Examples

Score of 4:

The customer is an 18-year-old male diagnosed with Autism and Pica. The caregiver reports that at least once a month, the customer puts objects in his ears, and eats his own feces, sand, or other household objects. This causes balance and gastrointestinal issues. The caregiver reports that if she sees the behavior when it is happening, she immediately grabs the customer’s hand to stop the behavior. The caregiver reports three months ago he was hospitalized after eating glass. He must be closely supervised at all times.

The behavior has caused immediate medical attention (one hospitalization) in the past year and requires close supervision and physical interruption.

Score of 3:

The customer is a 12-year-old male diagnosed with Autism and Mild Intellectual Disability. His father reports that when the customer gets upset, he pinches himself on the arms and legs. The father reports this behavior happens at least five times a week. The father said that the customer pinches himself so hard he has broken the skin and left bruises, but he has not needed immediate medical attention. The father said the only thing that stops the behavior is when he or his wife intervene and hold the customer’s arms tightly to his side until he calms down. This can take up to 30 minutes.

Although the behavior does not occur daily, the intervention is always physical interruption.

Score of 2:

The customer’s mother reports that the customer punches himself in the head when he is angry or upset. This happens about once a week. The behavior has caused headaches and bruising. The mother reports she or her husband talk to the customer until he calms down.

The behavior occurs weekly and requires supervision and verbal redirection.

Score of 1:

The customer’s mother reports that approximately once a month the customer will have a “meltdown” when doing homework that she doesn’t understand. The mother said the customer will grab her hair on each side of her head with her hands. The mother said sometimes the customer just does this for a second, and mom doesn’t do anything about it. But every other month the customer has pulled her hair out in clumps. The mother said, she will calmly tell the customer that she can take a break and come back to her homework later.

The behavior occurs less than weekly and sometimes requires verbal redirection.

Score of 0:

The customer is a 12-year-old female diagnosed with Moderate Intellectual Disability. Her mother reports that every other day the customer gets upset when her mom does not let her eat sweets for breakfast. The customer will cry and beat her fists on her chest. The mother said the customer never hurts herself, and mom ignores the behavior.

The customer acts physically aggressive but the behavior is occurring at a level that does not require intervention.