A comparison of procedures for eliminating self-injurious behavior of retarded adolescents.

Four teens with severe intellectual disability lived in a state hospital. Each hit, bit, or scratched themselves daily.

The team ran an alternating-treatments design. Sessions rotated among three plans: brief electric shock after each self-hit, rewards for safe hands, or no social reaction to the hits.

Shock stopped the self-injury fastest and in every teen. DRA and extinction helped, but not as fast or as fully.

When the teens moved to new rooms, the hits came back unless the shock also moved with them.

Jones et al. (1977) repeated the shock effect with an infant whose rumination almost killed him. Both studies show the same rapid drop, giving a second life-saving example.

Putnam et al. (2003) later got rid of self-hits without any pain. They used toys that vibrate and make noise when helmets come off. Their success shows you can match the old shock power with sensory items today.

Dowdy et al. (2020) used only differential reinforcement at a public pool. Two teens with autism still cut their pool-entry problem behavior by a lot. No shock, no extinction, just praise and tokens.

Nevin et al. (2016) warns that after big suppression, relapse is likely. They found adding a clear signal to lean DRA keeps the gains longer. Pair their plan with any large effect you see.

You now know shock works fastest, but the effect sticks only if you follow the child across places. Modern studies show you can reach the same safe outcome with toys, sound, or simple reinforcement. Use their tools first, keep the location rule in mind, and add a signal to protect the gain.