Functional assessment and treatment of self‐injury in a pediatric, nursing‐care resident

Abstract

The present study addressed the functional assessment and treatment of self-injury in an 18-yearold resident within a pediatric, nursing-care facility. During Phase 1 of the study, the rate of self-injurious eye-pressing was recorded when the client wore large protective mittens and conditions in which the mittens were absent in order to evaluate sensory reinforcing effects from the behavior. These results led to a program of sensory extinction combined with stimulus fading. The program featured the gradual reduction in the size of the mittens while rates of self-injury were maintained at reduced levels. During postfading assessment, near-zero rates were recorded.The treatment of self-injurious behavior [SIB] is a serious concern for many persons with developmental disabilities. For over two decades behavior modification procedures have been effective in decreasing self-injury (Luiselli, Matson & Singh, 1991). Although many successful interventions have been reported, both treatment philosophy and methodology have undergone numerous changes with the passage of time. For example, whereas punishment approaches were utilized extensively in earlier studies (Lovaas & Simmons, 1969), more recent research, as well as philosophical orientation, has emphasized nonaversive strategies and alternatives to punishinent (Repp & Singh, 1990). Similarly, many treatments for self-injury were implemented without determining causal variables. A very important development in contemporary treatment has been the design of functional analytic assessment procedures that focus on the motivational influences for SIB and how this information can be used to generate an individually tailored program (Schroeder, Rojahn, Mulick & Schroeder, 1990).The purpose of this study was to reduce the self-injurious eye-pressing behavior of a pediatric, nursing-care resident. Treatment was selected first by conducting a motivational analysis of suspected controlling variables. The resulting Requests for reprints should be addressed1 to James K. Luiselli, Psychological and Educational Resource Associates, 40 Bronson Way, Concord, MA 01742, USA.

Nonsuicidal self-injury among people with developmental disabilities.

“…Clinicians contemplating sensory extinction fot NSSI should note that it may be difficult to block some types of stimulation and that wearing protective equipment could be stigmatizing and interfete with insttuction. Accordingly, sensory extinction interventions must be systematically faded with the objective of gradually eliminating protective equipment while maintaining decreased NSSI (Luiselli, 1991).…”