Reducing Self-Injurious Behavior in an Adolescent With Williams Syndrome: A Case Study of an Adaptive Behavioral Intervention
Eitan Eldar, Michal Sapphire, Shirel Msika, Maya Elazar, Mariela Mosheva, Doron GothelfThis case study evaluated an adaptive behavioral intervention designed to reduce self-injurious behavior (SIB) in a 13-year-old adolescent diagnosed with Williams syndrome (WS), autism spectrum disorder, and severe intellectual disability. The intervention was implemented in the home setting and progressed through three sequential phases: response blocking, verbal reprimand, and a combined response interruption and redirection (RIRD) package with differential reinforcement of alternative behavior (DRA). Parents were trained to implement all procedures. Visual analysis of parent-collected data demonstrated a marked and sustained reduction in SIB observed concurrently with the final phase, which incorporated the combined RIRD and DRA package. The case highlights the clinical utility of systematically adapting intervention components based on functional behavior assessment (FBA) findings and ongoing adaptation, underscoring the importance of individualized and flexible treatment approaches for youth with complex needs.