Authors (including presenting author) :
So SH(1), Siu KC(1), Lai CF(1), Chan SM(1)
Affiliation :
(1)Occupational Therapy Department, Kowloon Hospital
Introduction :
Persons with intellectual disability (PID) is one of the most challenging clienteles because of high rate of hospital re-admission due to challenging behavior. To prevent challenging behavior, an Individualized Activity Engagement Program (IAEP) was developed by Occupational Therapy (OT) Department. The program was funded by Queen Elizabeth Foundation for the Mentally Handicapped.
Objectives :
A single case study was used to illustrate the process and effectiveness of the program in enhancing positive behavior and preventing challenging behavior of PID.
Methodology :
A 28-year-old male client having repeated admissions to psychiatric hospital previously due to aggression was selected as the subject of this case study. He was diagnosed to have mild grade intellectual disability and autism. He stayed in a hostel for PID before admission. Hostel staff complained client could hardly be engaged in activity and routine, depriving hostel of much manpower. Despite medication, he still had repeated aggression leading to admission to KH.
To implement IAEP, several rewarding activities were chosen after liaising with client’s caretaker. According to the result of Volitional Questionnaire, playing “nuts and bolts” was identified as a motivating activity for the client. The OT sessions were conducted at a designated place and time consistently, with support of visual cues, to habituate the client to the activity. The client’s desirable snack was used to reinforce his positive behavior.
Result & Outcome :
The client showed improvement in his behavior after the program. His activity tolerance increased from 10 mins to 80 mins. He required prompting from staff for more than 5 times in a 10-min session before. After the program, only 3-4 times of prompting were required in a 80-min session. He needed reinforcement every 5 mins in a 10-min session before. After the program, only one reinforcement was needed after the whole 80-min session. For off-task behaviour, there were more than 5 times in a 10-min session before. After the program, there were only 1-2 times in a 80-min session and the client was able to spontaneously re-engage the activity shortly. For aggressive behaviour, there were 3 times in the month before admission. After the program, no aggressive behaviour was noted.
The IAEP in this single case study suggested initial positive result in the use of activities for enhancement of positive behavior and prevention of challenging behavior of PID.
