Treating obsessive compulsive behavior and enhancing peer engagement in a preschooler with intellectual disability

Abstract

Intellectual disability (ID) is a neurodevelopmental disorder characterized by impairments in cognitive and adaptive functioning in social, practical, or conceptual domains. Individuals with ID present with higher-order repetitive behaviors such as a need for sameness, ritualistic, and compulsive behaviors. Often referred to as obsessive compulsive behaviors (OCBs), these behaviors increase in prevalence between 2 and 5 years of age. The present study evaluated an exposure-based behavioral intervention for decreasing OCBs and concomitantly increasing play skills in a 4-year-old boy with mild ID in an inclusive preschool setting. Using a multiple baseline across behaviors design, the intervention was associated with a decrease in target behaviors and an increase in the duration of peer social engagement, with results maintained at 3-week follow-up. The intervention consisted of exposure and response prevention with function-based components. Procedures including prompting and reinforcement were generalized to parent and teacher mediators. This study provides preliminary support for the use of an exposure-based behavioral intervention to treat OCBs in children of preschool age with ID.