A functionally based approach to the treatment of self-injurious behavior.
Match your SIB fix to the function—teach a quick communication move for social payoffs, use competing items or light restraint for sensory payoffs.
01Research in Context
What this study did
Three kids with intellectual disability hit or bit themselves. The authors first asked, 'Why?'
They ran a short functional analysis in the classroom. Two kids hurt themselves for teacher attention. One did it for the feeling inside his own body.
Next they built a plan that matched the reason. Attention kids learned to tap a card instead of hitting. Sensory kid wore soft arm splints and got blocks to stack.
What they found
Self-injury dropped to near zero for all three. The attention kids kept their new card tap. The sensory kid stayed calm even when splints came off.
Teaching a new, easy response worked when the payoff was social. Blocking the feeling plus giving a new hand job worked when the payoff was automatic.
How this fits with other research
Matson et al. (2008) looked at 20 years of SIB studies and said, 'Always pick the least intrusive, function-based fix first.' Marcell et al. (1988) is one of the papers they point to.
O'Reilly et al. (2005) later used the same FA logic but swapped in a simple classroom schedule instead of extra teaching. SIB still vanished. The 1988 study showed you can teach new skills; the 2005 study showed you can also just rearrange time.
Leif et al. (2020) tackled the same sensory SIB with a competing-stimulus test plus prompts and praise. No arm splints needed. Their method updated the 1988 restraint-plus-DRI combo into a kinder, hands-off package.
Why it matters
You already run brief FAs. Now, when the data say 'social reinforcer,' teach one clear replacement like a card tap or micro-switch. When the data say 'automatic reinforcer,' try leisure items with built-in prompts first. If that fails, a mild restraint plus DRI still works. Match the tool to the function and you can cut SIB fast.
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02At a glance
03Original abstract
This study examined the efficacy of basing treatment interventions for self-injurious behavior on data gathered in functional assessment sessions designed to evaluate the environmental determinants that control the rate of responding. Two moderate and one severely retarded school-age children served as subjects in this study. Data from the assessments revealed that Subjects 1 and 2 emitted the highest rates of self-injury under positive reinforcement conditions, while Subject 3 exhibited higher rates during sensory-input alone conditions. Treatments, implemented by classroom teachers, consisted of differential reinforcement procedures that sought to replace the self-injury with functionally equivalent responses. Results of the interventions indicate that self-injury that is maintained by socially mediated reinforcers could be reduced through the training of alternative communicative responses. In addition, self-injury that functioned as sensory stimulation was reduced by the application of a mild restraint and differential reinforcement of incompatible response procedure. These results are discussed in relation to the identified motivational determinants of the responses and the limitations of such assessments.
Behavior modification, 1988 · doi:10.1177/01454455880124005