People with intellectual disability, sensory impairments and behaviour disorder: a case series.

The team tracked 18 adults who had intellectual disability plus vision or hearing loss. All showed serious self-injury or aggression. Each person got a full medical, sensory, and psychiatric work-up. Treatments were then tailored to the causes that were found.

Every person improved after the custom plan. Some needed an antidepressant, others a quieter room or fewer drugs. No single fix worked for all; the key was matching the fix to the reason behind the behavior.

The 2018 review by Buket et al. pools 46 single-case studies and also shows most kids with autism or ID cut SIB after behavioral plans. It widens the lens beyond these 18 adults, but both papers point to the same rule: assess first, then tailor.

Foti et al. (2015) came later and turned the idea into a step-by-step algorithm. They keep the medical-plus-behavior blend that S et al. used, showing the field moved from stories to checklists.

S-Johnson et al. (2009) add hope. They followed adults with ID for two years and saw 38% lose their SIB without any new plan. This means some improvement in S et al.’s cases may also reflect natural remission, not just the custom care.

If your client has ID and sensory loss, think beyond behavior charts. Screen for pain, mood, and sensory mismatch. A simple med change or room dimmer can drop SIB faster than five extra hours of DTT. Start with the checklist Foti et al. (2015) give, but remember Buket et al.’s warning: we still don’t know which part of the package is magic, so track data and tweak one thing at a time.