Milieu Training for Adults With Severe Intellectual Disability: A Clinical Illustration

2016 ◽  
Vol 38 (3) ◽  
pp. 179-184 ◽  
Author(s):  
Emily A. B. Lacey ◽  
Billy T. Ogletree ◽  
Tracie Rice ◽  
Amy Rose
Keyword(s):  
Intellectual Disability ◽  
Intellectual Disabilities ◽  
Treatment Option ◽  
Functional Communication Training ◽  
Communication Training ◽  
Special Population ◽  
Functional Communication ◽  
Severe Intellectual Disability ◽  
Severe Intellectual Disabilities ◽  
Clinical Illustration

This brief clinical exchange article supports the use of milieu training (MT) as a communication treatment option for adults with severe intellectual disabilities (SID). It examines aspects of MT that appear well matched to the communication and other abilities of adults with SID. It also provides an argument that MT is not unlike functional communication training (FCT), an intervention frequently and successfully used with adults with SID. In addition, Developing Communicative Interactions (DCI), one little-known framework that advocates for MT use with this population, is briefly introduced. Finally, a clinical example is provided that illustrates the application of MT with one adult with SID. The article concludes with comments for clinicians charged with communication treatment for this special population.

PTSD in adults with intellectual disabilities: stabilisation during inpatient stay

2014 ◽  
Vol 8 (4) ◽  
pp. 237-247 ◽  
Author(s):  
Trine Lise Bakken ◽  
Vibeke Gjersoe ◽  
Espen Matre ◽  
Tone Kristiansen ◽  
Arvid Ro ◽  
...  
Keyword(s):  
Intellectual Disability ◽  
Intellectual Disabilities ◽  
Case Reports ◽  
Psychiatric Inpatient ◽  
Training Programme ◽  
Post Traumatic Stress ◽  
Core Element ◽  
Content Type ◽  
Severe Intellectual Disability ◽  
Severe Intellectual Disabilities

Purpose – The purpose of this paper is to describe and discuss interventions of stabilisation of emotions and behaviour in adults with post-traumatic stress disorder (PTSD). This topic is understudied in persons with intellectual disability. Design/methodology/approach – The aim of this study was to investigate interventions of stabilisation in persons with more severe intellectual disability; i.e. persons with moderate or severe intellectual disabilities. Five patients in a specialised psychiatric inpatient unit for patients with intellectual disabilities were included. Information about treatment of the patients was collected through case files, observations, and interviews. The authors of this paper followed a training programme for trauma therapists in addition to the inpatient treatment of the five patients. Findings – Six main areas of stabilisation of emotions and behaviour were identified: validation, anxiety relief, treatment of depressed mood, increased mastering of daily activities, protection against anxiety triggers, and facilitated staff communication. Protection from anxiety triggers seems to be a core element of milieu therapy interventions. Interventions for neurotypical PTSD patients, such as exposure therapy may be contraindicated for patients with more severe intellectual disabilities. Originality/value – Research on interventions of stabilisation towards adults with more severe intellectual disabilities is still in its infancy. The case reports may help milieu therapists to facilitate interventions towards patients with moderate or severe intellectual disabilities.

Delivering Interventions Via Telehealth: Functional Communication Training with a Child with Autism as a Case Example

2020 ◽  
pp. 154079692098045
Author(s):  
Matthew J. O’Brien ◽  
Kelly M. Schieltz ◽  
Wendy K. Berg ◽  
Jennifer J. McComas ◽  
David P. Wacker
Keyword(s):  
Real Time ◽  
Adaptive Behavior ◽  
Functional Communication Training ◽  
Communication Training ◽  
Functional Communication ◽  
Care Providers ◽  
Widespread Application ◽  
Behavior Analysts

In this article, we provide a case example of how telehealth can be used by care providers in their homes to access empirically validated procedures such as functional communication training. As shown in the case example, complex assessment and intervention procedures were implemented successfully by care providers in their homes while receiving real-time coaching by behavior analysts who were located in a hospital in a different city. This case example is representative of the results we obtained thus far; substantial improvements in challenging and adaptive behavior occurred. Given these results obtained to date with telehealth, in terms of both outcomes of interventions and rated acceptability of the procedures by care providers, further and more widespread application of telehealth is warranted.

Functional Communication Training and Most-To-Least Prompting as Treatments for Problem Behavior

2021 ◽  
pp. 153465012110302
Author(s):  
Judah B. Axe ◽  
Corinne M. Murphy ◽  
William L. Heward
Keyword(s):  
Problem Behavior ◽  
Functional Communication Training ◽  
Communication Training ◽  
Functional Communication ◽  
Communicative Behavior ◽  
Severe Developmental Disabilities ◽  
Abolishing Operation ◽  
Academic Responding ◽  
Multiple Treatments ◽  
Visual Prompt

Functional communication training (FCT) is a treatment for problem behavior in which the learner is taught a communicative behavior that fulfills the same function as the problem behavior. Although effective, when FCT is used to request breaks from work, limitations include increased time spent in breaks and reduced task-related responding. An alternative treatment is most-to-least prompting (MTL) of a task in which a therapist provides the most helpful prompts for task-related responding (e.g., physical guidance) and gradually reduces the amount of help (e.g., visual prompt and then verbal) until the learner responds independently. We evaluated FCT and MTL in a multiple treatments design with an 11-year-old girl with severe developmental disabilities. Both treatments reduced problem behavior from baseline levels, and academic responding was greater during MTL than during FCT. MTL is an errorless teaching approach conceptualized as an abolishing operation that reduces the aversiveness of a task and makes escape less valuable.

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