Intensive Outpatient Treatment for Patients With Severe Externalizing Behavior and Intellectual and Developmental Disability: An Electronic Health Record Review

OBJECTIVE: Evaluate the outcomes of individuals with intellectual and developmental disabilities (IDD) admitted to an intensive behavior treatment program to reduce severe externalizing behavior (e.g., aggression; self-injury). METHODS: The authors conducted a retrospective electronic health record review of 40 consecutive patients aged 6 to 19 years with severe externalizing behavior causing imminent risk of harm to self or others over a 4-year period (January 2020 to December 2023). The intensive outpatient model involved daily intervention (Monday-Friday; 5 hours per day across an approximate 5-month period) that was structured and individualized based on the tenants of applied behavior analysis. Systematic data extraction included participant characteristics, outcomes of behavioral assessments, components of the behavioral intervention, percent reduction of externalizing behavior, and percent of caregiver-directed goals met. RESULTS: All participants had a diagnosis of autism and 80% had a co-occurring intellectual disability. Participants presented with 3 primary types of externalizing behavior-aggression (87.5%), disruption (82.5%), and self-injury (67.5%). At discharge, participants had a 90.74% reduction in externalizing behavior and 82.5% of participants met their primary caregiver-directed goal. CONCLUSION: Findings provide provisional evidence regarding the benefits of intensive behavioral treatment for children with IDD and severe externalizing behavior.