Reducing Self-Injurious Behavior in an Adolescent With Williams Syndrome: A Case Study of an Adaptive Behavioral Intervention

This case study evaluated an adaptive behavioral intervention designed to reduce self-injurious behavior (SIB) in a 13-year-old adolescent diagnosed with Williams syndrome (WS), autism spectrum disorder, and severe intellectual disability. The intervention was implemented in the home setting and progressed through three sequential phases: response blocking, verbal reprimand, and a combined response interruption and redirection (RIRD) package with differential reinforcement of alternative behavior (DRA). Parents were trained to implement all procedures. Visual analysis of parent-collected data demonstrated a marked and sustained reduction in SIB observed concurrently with the final phase, which incorporated the combined RIRD and DRA package. The case highlights the clinical utility of systematically adapting intervention components based on functional behavior assessment (FBA) findings and ongoing adaptation, underscoring the importance of individualized and flexible treatment approaches for youth with complex needs.

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Publication Details

Journal
Clinical Case Studies
Published
2026-10-28
DOI
https://doi.org/10.1177/15346501261501092
Primary Topic
Behavioral and Psychological Studies
Type
article
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article

Reducing Self-Injurious Behavior in an Adolescent With Williams Syndrome: A Case Study of an Adaptive Behavioral Intervention

Eitan Eldar, Mariela Mosheva, Doron Gothelf, Maya Elazar et al.
1 links
Clinical Case Studies
Behavioral and Psychological Studies
article

Reducing Self-Injurious Behavior in an Adolescent With Williams Syndrome: A Case Study of an Adaptive Behavioral Intervention

Eitan Eldar, Mariela Mosheva, Doron Gothelf, Maya Elazar, Michal Sapphire, Shirel Msika
article en

Abstract

This case study evaluated an adaptive behavioral intervention designed to reduce self-injurious behavior (SIB) in a 13-year-old adolescent diagnosed with Williams syndrome (WS), autism spectrum disorder, and severe intellectual disability. The intervention was implemented in the home setting and progressed through three sequential phases: response blocking, verbal reprimand, and a combined response interruption and redirection (RIRD) package with differential reinforcement of alternative behavior (DRA). Parents were trained to implement all procedures. Visual analysis of parent-collected data demonstrated a marked and sustained reduction in SIB observed concurrently with the final phase, which incorporated the combined RIRD and DRA package. The case highlights the clinical utility of systematically adapting intervention components based on functional behavior assessment (FBA) findings and ongoing adaptation, underscoring the importance of individualized and flexible treatment approaches for youth with complex needs.

Clinical Case Studies
Sheba Medical Center (IL)
Good health and well-being
Openalex Percentile: Top 5%
Behavioral and Psychological Studies
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Reducing Self-Injurious Behavior in an Adolescent With Williams Syndrome: A Case Study of an Adaptive Behavioral Intervention — Eitan Eldar, Mariela Mosheva, et al. · Clinical Case Studies (2026) | TGRS Research Map | TGRS