Combining pharmacological and positive behaviour support strategies in the treatment of self-injury

Background: Positive behaviour support is increasingly using multiple perspectives to identify functional relationships and to examine and validate approaches for producing behavioural change. This would include gene-brain-behaviour relationships with the implication that pharmacological strategies could be incorporated in positive behaviour support plans.

Method and materials: A single-case methodology was used to examine the effects adding Naltrexone to the positive behaviour support plan of a woman with severe intellectual disability who presents self-injurious behaviour. Efficacy of the medication was examined across three functional analytic analogue conditions using a multi-element reversal design utilising blind ratings.

Results: Differential responding was observed across experimental conditions with tentative evidence of a positive treatment effect specifically and exclusively in the automatic reinforcement condition. Conclusions: Implications for prescribing practice of Naltrexone and other medications and the identification of behavioural markers correlated with positive treatment responses are highlighted.