The effect of an attachment-based intervention on challenging behaviour: visually and severe intellectually impaired children

Background A combination of an attachment-based therapy and behaviour modification was investigated for children with persistent challenging behaviour. Method Six clients with visual and severe intellectual disabilities, severe challenging behaviour and with a background of pathogenic care were treated. Challenging behaviour was recorded continuously in the residential home and during therapy sessions. Alternating treatments were given by two therapists. In phase 1, the experimental therapist attempted to build an attachment relationship in sessions alternating with sessions in which a control therapist provided positive attention only. In phase 2, both therapists applied the same behaviour modification protocol. Results Across clients, challenging behaviour in the residential home decreased during the attachment therapy phase. The behaviour modification sessions conducted by the experimental therapist resulted in significantly more adaptive target behaviour than the sessions with the control therapist. Conclusion For these clients with a background of attachment problems, attachment-based behaviour modification treatment may have important advantages over standard behaviour modification. © 2007 Blackwell Publishing Ltd.