Frequency of and Treatment Approach Used for Problem Behaviour and Mental Health Issues In Children with Severe DD with or without ASD

Background:

In addition to impairments in cognitive ability and adaptive skills, individuals diagnosed with Autism Spectrum Disorder (ASD) and/or a developmental disability (DD) often also exhibit different problem behaviors (e.g., self-injurious, stereotyped, aggressive or destructive behaviors) and/or mental health issues.  Given the potential consequences of these behaviors for both the individual and their family, it is important that individuals receive treatment (e.g., participation in behavioural programs, medication) to reduce the frequency and/or intensity of such behaviors.  Although formal behavioral methods have been shown to be most effective, there is some evidence to suggest that informal behavioral strategies (Feldman et al., 2004) and alternative approaches (e.g., diets, expressive therapies) (Green et al., 2004) are often used.

Objectives:

The purpose of the current investigation was to: 1) document the frequency of four types of behavioral/mental health issues (aggression, self-injury, stereotypy, and mental health issues such as anxiety, depression) among individuals with ASD and DD or DD alone; 2) examine the treatment methods used to treat each type of problem behavior/mental health issue in the above two diagnostic groups; and 3) explore the relationship between each type of problem behavior/mental health issue and the individual’s age, gender, diagnosis, and adaptive skill level.

Methods:

This project is part of GO4KIDDS (Great Outcomes for Children Impacted by Severe Developmental Disabilities), a CIHR Emerging Team Grant about the health, well-being, and social inclusion of school-aged children across Canada with severe DD.  One aspect of GO4KIDDS is a nationwide survey that includes information regarding adaptive skills, behavioral concerns, and treatment methods.  Participants currently consist of 80 parents raising children, between 6 and 18 years of age, with ASD and DD or DD alone.  Additional participant data continue to be collected.  Participants from the partial sample completed the GO4KIDDS Basic Survey.

Results:

Preliminary results indicated that 85% of the children in the sample were demonstrating some form of behavioral problem and/or mental health issue.  A greater proportion of children with diagnoses of ASD and DD demonstrated problem behaviors and/or mental health issues compared to children with diagnoses of only DD.  As well, a greater proportion of children with both ASD and DD received treatment than children with DD alone.  Interestingly, informal behavior programs are noted by parents to be the most frequently used form of treatment for problem behaviors and/or mental health issues.  Further data analysis incorporating the additional participants is underway, and examines predictors of treatment choice.

Conclusions:

Findings are consistent with research that shows that individuals with ASD and/or DD present with a variety of problem behaviors and/or mental health issues.  Despite research that has demonstrated that formal behavioral programs are the most effective, the most frequent form of treatment used within this sample was informal.  These findings have important implications for service providers and policy makers. Understanding what factors lead parents of children with severe DD to choose specific treatment options is critical if we are to work with families to ensure that treatments that are accessed are in line with empirically supported practices.