Autism spectrum disorder, severe intellectual disability and screen addiction: case report

Purpose The purpose of this paper is to analyze, describe and reflect upon the clinical complexity of the case, the diagnostic methodology, the need for an interdisciplinary approach, and the response to the clinical interventions. Design/methodology/approach An exploration of the patient’s different areas of functioning was carried out. A functional analysis of the behavior problems, observations in the natural environment, formulation of an individualized interdisciplinary therapeutic plan, and administration of pre–post intervention measurement instruments are described. To manage challenging behaviors, parent-mediated intervention and positive behavioral support principles were delivered, along with withdrawal of screens in the patient’s environment, sensory diet and structuring occupation time, and incorporation of an augmentative and alternative communication system in the family context. Pharmacological assessment and adjustment were also performed. Findings The use of screens is an important modulator of behavioral problems. At the pharmacological level, adjuvant treatment for attention deficit hyperactivity disorder was prescribed with a good response in attention symptoms. Behavioral problems decreased in frequency and severity. Better management of emotional and conduct challenges was achieved. Originality/value The diagnosis of a behavioral addiction is discussed. The literature does not contain information on behavioral addictions in patients with an autism spectrum disorder profile and moderate/severe intellectual disability, nor do specific diagnostic manuals contemplate their description. The intervention based on positive behavioral support produced improvement in the described clinical profile. The importance of and need for a multidisciplinary approach and a multimodal intervention are highlighted.