Surveys of the sexual behaviors of persons with cognitive disabilities report as a main problem unacceptably displayed autoerotic behaviors that are appropriate in private, but inappropriate or illegal in public situations. Public or distractingly excessive masturbation is socially unacceptable and has been addressed with several successful interventions different in nature. This review of the literature investigates factors that lead to necessary intervention, identifies associations of different effective treatment approaches with types of cognitive disabilities, and examines the evolution of documented interventions from the late 1960s to the early 2000s. Data suggest that theoretical advances toward more humane, supportive and self-regulative interventions are more likely to help persons with milder cognitive disabilities. Self-regulation, or differentiated control over the public aspect of masturbatory behaviors is less likely to be accomplished in cases with more severe cognitive and social skill deficits. Ethical and legal questions of different treatment approaches are discussed.