Evidence-Based Practice for Severe Behaviour in Individuals with Autism. What we are Doing and What Should we be Doing

Severe behaviour presents a significant challenge for both the individual and carers in terms of quality of life. Challenging behaviour is commonly reported in individuals with intellectual disabilities, 10-15 %, however for those with autism and / or profound intellectual disabilities the prevalence is much higher, 39-65%.  At least 10% of individuals in the latter category have challenging behaviour that would be considered to be severe. 
Adolescent and young adult males make up two-thirds of this group.

While the progression of severe behaviour disorders has not been well documented, it would appear that the overall prognosis for this group of individuals is not good, with potentially 80% continuing to engage in these behaviours 20 years later.

Many of the studies published contain complex multi-component interventions that do not always report long term follow up or generalisation data.  

This paper aims to review the behavioural literature for the intervention of the most severe challenging behaviour (e.g., aggression, property destruction and self-injurious behaviour) and determine evidence-based practice. 

Furthermore the ‘state of play’ for supporting individuals with severe behavior in New Zealand will be reviewed with reference to case studies.

It is hoped that this review will support all concerned in developing effective long lasting interventions that allow those with severe behaviours to live a less restricted life in the community.