Singh Nirbhay N, Lancioni Giulio E, Medvedev Oleg N, Hwang Yoon-Suk, Myers Rachel E
Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, GA 30912 USA.
Department of Neuroscience and Sense Organs, University of Bari, Bari, Italy.
Adv Neurodev Disord. 2021;5(2):170-182. doi: 10.1007/s41252-021-00192-z. Epub 2021 Jan 19.
Self-injurious behavior (SIB) refers to any repeated self-directed, non-suicidal, behavior that may cause or has the potential to cause physical harm to the person's body. Behavioral interventions provide the standard evidence-based treatments for SIB by people with autism spectrum disorder (ASD) and intellectual disabilities (ID). Translating the proven effectiveness of behavioral interventions to treatment of self-injury in community settings by clinicians and caregivers has not been totally successful. The aim of the present study was to advance translational research by providing real-time telehealth consultation to a treatment team at a community-based mental health agency that provided inpatient and outpatient services to individuals with ASD and ID.
The participants of this single-case experimental study were three adolescents with ASD who had been referred for services because of their increasingly unmanageable SIB both at home and at school. The telehealth consultant provided real-time assistance to the treatment team within a translational model of care in the development and implementation of a behavior support plan and an informal mindfulness-based Soles of the Feet (SoF) program.
Both visual and statistical analyses demonstrated reductions in the frequency of SIB for all three adolescents, with overall clinically significant reductions only with the SoF intervention.
The results of this translational study suggest that telehealth consultation might be a viable technological alternative in situations which preclude face-to-face consultation. Telehealth consultation could be one method of supporting people with behavioral difficulties during pandemics, such as COVID-19.
自伤行为（SIB）是指任何反复的、自我导向的、非自杀性的行为，这种行为可能导致或有可能对个人身体造成伤害。行为干预为自闭症谱系障碍（ASD）和智力残疾（ID）患者的自伤行为提供了基于证据的标准治疗方法。将行为干预已证实的有效性转化为临床医生和护理人员在社区环境中对自伤行为的治疗，尚未完全成功。本研究的目的是通过为一家社区心理健康机构的治疗团队提供实时远程医疗咨询来推进转化研究，该机构为患有ASD和ID的个体提供住院和门诊服务。
这项单病例实验研究的参与者是三名患有ASD的青少年，他们因在家中和学校中日益难以控制的自伤行为而被转介接受服务。远程医疗顾问在护理转化模型中为治疗团队提供实时协助，以制定和实施行为支持计划以及基于正念的非正式足底疗法（SoF）项目。
视觉分析和统计分析均表明，所有三名青少年的自伤行为频率均有所降低，仅通过足底疗法干预总体上有临床上显著的降低。
这项转化研究的结果表明，在无法进行面对面咨询的情况下，远程医疗咨询可能是一种可行的技术替代方案。远程医疗咨询可能是在大流行期间（如COVID-19）为有行为困难的人提供支持的一种方法。
