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皮质视觉障碍(CVI)知情评估和治疗 SCN2A 相关障碍儿童的挑战性行为。

Cortical Vision Impairment (CVI)-informed assessment and treatment of challenging behavior in a child with SCN2A-related disorder.

机构信息

Department of Behavioral Psychology, Kennedy Krieger Institute, Baltimore, MD, USA.

Center for Autism Spectrum Disorders, Nationwide Children's Hospital, 189 West Schrock Rd, Westerville, OH, 43081, USA.

出版信息

J Neurodev Disord. 2024 Nov 28;16(1):66. doi: 10.1186/s11689-024-09580-7.

Abstract

This report presents results of parent-implemented behavioral treatments for a child with cortical visual impairment (CVI), intellectual disability (ID), epilepsy, and autism spectrum disorder (ASD) associated with a pathogenic variant in the SCN2A gene (i.e., SCN2A-Related Disorder). Treatment evaluations were informed by combined results of functional behavior assessment (FBA) and functional vision assessment (FVA) which yielded CVI-related accommodations. The treatment of escape-maintained challenging behavior involved the evaluation of behavioral prompting strategies in accordance with CVI-related accommodations, extinction (EXT), and differential reinforcement modifications. The treatment for behavior problems maintained by access to food (tangible-edible) included functional communication training (FCT), EXT, and schedule thinning with schedule-correlated visual signals. Overall, integrating child-specific CVI-related accommodations was essential for developing effective behavioral interventions for this child. FVAs are accessible and practical for uptake by behavior analysts in vision-informed assessment and treatment of challenging behavior.

摘要

本报告介绍了针对一名患有皮质视觉障碍 (CVI)、智力障碍 (ID)、癫痫和自闭症谱系障碍 (ASD) 的儿童实施的家长实施的行为治疗的结果,这些障碍与 SCN2A 基因中的致病性变异有关(即 SCN2A 相关障碍)。治疗评估的依据是功能行为评估 (FBA) 和功能视觉评估 (FVA) 的综合结果,这些结果产生了与 CVI 相关的适应。针对逃避维持的挑战性行为的治疗涉及根据与 CVI 相关的适应情况、消退 (EXT) 和差异强化修正来评估行为提示策略。针对通过获取食物(可食用的有形物)维持的行为问题的治疗包括功能性沟通训练 (FCT)、EXT 和带有与时间表相关的视觉信号的时间表变薄。总的来说,针对特定儿童的与 CVI 相关的适应是为这名儿童制定有效的行为干预措施的关键。FVAs 可用于行为分析师进行视觉知情评估和治疗挑战性行为,具有可及性和实用性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e5b/11603671/90d562ae04e3/11689_2024_9580_Fig1_HTML.jpg

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