Simplified methods for identifying subtypes of automatically maintained self‐injury

Abstract

Subtypes of automatically maintained self‐injurious behavior (SIB) have been defined based on response patterns observed during the functional analysis, which are thought to reflect each subtype's distinct mechanisms. Current practice for identifying subtypes involves using structured criteria to identify whether SIB is automatically maintained, followed by the application of additional criteria to identify the subtype. We describe a series of studies directed at simplifying these methods to facilitate wider application of the subtyping model in research and practice. In Studies 1 and 2, we demonstrate the accuracy of modified criteria using the level of differentiation of SIB across the play and no‐interaction conditions at distinguishing between two subtypes (i.e., Subtypes 1 and 2). We then demonstrate visual analysis (without structured criteria) can accurately identify SIB as automatically maintained in Study 3, which can be used in combination with level of differentiation to enable application of the subtyping model in practice.

Further evidence of renewal in automatically maintained behavior

“…This involved first using visual analysis to determine (a) whether the frequency or duration values of challenging behavior in the alone or no‐interaction conditions of the functional analyses differed from those in the toy‐play condition or (b) whether the challenging behavior occurred at high levels across all conditions. Both patterns of responding are generally indicative of automatically maintained behavior (Hagopian et al, 2023). Participants were excluded from the study if visual analysis did not suggest that at least one topography of behavior was likely automatically maintained.…”

“…For individuals who engaged in automatically maintained SIB, behavior was characterized as Subtype 1, 2, or 3 based on the level of differentiation (LOD) between the no‐interaction condition and the toy‐play condition (Hagopian et al, 2023). The LOD was calculated by dividing the mean rate (or duration) of SIB in the play condition by the mean rate (or duration) in the no‐interaction condition, subtracting this quotient from 1, and then multiplying that difference by 100 to convert it into a percentage.…”

“…The LOD was calculated by dividing the mean rate (or duration) of SIB in the play condition by the mean rate (or duration) in the no‐interaction condition, subtracting this quotient from 1, and then multiplying that difference by 100 to convert it into a percentage. The empirically derived LOD cutoff for differentiating Subtype 1 from non‐Subtype 1 is 62.5%; values at or above 62.5% indicate Subtype 1, and those below indicate non‐Subtype 1 (i.e., Hagopian et al, 2023). Additionally, SIB for individuals who engaged in self‐restraint was characterized as Subtype 3 if self‐restraint occurred in at least 25% of 10‐s intervals across 30% of the no‐interaction sessions regardless of the LOD.…”

“…Next, the third and fourth authors applied structured criteria to each functional analysis to confirm that the behavior that was previously identified by visual analysis was automatically maintained (Hagopian et al, 2023). Structured criteria were further reviewed by the first or sixth author if (a) either coder disagreed with the results generated by our structured-criteria-analysis template (i.e., spreadsheet that applied the structured criteria), (b) behavior appeared to be multiply maintained, (c) there was an overall trend in the functional analysis data, or (d) the mean ranks of rate or duration of the response suggested an automatic function.…”

“…One particularly dangerous and problematic topography of automatically maintained behavior is SIB. Recent research has identified subtypes of automatically maintained SIB that are hypothesized to reflect its distinct functional properties (Hagopian et al, 2015(Hagopian et al, , 2017(Hagopian et al, , 2023. These subtypes have been shown to be differentially affected by the presence of alternative reinforcement (Subtypes 1 and 2) or self-restraint (Subtype 3).…”