The Long-term successful treatment of the very severe behaviors of a preadolescent with autism
The Long-term successful treatment of the very severe behaviors of a preadolescent with autism is a 2007 article by Richard Foxx and Jeffrey Garito that analyses the treatment procedure for one autistic 12-year-old boy. The article gives precise processes during the boy’s treatment, describing reinforcements or treatments that worked and those that did not. The authors used different types of interventions during a two-year program that ensured corrected behavior in the participant. This paper critically analyses Foxx’s and Garito’s article while offering views on its strengths, weaknesses, and inadequacies.
The authors in this study hypothesized that Ned’s destructive and aggressive behavior was a way for him to escape from demands, gain attention, access things he wanted, and sensory reinforce (Foxx & Garito, 2007). The authors’ primary purpose was to reduce Ned’s severe behaviors that included disruptive behavior, inappropriate toileting, induced vomiting, dangerous behavior, aggression, and self-injury. Ned had been adopted from Romania at the age of 2 (Foxx & Garito, 2007). He had attention deficit hyperactivity disorder, autism, and mental retardation. Before the authors intervened in his treatment, Ned was enrolled in a 9-month inpatient program that used discrimination and extinction training methods. However, these methods did not work as Ned left the program with an escalation in his severe behaviors.
The authors used a four-phase procedure that ensured changed settings during the treatment. In all these phases, Ned studied in a single room as the only student. His staff included therapeutic support staff, one teacher, two teacher’s aides (one accurately recorded data on Ned’s progress), and the authors (Foxx & Garito, 2007). Phase 1 was the baseline phase that used the inpatient facility’s instructions. Ned thus had a Ned’s way/Our way program that ran for 5 and 10 minutes, respectively. Step 2 comprised of a home and community-based program with reinforcement programs such as a token economy or a response cost program. The senior author’s presence is constant during this phase. In phase 3, the program’s setting moves to the district’s church, where the junior author oversees the interventions. Here, exercises such as overcorrection and contingent physical exercises are utilized to reduce severe behavior. The fourth phase is a transition from seclusion training to a public school system. By the fourth phase, Foxx and Garito (2007) assert that Ned’s behavioral excesses had diminished considerably.
The article shows many positive aspects of behavioral intervention. It also indicates that all autistic individuals respond differently to different interventions. For instance, factors such as discrimination training and Ned’s way/Our way system only escalated his tendencies. However, a gradual change in Ned’s settings, permanent support staff, and reinforcements, such as the token economy, led to the success of the treatment program. The program was successful as it gave Ned the chance to enjoy reinforcement and partake in more challenging activities.
Similarly, Foxx and Meindl (2007) show that high-density reinforcements are critical in changing the target behaviors. Moreover, Foxx and Meindl (2007) contend that target behaviors such as aggression in autistic preteenagers may also be due to oversimplification of their schoolwork. Therefore, the Foxx and Garito (2007) study tried to ensure that Ned underwent a constant learning process.
The program also facilitates educational growth. Ned developed educational skills in phase 2 after the eradication of non-challenging and Ned’s way/Our way techniques. The use of an Individualized Education Plan (IEP) also reduced Ned’s stigmatization from other students, thus providing him with a conducive learning environment. Additionally, Ned was receptive to this treatment as it took gradual steps from a secluded training environment to a more social setting, as shown in phase four, during his move to a primary school in his district. Foxx and Meindl (2007) also used similar treatment procedures in a preteen patient with autism and derived results showing high levels of educational growth.
Furthermore, the Fox and Garito (2007) program ensured Ned’s severe behaviors diminished and did not produce escape from challenges or educational activities. Also, the program helped Ned express his needs in a more coherent manner that did not scare or harm his teachers and parents. Ned also understood that to access reinforcers; he had to display appropriate behaviors and make relevant requests. Although long, the program also succeeded in ensuring that Ned could not impose harm on himself or others.
Regardless of the many positive impacts of the study on Ned’s behaviors, the program did not comprehensively cover his social interactions. Sarris (2017) states that social interactions are critical in the successful treatment of behavioral excesses in autistic patients. However, Ned’s procedure was largely centralized on his isolation from his peers. Even after he was moved to a public school, he was still taught in a separate individualized classroom, with minimal interaction with his peers. The most suitable way to test Ned’s newly-acquired normalized behaviors would be to place him in a setting with his age mates or fellow autistic students.
Sarris (2017) also avers that it is difficult for psychologists to determine effective treatment mechanisms for different autistic patients. The program use for Ned’s treatment may, therefore, be ineffective for other patients. The Foxx and Garito (2007) article, thus fails in providing a treatment procedure that is uniform to many autistic preteens. It also fails in providing more scientific analyses of the process as the treatment is a clinical program.
The Long-term successful treatment of the very severe behaviors of a preadolescent with autism article is critical as it provided possible solutions for aggressive behavior. Not only does the program used increase educational growth, but it also improves a patient’s overall functioning. Nonetheless, the program provides limited evidence on the effectiveness of its interventions on other autistic preteenagers.
References
Foxx, M., & Garito, J. (2007). The long term successful treatment of the very severe behaviors of a preadolescent with autism. Behavioral Interventions, 22, 69–82. 10.1002/bin.232
Foxx, R., & Miendl, J. (2007). The long term successful treatment of the aggressive/destructive behaviors of a preadolescent with autism. Behavioral Interventions, 22, 83-97. 10.1002/bin.233
Sarris, M. (2015). Diagnosing and treating extreme behavior in children with autism. IAN Community. https://iancommunity.org/ssc/diagnosing-treating-extreme-behavior-autism