Association for Behavior Analysis International

Adults and children with intellectual disabilities and problematic sexual behavior (IDPSB) can pose serious risks to themselves, as well as to others. While results from studies vary, the general consensus is that individuals with IDPSB are over-represented in the criminal justice system. In addition, specialized treatment options in the community are often limited. This symposium focuses on community-based treatment strategies designed to reduce problematic sexual behavior. The first study evaluates a multi-component residential treatment program for children who have engaged in sexually harmful behavior. The second and third presentations both provide case examples of longer-term treatment for adults with forensic involvement, and specific, individualized treatment strategies are presented. Challenges related to treatment provision in real world settings with this high risk population will be discussed. The importance of individualized treatment and probes to measure success were identified as critical factors in all three presentations.

A multi-component behavioral intervention (MCBI) was associated with a reduction in harmful sexual behaviour in children attending a residential program. The MCBI was comprised of a points and levels system, sex and relationships education, cognitive behaviour therapy, counselling and behavior contracts. Successful adherence to the program (e.g., safe and respectful behaviour, attendance in school, compliance with the therapy program etc.) earned the children access to high tariff activities and access to the internet and social media contingent on achieving the relevant level. Those who earned high level status attended college and work experience with staff support. Staff support was systematically faded out for those young people who graduated from the program. Inadvertent probes demonstrated that harmful sexual behaviour relapsed in a number of children.

Human Development Center (HDC), inc., is a non-profit organization that provides behavior analytic treatment to consumers with intellectual disabilities in a variety of community-based settings. HDC specializes in assessing and treating behaviors that interfere with the consumers ability to live successfully and safely in the community. Assessment involves extensive reviews of records and data on target and replacement behaviors, along with ongoing interviews, observations, and probes. The treatment approach includes the design and implementation of individualized behavior plans with skill programs designed to increase pro-social behaviors and decrease challenging behaviors, and an emphasis on teaching societal rules for sexual behavior, increasing appropriate avoidance behaviors and strengthening coping skills. Behavior analysts work closely with each consumer to develop a rapport and build a collaborative relationship in order to help each person achieve his identified goals. Ongoing assessment, twenty-four support, open communication, probes and data-based program changes along the way are designed to contribute to success. While highlighting one individuals successful journey from intensive residential supports to his own home, this presentation will provide a customized overview of a treatment package for an individual with forensic involvement as a result of sexual offending behavior.

Ethical considerations require that all interventions include plans to fade out treatment once intermediate goals are achieved. This is particularly challenging when the target behaviors are related to problematic sexual behavior or illegal practices. Our agency provides services to adult males diagnosed with intellectual disabilities with forensic involvement, including registered sexual offenders, predators, or consumers that have been referred to residential treatment as part of their parole agreement. A summary of assessment, long term individualized interventions and results for an individual with a substance abuse history and forensic involvement as a result of sexual offending behavior will be presented. Specific instruction will be provided regarding using consequence avoidance strategies to help treat behaviors that occur or are observed less frequently, and how to conduct probes to evaluate the use of skills in situ. This individual was able to successfully transition from intensive residential habilitation to supported living, maintain success while living independently, and achieve major life goals, such as getting married.