Treatment and Maintenance Effects of Behavioral Intervention and Electroconvulsive Therapy (ECT) in a Man with Catatonia, Life-Threatening Self-Injury, and Autism Spectrum Disorder

Objectives: The objectives addressed in this case study were to reduce and eliminate life-threatening self-injury and aggression in a man diagnosed with autism spectrum disorder (ASD), intellectual disability, post-traumatic stress disorder, and catatonia. Methods: Treatment included comprehensive applied behavior analysis (ABA) and pharmacological intervention delivered at a residential care setting in conjunction with electroconvulsive therapy (ECT). Results: A baseline average of 33.7 incidents of combined self-injury and aggression per day decreased to near-zero occurrence over approximately 2 years of ECT that was administered with gradually reduced frequency. In response to ECT, the man also regained previously lost communication, self-care, and social skills; had improved health status; was no longer required to wear protective equipment; and did not experience negative side effects. Conclusions: These results support other reported cases of persons with ASD, catatonia, and serious challenging behavior who responded positively to initial and maintenance ECT. Additional research is necessary to confirm therapeutic benefits from and safe toleration of ECT among this clinical population.