Decreasing self-injury in a child with multiple disabilities: A practitioner's demonstration

Self-injurious behavior is thought to be the product of interactions between deficits related to a primary disability (e.g., limited communication repertoires and adaptive skills) and learning experiences that reinforce problem behavior (e.g., consoling the child, terminating non-preferred activities, etc.). For these cases, functional communication training (FCT) may be prescribed to decrease challenging behavior and increase the client's communicative repertoire. However, FCT procedures for individuals with multiple physical impairments may require considerable individualization and modifications. Unfortunately, the existing body of research related to the assessment and treatment of behavior of individuals with motor, visual, or other impairments is relatively limited. The purpose of this report is to demonstrate how practitioners can modify assessment and treatment procedures to decrease challenging behavior and promote independence when working with individuals with multiple impairments. We provide an example of effective skill acquisition and behavior reduction interventions for a young girl, Ava, presenting with multiple disabilities—including visual, hearing, and motor impairments. Consistent with the habilitative aims of applied behavior analysis, the intervention was effective at decreasing Ava's challenging behavior and increasing her independent communication and adaptive behavior.