|
| Effective Treatment of Students with Severe Behavior Disorders Who Failed to Respond to Traditional Positive-Only Treatment Programs |
| Saturday, May 26, 2007 |
| 2:00 PM–3:20 PM |
| Randle D |
| Area: EDC; Domain: Service Delivery |
| Chair: Patricia Rivera (Judge Rotenberg Center) |
| CE Instructor: Nathan Blenkush, Ph.D. |
| Abstract: This symposium will address effective treatment of students with severe behavior disorders who have a history of not responding to traditional positive-only programs. The first presenter will present various case studies of specific students. A review of the students treatment histories will also be discussed and behavioral charts will be shown to document the students behavioral improvement. The second presenter will discuss the implementation of contingent skin shock as a supplement to positive behavior programming for students with significant histories of severe behavior disorders. Safeguards to ensure the proper implementation of the skin shock will also be discussed. A demonstration of the Graduated Electronic Decelerator (GED) used at the Judge Rotenberg Center will be provided. The third presentation will include the effects of sudden fading of the contingent skin shock device. Case studies will be discussed and behavioral charts presented documenting the behavioral regressions when the GED is faded abruptly. Finally, case studies will be presented showing the successful fading of the GED. |
| |
| Successful Treatment of Students Who Have Failed Positive-Only Programs. |
| RACHEL NICOLLE MATTHEWS (Judge Rotenberg Center), Christine Chiudina (Judge Rotenberg Center) |
| Abstract: Historically, some students have been enrolled at the Judge Rotenberg Center (JRC) after other, positive-only programs, have failed to contain, manage or modify their most problematic and severe behaviors. For most students, JRC is not their first residential placement and must come out of necessity when other treatment facilities either refuse to accept them or discharge them from their program due to an inability to provide successful treatment. Students who once required multiple staff and daily emergency restraints at other programs are now engaging in consistent academic completion in a classroom with peers and require no additional staff or emergency restraint. The Judge Rotenberg Center is not only able to contain severe aggressive and self-injurious behaviors; they are able to provide a better quality of life for these students, often free of psychotropic medication. |
| |
| Approval Process for the Use of Contingent Skin Shock and Subsequent Monitoring. |
| ROBERT VON HEYN (Judge Rotenberg Center) |
| Abstract: The process of getting approval to use contingent skin shock and the safeguards of its use will be presented. The first step is getting signed consent from the parent/guardian and approval from the funding agency. Next a detailed, individualized proposal is prepared by a doctoral level clinician and submitted to the court. The court then assigns an attorney to represent the individual who, in most cases, hires an expert to review the proposed treatment plan. An independent clinician also reviews the plan and writes their recommendations to the court. A hearing is scheduled and a judge decides whether he/she believes this proposed treatment is the most effective, least intrusive treatment available for that individual. Peer Review and Human Rights Committees must grant their approval before the plan can be implemented. All treatment is monitored across school, residence and during transportation by a digital video recording system which is also live monitored 24 hours a day. Quarterly reports are sent to the guardian, court and funding agencies and plans are reviewed yearly. A demonstration of the skin shock device used at JRC will be given. |
| |
| Successful Fading of Contingent Skin Shock when Combined with Positive Behavioral Programming. |
| PATRICIA RIVERA (Judge Rotenberg Center) |
| Abstract: Students in residential treatment with severe behavior disorders may require some type of aversive interventions to supplement positive behavioral programming when positive programming alone has not proved to be successful in reducing the frequency of dangerous behaviors. Case studies will be presented showing the course of treatment for some of these students from the Judge Rotenberg Center including the successful fading of contingent skin shock. Case histories will be presented along with behavioral charts documenting the success of the fading program. Academic progress and transitional planning will also be addressed. |
| |
| The Effect of Abruptly Removing an Aversive Intervention. |
| NATHAN BLENKUSH (Judge Rotenberg Center) |
| Abstract: In June of 2006, JRC was forced to remove interventions that had proven extremely effective in eliminating or significantly reducing the occurrence of severe problem behaviors for over 50 students who had not responded to positive-only interventions. After a Federal court order in September of 2006, these treatments were reinstated. In this presentation, we (a) discuss the effects of the abrupt removal in comparison with our gradual fading plan (b) present charts that describe the changes and (c) discuss clinical implications of abruptly removing an effective punishment contingency. |
|
| |