J.T. is a teenager with intellectual disability who lives in a group home with other teenagers with disabilities. He engages in self-injurious behavior involving face-slapping and ear-slapping. The staff is concerned that he will damage his hearing if he continues to slap himself in the ear. They report that he usually slaps himself when they are occupied in training programs with other residents. The group home manager has read a research study in which aromatic ammonia was shown to be an effective treatment for self-injurious behavior. He thinks it might work with J.T. However, before going to the effort of writing up a program, having the program reviewed by the behavior intervention committee, and training staff to implement the procedure, he decides on a pilot program to see whether the procedure will work. He gives a box of ammonia capsules to the staff working with J.T. and instructs them to break open a capsule and wave it under J.T.’s nose when he slaps himself. The manager tells the staff to use the procedure for a few days and see whether it decreases the face-slapping. If it does, he will take all the necessary steps and formally implement the punishment procedure.
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