Behavioural interventions for self injurious behaviour: a review of recent evidence (1998–2008)

Abstract

Accessible summary• One in four people with a severe learning disability harm themselves.• This affects their health and quality of life.• This study looks at research on helping people who harm themselves.• More research needs to be done to find better ways of helping people who harm themselves. SummaryEstimates suggest that up to one quarter of people who have a severe learning disability engage in self injurious behaviour (SIB). SIB poses serious risks, both to the person's physical health and their quality of life. Behavioural approaches have made a contribution to supporting people who engage in SIB, although the last review of these approaches was completed in 2001. The current study provides an update to this review, and has considered papers published over the last 10 years. A systematic search of peer reviewed journals and the 'grey' literature identified 34 relevant documents, the majority of which were single case studies. These papers tended to report only on changes in the frequency of SIB during the intervention; one cannot conclude, therefore, about the long term efficacy and generalisability of these approaches. Reductions in SIB were highly variable, often produced in controlled environments and with the use of aversive interventions. The current study presents implications for research and clinical practice and highlights the need for more research reporting on the effectiveness of new interventions such as positive behavioural support.

Systematic Reviews of the Health or Health care of People with Intellectual Disabilities: A Systematic Review to Identify Gaps in the Evidence Base

“…); behavioural treatment of elopement (Lang et al . ); and behavioural treatment for self‐injurious behaviour (Prangnell ).…”

“…) although in some cases, as noted in the latter study, evidence is limited due to a paucity of studies. The one exception was a review on behavioural interventions for self‐injurious behaviour, which found that efficacy was highly variable (Prangnell ).…”

“…These reviews tend to be based predominantly on single-participant research using designs such as multiple baseline, alternating treatments and reversal. These reviews have looked at the following: types of motivating operations in interventions for problem behaviour with school age children (Sim o-Pinatella et al (Brosnan & Healy 2011); differential reinforcement to manage problem behaviour in adults (Chowdhury & Benson 2011); behavioural interventions for rumination and operant vomiting (Lang et al 2011); behavioural treatment of chronic skin-picking (Lang et al 2010); noncontingent reinforcement for problem behaviour (Carr et al 2009); behavioural treatment of elopement (Lang et al 2009a); and behavioural treatment for self-injurious behaviour (Prangnell 2010).…”

Recent research on aetiology, development and phenomenology of self‐injurious behaviour in people with intellectual disabilities: a systematic review and implications for treatment

“…Further, there have been few studies of the long‐term efficacy of these interventions or of their effectiveness, i.e. their impact when applied in routine clinical or educational settings (Prangnell 2009).…”

‘Change can only be a good thing:’ staff views on the introduction of a harm minimisation policy in a Forensic Learning Disability service

“…This study has responded to the need for more research into the effectiveness of new, non‐aversive interventions (Prangnell 2010). Staff in this study gave extremely in‐depth and well thought out responses to the questionnaire; it was clear that staff have clients’ interests at the forefront of their minds.…”