This study investigated the usefulness of aversive conditioning of a mild punishment procedure that had ceased to suppress target behaviors to clinically acceptable levels. A 6.8-year-old severely retarded boy with high levels of aggressive, destructive, and loud screeching behaviors was readmitted to a psychiatric facility to adjust behavioral programs and rule out seizure disorder. A design combining withdrawal and multiple baselines across behaviors tested the effects of aversive conditioning of visual screening with ammonia and the impact of anticonvulsant medication (carbamazepine, phenytoin). Data indicated that aversively conditioned visual screening temporarily lowered rates of responding. It is tentatively concluded that aversive conditioning might be a useful mechanism to strengthen suppressive effects of mild punishment procedures and a promising approach for alleviating placement problems due to maladaptive behaviors in mentally retarded persons. Maintenance of treatment effects, community placement, and the mandate to choose the least restrictive aversive treatment alternative are discussed. Anticonvulsant medication showed no beneficial effect for the target behaviors investigated.
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