There is growing evidence of an association between physical illness and problem behavior in children with developmental disabilities. Such behavior can compromise school performance. Therefore, the purpose of the present study was to evaluate, using a group design, the effectiveness of medical intervention alone (N = 11) versus behavioral plus medical intervention (N = 10) for illness-related problem behavior in a school setting. Following intervention, the behavioral plus medical intervention group showed lower levels of problem behavior and completed more academic tasks than did the medical intervention alone group. The results are discussed with respect to the concept of illness and pain as a setting event for problem behavior. The need for research to develop algorithms that allow one to select the best combination of medical and behavioral interventions for specific illnesses and contexts is noted.
Aman, M. G., Singh, N. N., Stewart, A. W., & Field, C. J. (1985). Psychometric characteristics of the Aberrant Behavior Checklist. American Journal of Mental Deficiency, 89, 492-502.
2.
Bijou, S. W., & Baer, D. M. (1961). Child development I: A systematic and empirical theory. Englewood Cliffs, NJ: Prentice Hall.
3.
Bosch, J., Van Dyke, D. C., Smith, S. M., & Poulton, S. (1997). Role of medical conditions in the exacerbation of self-injurious behavior: An exploratory study. Mental Retardation, 35, 124-130.
4.
Bruininks, R. H., Hill, B. K., & Moreau, L. E. (1988). Prevalence and implications of mal-adaptive behaviors and dual diagnosis in residential and other service programs. In J. A. Stark, F. J. Menolascino, M. H., Albarelli, & V. C. Gray (Eds.), Mental retardation and mental health (pp. 3-29). New York: Springer Verlag.
5.
Carr, E. G., Horner, R. H., Turnbull, A. P., Marquis, J. G., Magito McLaughlin, D., McAtee, M. L., et al. (1999). Positive behavior support for people with developmental disabilities: A research synthesis. Washington, DC: American Association on Mental Retardation.
6.
Carr, E. G., Newsom, C. D., & Binkoff, J. A. (1976). Stimulus control of self-destructive behavior in a psychotic child. Journal of Abnormal Child Psychology, 4, 139-153.
7.
Carr, E. G., Newsom, C. D., & Binkoff, J. A. (1980). Escape as a factor in the aggressive behavior of two retarded children. Journal of Applied Behavior Analysis, 13, 101-117.
8.
Carr, E. G., & Owen-DeSchryer, J. S. (in press). Physical illness, pain, and problem behavior in minimally verbal people with developmental disabilities. Journal of Autism and Developmental Disorders.
9.
Carr, E. G., & Smith, C. E. (1995). Biological setting events for self-injury. Mental Retardation and Developmental Disabilities Research Reviews, 1, 94-98.
10.
Carr, E. G., Smith, C. E., Giacin, T. A., Whelan, B. M., & Pancari, J. (2003). Menstrual discomfort as a biological setting event for severe problem behavior: Assessment and intervention. American Journal on Mental Retardation, 108, 117-133.
11.
Cooper, S. (1998). Clinical study of the effects of age on the physical health of adults with mental retardation. American Journal on Mental Retardation, 102, 582-589.
12.
Dunlap, G., Kern-Dunlap, L., Clarke, S., & Robbins, F. R. (1991). Functional assessment, curricular revision, and severe behavior problems. Journal of Applied Behavior Analysis, 24, 387-397.
13.
Dunlap, G., & Koegel, R. L. (1980). Motivating autistic children through stimulus variation. Journal of Applied Behavior Analysis, 13, 619-627.
14.
Durand, V. M., Crimmins, D. B., Caulfied, M., & Taylor, J. (1989). Reinforcer assessment I: Using problem behavior to select reinforcers. Journal of the Association for Persons with Severe Handicaps, 14, 113-126.
15.
Dyer, K., Dunlap, G., & Winterling, V. (1990). Effects of choice making on the serious problem behaviors of students with severe handicaps. Journal of Applied Behavior Analysis, 23, 515-524.
16.
Ghaziuddin, M., Elkins, T. E., McNeeley, S. G., & Ghaziuddin, N. (1993). Premenstrual syndrome in women with mental handicap: A pilot study. British Journal of Developmental Disabilities, 77, 104-107.
17.
Gunsett, R. P., Mulick, J. A., Fernald, W. B., & Martin, J. L. (1989). Brief report: Indications for medical screening prior to behavior programming for severely and profoundly mentally retarded clients. Journal of Autism and Developmental Disorders, 19, 167-172.
18.
Horner, R. H., Vaughn, B. J., Day, H. M., & Ard, W. R., Jr. (1996). The relationship between setting events and problem behavior. In R. L. Koegel, L. K. Koegel, & G. Dunlap (Eds.), Positive behavioral support (pp. 381-402). Baltimore: Paul H. Brookes.
19.
Kennedy, C. H., & Meyer, K. A. (1996). Sleep deprivation, allergy symptoms, and negatively reinforced problem behavior. Journal of Applied Behavior Analysis, 29, 133-135.
20.
Koegel, L. K., Koegel, R. L., & Dunlap, G. (Eds.). (1996). Positive behavioral support. Baltimore: Paul H. Brookes.
21.
Lekkas, C. N., & Lentino, W. (1978). Symptom-producing interposition of the colon: Clinical syndrome in mentally deficient adults. Journal of the American Medical Association, 240, 747-750.
22.
Luiselli, J. K., & Cameron, M. J. (Eds.). (1998). Antecedent control procedures for the behavioral support of persons with developmental disabilities. Baltimore: Paul H. Brookes.
23.
Mace, F. C., Hock, M. L., Lalli, J. S., West, B. J., Belfiore, P., Pinter, E., et al. (1988). Behavioral momentum in the treatment of noncompliance. Journal of Applied Behavior Analysis, 21, 123-141.
24.
Michael, J. (1982). Distinguishing between discriminative and motivational functions of stimuli. Journal of the Experimental Analysis of Behavior, 37, 149-155.
25.
Minihan, P. (1986). Planning for community physician services prior to deinstitutionalization of mentally retarded persons. American Journal of Public Health, 76, 1202-1206.
26.
O’Reilly, M. F. (1997). Functional analysis of episodic self-injury correlated with recurrent otitis media. Journal of Applied Behavior Analysis, 30, 165-167.
27.
Peine, H. A., Rokneddin, D., Adams, K., Blakelock, H., Jenson, W., & Osborne, J. G. (1995). Medical problems, maladaptive behaviors, and the developmentally disabled. Behavioral Interventions, 10, 149-159.
28.
Schreibman, L. (1988). Autism. Newbury Park, CA: Sage.
