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Functional analysis and treatment of aggressive behavior following resection of a craniopharyngioma
Jennifer L Hammond1, Scott S Hall
1Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA. hammond1@stanford.edu
Insights
Craniopharyngioma surgery can cause aggressive behavior in children. Applied behavior analysis effectively reduced aggression and improved adaptive behaviors in a young patient.
Area of Science:
- Neuro-oncology
- Pediatric Psychology
- Behavioral Science
Background:
- Craniopharyngioma, a rare benign brain tumor, often affects children.
- Surgical resection is a primary treatment, but can lead to significant behavioral side effects, including aggression.
Observation:
- A 6-year-old female with craniopharyngioma developed severe aggressive behavior post-surgery.
- This behavior impeded her recovery and daily functioning.
Findings:
- Functional analysis revealed aggression was reinforced by escape from demands and access to food.
- A structured behavioral intervention, using differential reinforcement and extinction, reduced aggression by over 88%.
Implications:
- Applied behavior analysis offers a viable treatment for aggression following craniopharyngioma resection.
- Behavioral interventions can improve outcomes and adaptive functioning in pediatric patients with brain tumors.
Abstract:
Craniopharyngioma is a relatively rare, benign tumor that most often affects pre-adolescent children. Surgical resection is a common form of treatment, which may result in adverse physical, neurological, and behavioral effects, most notably, aggressive behavior. In this case study we describe a typically developing 6 year old female who had resection of a craniopharyngioma and subsequently developed severe aggressive behavior that interfered significantly with her recovery and functioning. Results of a functional analysis indicated that her aggression was maintained by contingent escape from task demands and access to preferred food items. A highly structured behavioral intervention, consisting of differential reinforcement of alternative behaviors, together with extinction targeted to each function of the behavior, was effective in reducing her aggression to below 88% of baseline levels. Her adaptive behaviors also increased significantly. These results suggest that assessment and treatment utilizing principles of applied behavior analysis can ameliorate the occurrence of problem behavior following craniopharyngioma resection.
