter, A. S. (2017). Vineland III. In F. Volkmar (Ed.), Encyclopedia of autism Spectrum disorders. New York: Springer.

    Google Scholar 

  9. Jastreboff, P. J., & Jastreboff, M. M. (2014). Treatments for decreased sound tolerance (hyperacusis and misophonia). Seminars in Hearing, 35, 105–120. https://doi.org/10.1055/s-0034-1372527.

    Article  Google Scholar 

  10. McCord, B. E., Iwata, B. A., Galensky, T. L., Ellingson, S. A., & Thomson, R. J. (2001). Functional analysis and treatment of problem behavior evoked by noise. Journal of Applied Behavior Analysis, 34, 447–462. https://doi.org/10.1901/jaba.2001.34-447.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Moller, A. R. (2011). Misophonia, phonophobia, and “exploding head” syndrome. In (Eds.) a. R. Moller, B. Lannguth, D. De Ridder, and T. Kleinjung (pps. 25-26). New York, NY: Springer. doi: https://doi.org/10.1007/978-1-60761-145-5_4.

  12. National Research Council (2001). Educating children with autism. Committee on Educational Interventions for Children with Autism. C. Lord & J. P. McGee (Eds.). Division of Behavioral and Social Sciences and Education. Washington, DC: National Academy Press.

  13. Petscher, E. S., Rey, C., & Bailey, J. S. (2009). A review of empirical support for differential reinforcement of alternative behavior. Research in Developmental Disabilities, 30, 409–425. https://doi.org/10.1016/j.ridd.2008.08.008.

    Article  PubMed  Google Scholar 

  14. Schroder, A. E., Vulink, N. C., van Loon, A. J., & Denys, D. A. (2017). Cognitive behavioral therapy is effective in misophonia: An open trial. Journal of Affective Disorders, 217, 289–294. https://doi.org/10.1016/j.jad.2017.04.017.

    Article  PubMed  Google Scholar 

  15. Schwartz, P., Leyendecker, J., & Conlon, M. (2011). Hyperacusis and misophonia: The lesser-known siblings of tinnitus. Minnesota Medicine, 94, 42–43.

    PubMed  Google Scholar 

  16. Stokes, T. F., & Baer, D. M. (1977). An implicit technology of generalization. Journal ofApplied Behavior Analysis, 10(2), 349–367. https://doi.org/10.1901/jaba.1977.10-349.

    Article  Google Scholar 

  17. van de Mortel, T. F. (2008). Faking it: Social desirability response bias in self-report research. Australian Journal of Advanced Nursing, 25, 40–48.

    Google Scholar 

  18. Vigerland, S., Lenhard, F., Bonnert, M., Lolouni, M., Hedman, E., Ahlen, J., et al. (2016). Internet-delivered cognitive behavior therapy for children and adolescents: A systematic review and meta-analysis. Clinical Psychology Review, 50, 1–10. https://doi.org/10.1016/j.cpr.2016.09.005.

    Article  PubMed  Google Scholar 

  19. Wacker, D. P., Harding, J. W., Berg, W. K., Lee, J. F., Schieltz, K. M., Padilla, Y. C., Nevin, J. A., & Shahan, T. A. (2011). An evaluation of persistence of treatment effects during long-term treatment of destructive behavior. Journal of the Experimental Analysis of Behavior, 96(2), 261–282. https://doi.org/10.1901/jeab.2011.96-261.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Wolpe, J. (1995). Reciprocal inhibition: Major agent of behavior change. In W. T. O’Donohue & L. Krasner (Eds.), Theories of behavior therapy: Exploring behavior change (pp. 23–57). American Psychological Association. https://doi.org/10.1037/10169-002.

  21. Wu, M. S., Lewin, A. B., Murphy, T. K., & Storch, E. A. (2014). Misophonia: Incidence, phenomenology, and clinical correlates in an undergraduate student sample. Journal of Clinical Psychology, 70, 994–1007. https://doi.org/10.1002/jclp.22098.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We wish to thank Alex Silva, Amber Shultz, Cristian Ceja, Ignacio Aviles, Juan Rafael, and Ken Nhu for their assistance with this study.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Shaji S. Haq.

Ethics declarations

Disclosure of Potential Conflicts of Interest

All authors of this manuscript declare that they have no conflicts of interest.

Research Involving Human Participants

Ethical approval: 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 Helsinski declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from the guardian of the participant included in this study.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Haq, S.S., Alresheed, F. & Tu, J.C. Behavioral Treatment of Problem Behavior for an Adult with Autism Spectrum Disorder and Misophonia. J Dev Phys Disabil 33, 1005–1015 (2021). https://doi.org/10.1007/s10882-020-09780-8

Download citation

Keywords

  • Autism spectrum disorder
  • Fixed-time schedule
  • Misophonia
  • Problem behavior