Premeditated assaults on young boys by a man with spina bifida and hydrocephalus--a cognitive-behavioural approach to treatment.

This paper describes the case of a 25-year-old man with spina bifida and hydrocephalus, who had at least a ten-year history of physically assaulting young boys. Anti-social behaviour is reported as comparatively rare in people with this disability, and the case study illustrates how psychological assessment and treatment techniques were successfully applied. Information from his personal history plus a functional analysis of the assaults suggested that a combination of existing psychological difficulties and learning experiences contributed to the development of his behaviour. A behavioural model of the psychological mechanisms underlying the behaviour was suggested and treatment objectives defined. Cognitive and behavioural treatment techniques were adapted where necessary, with a good outcome. A gap in services for physically handicapped people with behavioural problems is noted and briefly discussed.