Developmental Disabilities

Background: People with developmental disabilities are particularly at risk for developing self-injurious behaviour (SIB). Functional communication training (FCT) views the challenging behaviours possess its own meaning and is a way of communication. The purpose of FCT is to teach an individual an appropriate alternative response to obtain reinforcement and to replace behaviour. It is frequently used for reducing problem behaviour exhibited by individuals with developmental disability. Methods: The case study described the application of FCT to reduce the frequency of SIB on an adult diagnosed with moderate mental retardation and autism spectrum disorder (ASD). The client’s SIB caused him to sustain a wound at forehead and did not heal up even though with constant wound care. The baseline frequency of SIB across 5 days was collected. Results: A functional analysis with sensory integration assessment has been done, the client’s need on tactile stimulation was found and speculated that the SIB was his way to “communicate” about his sensation need. The client was then trained to express his sensation need with scratching gesture instead of doing SIB. At the same time, a special designed tactile stimulation vest was fabricated to satisfy his tactile need, the vest was only put on the client if he made the scratching gesture correctly. The client gradually learned the relationship between gesture and sensation satisfaction. Conclusion: The programme successfully reduced the frequency of SIB to nearly zero in the post training evaluation and the wound at forehead healed up eventually.