A comparison of DRO to movement suppression time-out and DRO with two self-injurious and aggressive mentally retarded adults.
For adults with ID whose severe SIB or aggression ignores DRO, adding Movement Suppression Time-Out turns a flat line into a clear drop.
01Research in Context
What this study did
Two adults with intellectual disability lived in a state facility. Both hit themselves and others every day.
The team first tried DRO plus a verbal "no." When that failed, they added Movement Suppression Time-Out. The person had to sit still for three minutes after each hit.
Researchers used a multiple-baseline design across the two adults to see which package worked.
What they found
DRO with only a reprimand did almost nothing. Hits stayed high.
Once Movement Suppression Time-Out was added, hits dropped fast and stayed low. One adult still did well eight months later.
How this fits with other research
Linton et al. (2025) saw the same pattern on a playground. DRO alone helped only one preschooler. Adding a 30-second time-out helped the rest.
Byrne et al. (2000) looks like a contradiction. DRO alone cut aggression 74% in an adult with brain injury. The difference: that adult had no intellectual disability and only mild aggression.
Martin et al. (1997) built on the 1990 idea. They kept the DRO-plus-time-out core but added DRA for social skills and a quick chore during time-out. Aggression fell even further.
Why it matters
If you run DRO for serious SIB or aggression and see no change, do not abandon ship. Add a brief, safe time-out that stops movement. Sit the client in a chair for two-three minutes with no toys or talk. Track hits daily; you should see a drop within a week. One client kept the gains for eight months, so brief time-outs can have lasting power when paired with DRO.
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02At a glance
03Original abstract
Movement Suppression Time-Out is a recently developed variant of physical restraint which may have applicability for serious behavior problems of developmentally disabled persons. However, the current debate over aversives and the argument by some that positives alone are sufficient to treat all behavior problems requires study. Initial trials with reinforcement alone, compared to reinforcement and punishers are necessary to empirically establish the limits of various treatment methodologies. This study was designed to evaluate reinforcement of other behavior (DRO) and verbal reprimands and Movement Suppression Time-Out, DRO and verbal reprimands with two severely mentally retarded males, 35 and 39 years of age. Using a multiple baseline design, self-injury was studied across setting with one client and across self-injury and aggression with the second person. Improvements were only apparent when Movement Suppression Time-Out was paired with verbal reprimands and DRO. With one client effects were maintained at an 8 month follow-up. The implications of these findings are discussed.
Research in developmental disabilities, 1990 · doi:10.1016/0891-4222(90)90008-v