Integrated Function-Based Intervention, Acceptance and Commitment Therapy, and ICT-Enabled Collaboration for Chronic Self-Injurious Behavior in an Adult with Severe Intellectual Disability: A Case Report.

This case report describes an integrated intervention for chronic self-injurious behavior (SIB) in an adult woman with severe intellectual disability and autism spectrum disorder features. The intervention was delivered primarily through monthly consultations with her mother, with periodic involvement of community-based service providers. A functional assessment interview identified routine-specific antecedents and maintaining contingencies in bedtime, living room, undressing, hair-drying, and transportation settings. Based on these findings, context-specific environmental modifications and alternative responses were introduced. In parallel, Acceptance and Commitment Therapy-based psychological support was provided to the mother to reduce caregiving distress and promote more flexible, values-consistent responding. In addition, information and communication technology-enabled collaboration through a secure group chat-connecting the specialist, the mother, and community service providers-served three documented functions: real-time procedural alignment across care settings, rapid multi-agency behavioral assessment, and caregiver psychological support. Following implementation of the function-based strategies, SIB markedly decreased in the targeted settings. The mother's depressive symptoms also decreased, and interagency support became more consistent and sustainable. This case suggests that combining a function-based behavioral approach with caregiver-focused psychological support and ICT-enabled collaboration may be clinically useful for managing chronic SIB in adults with severe intellectual disability.