Treatment of Challenging Behavior in a Young Adult with SYNGAP1-Related Disorder

Individuals with SYNGAP1-related disorder (SYNGAP1-RD) are increasingly identified as exhibiting severe, intensive, and challenging behavior. Research indicates that behavior dysregulation and need for mitigation strategies are top concerns for caregivers of those with SYNGAP1-RD. This paper reports on the functional analysis (FA) and behavioral treatment of challenging behavior in an adult with SYNGAP1-RD in a primary care setting.

Pretreatment assessments included Reinforcer Assessment for Individuals with Severe Disability (RAISD; Fisher et al., 1996), Adolescent/Adult Sensory Profile® (SPAA; Brown & Dunn, 2002), paired-choice preference assessment (Fisher et al., 1992), a pairwise, test-control functional analysis (FA; Iwata et al., 1994), and competing stimulus assessments (e.g., Piazza et al., 1998). Treatments were evaluated with a multiple-baseline design across functions and an embedded ABAB reversal design (Baer et al., 1968).

FA revealed environmental sources of the behavior, including a socially-mediated contingency (access to preferred stimuli) as well as sensory stimulation the behavior produced (i.e., automatic reinforcement). Competing-stimulus treatments led to rapid reduction and behavioral stabilization across several settings with caregivers.

Results have implications for the emerging behavioral and sensory phenotypes in SYNGAP1-RD, as well as providing behavioral supports for adults with neurodevelopmental disorders in transitional medicine primary care settings.