Assessment and treatment of ventilator tube disconnection exhibited by a toddler

This report describes the behavioral assessment procedures and treatment developed for a ventilator-dependent, 2-year-old male with severe developmental delays who displayed life-threatening behavior in the form of ventilator tube disconnection. An evaluation of possible environmental variables that served to maintain this behavior was conducted utilizing functional analysis methodology [Iwata, B. A., Dorsey, M. F., Slifer, K. J., Bauman, K. E., and Richman, G. S. (1982, 1994). J. Appl. Behav. Anal. 27: 197-209]. Results of the functional analysis of ventilator tube disconnection were undifferentiated. A treatment program consisting of the provision of a foam-padded bib and access to high preference toys was effective in eliminating ventilator tube disconnection; increased rates of toy engagement were also observed. While use of behavior analytic procedures is common with developmentally disabled children who display self-injury or aggression, similar procedures can be applied in pediatric settings to manage behavior problems specific to ventilator-dependent children.