A Functionally Based Approach to the Treatment of Self-Injurious Behavior

Abstract

This study examined the efficacy of basing treatment interventions for self-injurious behavior on data gathered in functional assessment sessions designed to evaluate the environmental determinants that control the rate of responding. Two moderate and one severely retarded school-age children served as subjects in this study. Data from the assessments revealed that Subjects 1 and 2 emitted the highest rates of self-injury under positive reinforcement conditions, while Subject 3 exhibited higher rates during sensory-input alone conditions. Treatments, implemented by classroom teachers, consisted of differential reinforcement procedures that sought to replace the self-injury with functionally equivalent responses. Results of the interventions indicate that self-injury that is maintained by socially mediated reinforcers could be reduced through the training of alternative communicative responses. In addition, self-injury that functioned as sensory stimulation was reduced by the application of a mild restraint and differential reinforcement of incompatible response procedure. These results are discussed in relation to the identified motivational determinants of the responses and the limitations of such assessments.

An Analysis of Reinforcer Substitutability Using Object Manipulation and Self‐injury as Competing Responses

“…DESCRIPTORS: stereotypy, self-injurious behavior, reinforcer substitutability, differential reinforcement of other behavior Although considerable research has shown that many behavior problems are maintained by social reinforcement, such as attention from caregivers (Day, Rea, Schussler, Larsen, & Johnson, 1988) or escape from task demands (Iwata, Pace, Kalsher, Cowdery, & This research was supported in part by a grant from the Florida Department of Health and Rehabilitative Services and is based on a dissertation submitted by the first author to the University of Florida in partial fulfillment of requirements for the PhD degree. We thank Julie Burke, Han-Leong Goh, Sonya Fischer, Dorothea Lerman, and April Worsdell for their assistance in conducting various aspects of the research.…”

What Makes Extinction Work: An Analysis of Procedural Form and Function

“…In cases in which SIB was maintained by socialpositive reinforcement in the form of adult attention, extinction consisted of withholding attention or terminating it contingent on the occurrence of SIB (e.g., Day, Rea, Schussler, Larsen, & Johnson, 1988;Lovaas & Simmons, 1969). By contrast, SIB maintained through social-negative reinforcement in the form of escape from task demands has been extinguished by preventing escape; in other words, continuing and not terminating the ongoing situation (e.g., Iwata, Pace, Kalsher, Cowdery, & Cataldo, 1990;Repp, Felce, & Barton, 1988).…”

Descriptive and Experimental Analyses of Variables Maintaining Self‐injurious Behavior

“…In particular, variables that maintain self-injurious behavior (SIB), a chronic and sometimes life-threatening disorder, have been examined extensively. Studies have shown that SIB can be maintained by social-positive reinforcement in the form of attention or materials provided by caretakers (Day, Rea, Schussler, Larsen, & Johnson, 1988) or by social-negative reinforcement in the form of escape from task demands (Iwata, Pace, Kalsher, Cowdery, & Cataldo, 1990). For some individuals, SIB appears to be maintained by automatic, nonsocial reinforcers, such as changes in sensory stimulation (Repp, Singh, Olinger, & Olson, 1990).…”

“…Advantages of the experimental analysis include its objectivity and quantitative precision (Iwata, Vollmer, & Zarcone, 1990 (FAu 1993) tablished for SIB (e.g., Day et al, 1988;Steege et al, 1990), stereotypy (Sturmey, Carlsen, Crisp, & Newton, 1988), aggression (Slifer, Ivancic, Parrish, Page, & Burgio, 1986), and disruption (Carr & Durand, 1985). Despite the importance of functional analysis to assessment, the procedures may be complex and time consuming (Lennox & Miltenberger, 1989;Repp et al, 1990), and it may not always be possible to manipulate directly the variables related to problem behavior.…”