Objective:

To evaluate the efficacy and safety of modified electroconvulsive therapy (MECT) in reducing treatment-refractory self-injurious behavior (SIB) in a patient with autism spectrum disorder (ASD) and severe intellectual disability (ID), particularly in the context of limited treatment options.

Key Findings:

• Complete resolution of SIB was observed after MECT, with no hand-biting episodes reported.
• Significant reductions in VRAS score (from 18 to 7), BPRS score (from 74 to 35), and improvement in ADL score (from 46 to 30) were noted.
• Therapeutic gains were sustained and further enhanced at 30 days post-MECT.

Interpretation:

The case provides preliminary observational evidence that MECT may effectively reduce treatment-refractory SIB in patients with ASD and severe ID, highlighting the need for further research in this area.

Limitations:

• The study is based on a single-case design, limiting generalizability and the ability to draw definitive conclusions.
• Lack of validated SIB-specific instruments for standardized outcome measures may affect the reliability of the findings.

Conclusion:

Further controlled studies using standardized SIB outcome measures are warranted to validate these findings and explore the long-term effects of MECT on SIB in this population.