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.