Teaching Manding Through Functional Communication
Teaching Manding Thorugh Functional Communication Training To A 53-year-old Man With Cerebral Palsy
Self-injurious behavior (SIB) usually occurs in mentally retarded persons. There are certain genetic syndromes which are more likely to cause self-injury as part of the behavioral phenotype of the condition. SIB can be quite devastating since it is a characteristic of several mental disorders. About 5-17% of all people who have intellectual disabilities and developmental disabilities usually engage in self-injurious behavior in a repetitive nature with some having the number of incidences of self-injurious behavior being quite high. The incidence of self-injurious behavior in those who are mentally retarded can exceed 50%. SIB is a chronic problem Mikhail & King, 2001.
Emerson (1995)
found that out of 95 individuals who were mentally retarded, about 71% of them still showed signs of self-injurious behavior up to 7 years later. Functional communication is one of the methods of reduction of occurrence of self-injurious behavior.
SIB in cerebral palsy patients
A good number of patients with cerebral palsy usually have developmental and intellectual disabilities which causes them to have severe cognitive impairment. For this reason, they are unable to understand their environment well and thus they exhibit self-injurious behavior especially when they are unable to communicate with ease. There are three major risk factors which act as indicators of self-injurious behaviors in cerebral palsy patients. These are the damage to the nervous system, epilepsy and their learning disability. Other risk factors include age - research has shown that the incidence of SIB is at peak in patients between 15-34years, gender -- research has shown that men exhibit more incidence of SIB than women. Other factors include communication difficulties and multiple impairments Scope ()
Functional communication
Lingraphica News (2006)
states that functional communication is a term which refers to the capability of a person to receive a message or convey it regardless of the mode used to pass the message in order to make sure communication is effective and independent of the environment. This is the definition of functional communication as given by the American Speech-Language-Hearing Association. In simpler terms, functional communication is basically making oneself understood by whatever means possible even though it may include the use of aid devices such as communications boards or speech generators. It also involves the person being able to communication in this way without being assisted. Simply responding to a question using yes or no does not include functional communication Schieltz et al., 2010()
Functional communication has been recognized in the field of psychology as one of the methods that has been used to help individuals who have behavioral problems. It is used to prevent the escalation of wild behavior such as self-injury or aggression from previously mild behaviors. It is often an intervention measure taken by the people in charge of the care of the patient. All that needs to be done is to educate them on this method. Functional communication has come to be praised greatly by both practitioners and researchers because of its huge success Sternberg, 1991()
Functional communication and extinction
Extinction is an important variable in the use of functional communication in the treatment of self-injurious behavior. Extinction means that functional communication is combined with time-out.
In a research study conducted by Shirley, Iwata, Kahng, Mazaleski, and Lerman (1997)
it was found that when functional communication was combined with extinction or time-out, it was more effective in decreasing the occurrence of self-injurious behavior. The study was conducted on two participants, Rick and Sue. The former was used to test the use of extinction while the latter was testing functional communication without extinction. For Rick's case, it was found that when functional communication was combined with extinction, the incidence of self-injurious behavior increased at the initial stage but this decreased thereafter. At the beginning of the experiment, the average number of responses of self-injurious behavior was 2.54 per minute which then reduced to 0.08 per minute during the last five sessions which were combined with extinction. At this point, when extinction was removed, the number of responses continued to reduce to 0.02 per minute. For Sue who did not have time-out, the initial number of responses increased before decreasing to 0.19 responses per minute during the last five sessions. This goes to show that extinction is quite important in the reduction of incidences and treatment of self-injurious behavior Shirley et al., 1997()
Manding
Manding is a form of functional communication...
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