Many of the causes of problem behaviors in individuals with developmental disabilities are associated with deficits in important skills, such as communication, executive functioning, and impulse control. One of the methods for correcting problem behaviors in such individuals is to teach new skills that can replace the undesirable skills.
Group therapy has become popular for people with developmental disabilities. Group therapy has several advantages for individuals with speech, language, or cognitive disorders:42
Many organizations use group therapy to teach skills and personal management. Groups may be established for individuals of all ages and intelligence levels and with all types of problem behaviors.
Counseling and psychotherapy also can be very effective interventions for individuals with developmental disabilities.43,44 Clearly, the standard techniques have to be modified, but they can be effective for these individuals if the therapy materials are made simpler and more concrete.45
Brier and Demb46 described the efficacy of psychotherapeutic intervention for disabled adolescents. They also emphasized the need to consider the cognitive deficits of affected individuals. A direct teaching approach, involving a great deal of behavioral rehearsal and repetition, is most useful.
Problem behaviors frequently are a form of communicating wants and needs when more conventional forms of communication are closed to the individual. Nonetheless, individuals with developmental disabilities often are not taught alternative forms of communication. Speech difficulties frequently are explained (and dismissed) by the fact that the person has learning difficulties, and intensive speech therapy is not attempted. Such individuals are left without an effective form of communication and, as a result, can become aggressive or self-abusive in an attempt to express themselves and gain attention.47–49
When maladaptive behavior is reinterpreted as an attempt to communicate and individuals are given an effective form of communication, the maladaptive behavior abates.50,51 Alternative forms of communication that can be used in place of speech include:
Such alternatives should be explored for use with people for whom verbal expression is not an option.
The use of video recording and playback has recently become very popular as a method for teaching new skills to children and adults with developmental disabilities. Individuals can view people performing certain target skills on the video and then try to perform these same skills in their own environments. They also can watch themselves performing already acquired skills. By performing an activity with new items, with new people, or in a new setting, affected individuals learn to generalize their newly acquired skills.
Role modeling is also a very effective means of teaching new skills. In this exercise, the therapist and the developmentally disabled person practice new conversational routines or social routines before the individual has to perform those skills in a real situation. The repetition of the routine lowers the anxiety that naturally accompanies the learning of novel tasks and helps in the successful learning and execution of new skills.
Reviewed and revised May 2004 by Steven C. Schachter, MD, epilepsy.com Editorial Board.
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