A major focus of the Severe Behavior Program within the Center for Autism Spectrum Disorders is to provide specialized services to children with developmental disabilities who display destructive behaviors, such as aggression, self injury, pica or property destruction. These problems occur in about 10–15 percent of children with autism, developmental disabilities and traumatic brain injuries. Children displaying severe behavior problems may:

  • pose significant health risks to self and others
  • interrupt learning and development
  • cause immeasurable stress and hardship to families
  • be at risk for long-term institutionalization

The mission of the program is to improve the quality of life for children with severe behavior disorders and their families by:

  • providing the most advanced and comprehensive treatment services
  • continuing to develop and refine of effective treatments through clinical research
  • promoting the effective treatment technologies through training and consultation

The Severe Behavior Program at the Munroe-Meyer Institute offers services including evaluation, outpatient services, and a day treatment program. Each child moves through the program based on his or her individual needs. During therapy sessions, techniques are used to identify environmental variables that may be contributing to the behavior problem. Trained therapists, as well as the child’s caregivers, conduct sessions to directly test the effects of specific environmental precursors and consequences on the behavior. A specialized therapeutic environment is used to allow safe evaluation of dangerous behaviors. Padded treatment rooms with one-way windows for observation are used to allow safe evaluation of behaviors.

Therapists record occurrences of certain child and parent behaviors on laptop computers. Session-by-session data are graphed, reviewed and analyzed multiple times each day by therapists and supervising psychologists. Data are used to guide assessment and development of treatment. Treatment is refined until goals are achieved.

A psychologist with specialty training in applied behavior analysis oversees all therapy sessions. Assessments and treatments for each patient receive daily peer review by multiple senior behavior analysts and staff.

“Before coming to the Munroe-Meyer Institute Jack’s frustrations with not being able to communicate would lead to temper tantrums. Now, he understands his voice has power and tries to verbalize his needs more often. It’s the little things that have made such a big difference!” -mother of a severe behavior program participant

Population Served

The program provides services to school-aged children (ages 3–21) who display severe destructive behavior, such as self-injurious behavior, aggression or property destruction that poses a significant risk to self, others or the environment that cannot be safely managed or effectively treated in a less intensive program.

Initial Evaluation

The family and child will be seen by a team of specialists with training and expertise in the assessment of severe destructive behavior. Some children require only an evaluation and written recommendations, whereas others require outpatient therapy or day treatment.

Outpatient Therapy

Children with less severe behaviors will be seen once a week for 1-2 hours, whereas children with more severe problems can be seen daily for 2 hours each day.

Day Treatment Therapy

Those with the most severe behavior problems attend the day treatment program for 3–6 hours per day, 5 days per week for 2–16 weeks.

Parent Training

Once an effective treatment is developed, parents and other care providers are trained on how to use it. The long-term success of the treatment depends on how accurately the program is carried out by parents, in-home aides and other care providers. To facilitate accurate use of the treatment, our training for parents and caregivers involves written and spoken instruction, modeling, role-play and feedback.

Treatment Outcomes

Over 50 research investigations published in peer-reviewed journals have documented the success of the treatment approach used at the UNMC Munroe-Meyer Institute. Destructive behavior is reduced by 80–100 percent in 80 percent of children who receive this treatment approach. In almost all cases the treatments developed are equally effective in the child’s natural environment at the time of completion of the program.

Referrals and Appointments

A physician, community health nurse, school therapist, or other specialist may refer patients to the Munroe-Meyer Institute’s Severe Behavior Program. Please fax (402) 559-5004 or email (cawilli1@unmc.edu) referrals. They should include the child’s name, date of birth, reason for referral and contact information for caregivers and referral source. Intake specialists are available at (402) 559-3716, Monday through Friday, from 8:30 a.m.–4:30 p.m. to answer any questions you may have. You may also leave a message and your call will be returned promptly.

for more information
Center for Autism Spectrum Disorders
UNMC Munroe-Meyer Institute
985450 Nebraska Medical Center
Omaha, NE 68198-5450

Phone: (402) 559-3716
Toll Free: (800) 656-3937 ext 93716

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