Association for Behavior Analysis International

The Association for Behavior Analysis International® (ABAI) is a nonprofit membership organization with the mission to contribute to the well-being of society by developing, enhancing, and supporting the growth and vitality of the science of behavior analysis through research, education, and practice.


43rd Annual Convention; Denver, CO; 2017

Event Details

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Symposium #397
CE Offered: BACB
Using Behavioral Assessment to Identify Co-Morbid Medical and Psychiatric Concerns in Individuals With Autism
Monday, May 29, 2017
9:00 AM–9:50 AM
Hyatt Regency, Capitol Ballroom 5-7
Area: CBM/CBM; Domain: Applied Research
Chair: Patrick Thulen (Bancroft)
Discussant: Lisa Alberts (Bancroft)
CE Instructor: Patrick Thulen, M.A.

A growing body of research demonstrates that medical and psychiatric concerns can affect the frequency and intensity of problem behavior for individuals with autism (May & Kennedy, 2010; Lowry & Sovner, 1992). This symposium will discuss how behavioral data collection and behavioral assessment may be beneficial in diagnosing and treating underlying conditions. Psychiatric disorders such as Panic Disorder, Anxiety, and Obsessive Compulsive Disorder can present behavioral symptoms, which can be measured to aid in diagnosis. It can be difficult to accurately diagnose psychiatric disorders in individuals with Autism Spectrum Disorder (ASD) due to the challenges inherent with the developmental disability (e.g. communication impairment) and the overlapping clinical presentation of ASD and certain psychiatric conditions. If the behavioral changes caused by these underlying conditions are accurately measured, however, these data may improve clinicians diagnostic capabilities. Thus, analyzing the environmental variables related to the individual's problem behavior will lead to quicker access to correct medical treatment, more appropriate pharmacological interventions for psychiatric conditions, and more robust behavior analytic treatments.

Instruction Level: Intermediate
Keyword(s): behavioral pharmacology, constipation

Diagnosing Psychiatric Disorders with Behavioral Assessments for Individuals With Autism Spectrum Disorder and Intellectual Disability

SEAN SMITH (Bancroft), Lisa Alberts (Bancroft), Nicole L Keys (Bancroft), Tracy L. Kettering (Bancroft)

A population based study found that 44% of individuals diagnosed with autism have also been diagnosed with a comorbid emotional disorder (Simonoff et al. 2008). Although more than 70% of individuals with ASD are diagnosed with intellectual disability, the majority of research on psychiatric comorbidities in the ASD population focuses on individuals with average intelligence quotients (Matson & Cervantes 2014). Since most diagnoses are based on structured interviews and self-report questionnaires, the nature of ASD symptoms makes it difficult to accurately diagnose comorbid psychiatric issues, especially when the individual also has an intellectual disability (Lecavalier et al. 2014; Mazefsky et al. 2011). In this study, a synthesized functional analysis (Hanley et al. 2014) involving one control condition and one test condition (i.e. blocking self-restraint plus escape from a disruptive environment) was used to identify the function of combined inappropriate behaviors and also led to a diagnosis of panic disorder in an individual with ASD. In a second participant, daily data collection on target problem behaviors, responding to social initiation, acceptance of food, and compliance led to a diagnosis of PMDD. Data from additional assessments of anxiety disorder and depression will also be presented.

Constipation as a Setting Event for Problem Behavior: Diagnosis and Treatment
CAITLIN PARKER (Bancroft), Lisa Alberts (Bancroft), Kellie P. Goldberg (Bancroft), Joshua LaForte (Bancroft), Sean Smith (Bancroft), Patrick Thulen (Bancroft), Tracy L. Kettering (Bancroft)
Abstract: Individuals with autism often have comorbid health conditions that are difficult to diagnose due to their disability. These comorbid health concerns may contribute to challenging behaviors (May & Kennedy, 2010). While there is an increasing demand for effective assessments and treatments that combine both behavioral and medical methodologies (May & Kennedy, 2010), little research has been conducted to evaluate the relationship between medical concerns and challenging behavior. Approximately 75% of individuals with intellectual disabilities experience constipation on a regular basis (Bohmer et al., 2010). Christensen et al., (2009) evaluated the effect of constipation on self-injury and aggression in a young boy with autism. Results showed decreased rates of problem behavior following bowel cleanout. The current presentation examines data collection on frequency and consistency of stool, as measured using the Bristol stool scale (Lewis & Heaton, 1997), for individuals with ID. Data were used to inform medical staff of bowel irregularity and subsequently diagnose constipation. In some cases, flat plate exams were ordered to confirm diagnoses. Interventions such as laxatives or enemas were delivered following several days without stool. The effect of treatment of constipation on problem behavior will also be discussed.



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