The Handbook of High-Risk Challenging Behaviors in People with Intellectual and Neurodevelopmental Disabilities

Edited by

James K. Luiselli, Ed.D., ABPP, BCBA-D

Table of Contents

I Self-Injurious Behavior

1. Biological Perspectives on Self-Injury Among People with Intellectual and Neurodevelopmental Disabilities
   Frank J. Symons and Craig H. Kennedy
   Page 3
2. Functional Behavioral Assessment and Functional Analysis of Self-Injury
   David E. Kuhn
   Page 21
3. Function-Based Behavioral Intervention for Self-Injury
   Johannes Rojahn, Iser G. DeLeon, Griffin W. Rooker, Michelle A. Frank-Crawford, Abbey B. Carreau-Webster, and Yanerys Leon-Enriquez
   Page 39

II Aggressive Behavior

4. Environmental Determinants of Aggressive Behavior
   Johnny L. Matson and Alison M. Kozlowski
   Page 63
5. Biopsychosocial Features Influencing Aggression: A Multimodal Assessment and Therapy Approach
   William I. Gardner, Dorothy M. Griffiths, and Jeffery P. Hamelin
   Page 83

III Sexual Offending Behavior

6. Risk Assessment for Sexual Offending
   Further content not included
7. Behavioral Assessment and Intervention for Sex Offenders with Intellectual and Developmental Disabilities
   Timothy R. Vollmer, Jorge R. Reyes, and Stephen F. Walker
   Page 121
8. Problem-Solving Treatment for Sexual Offending
   Christine Maguth Nezu, Travis A. Cos, and Arthur M. Nezu
   Page 145

IV Health-Threatening Eating Disorders

9. Behavioral Assessment and Treatment of Pica
   Louis P. Hagopian, Natalie U. Rolider, and Griffin W. Rooker
   Page 161
10. Ruminative Vomiting
    Jonathan Tarbox, Amy L. Kenzer, and Michele R. Bishop
    Page 177
11. Obesity and Weight Regulation
    Richard K. Fleming
    Page 195

V Criminal Behavior

12. People with Intellectual and Developmental Disabilities in the Criminal Justice System
    Susan Carol Hayes
    Page 211
13. The Death Penalty, the Courts, and Intellectual Disabilities
    J. Gregory Olley
    Page 229

VI Therapeutic (Physical) Restraint

14. Therapeutic Implementation of Physical Restraint
    James K. Luiselli
    Page 243
15. Regulatory Governance of Physical Restraint in Schools
    Joseph B. Ryan and Reece L. Peterson
    Page 257
16. Emergency Physical Restraint: Considerations for Staff Training and Supervision
    David Lennox, Mark A. Geren, and David Rourke
    Page 271

Behavioral Assessment and Treatment of Pica

Pica is defined diagnostically as:

1. Consumption of nonnutritive items for more than a month.
2. Consumption of nonnutritive items inappropriate to developmental age.
3. Eating that is not part of culturally sanctioned activity.
4. A behavior severe enough to require independent clinical attention when other clinical services are being provided for another mental disorder.

Several severe health risks are associated with pica, including lead poisoning, intestinal perforation, and death. The literature describes three populations engaging in pica, including typically developing individuals with a nutritional disorder.

In assessing pica, a Functional Behavioral Assessment (FBA) is recommended. This includes:

• Indirect methods like interviews and questionnaires.
• Direct methods involving behavior observation categorized as either correlational or experimental.

Use of Safe and Simulated Pica Items

Using safe and simulated pica items during assessments allows safe observation of pica behavior, ensuring that individuals do not ingest harmful items.

Conclusions and Recommendations

The treatment of pica should aim to distinguish edible and inedible items, promoting safe responses through differential consequences and providing opportunities for positive behavior. Regular assessments of behavioral interventions are crucial, with care taken to ensure intervention integrity and safety.