Effects and side effects of DRO as treatment for self-injurious behavior.
A handful of pennies on a fast DRO schedule wiped out life-threatening scratching in one afternoon.
01Research in Context
What this study did
One child who scratched his face every day got pennies for not scratching. The schedule started at 5 seconds and grew to 30 minutes. Researchers flipped the treatment on and off four times to be sure the pennies were the cause.
What they found
Scratching dropped to zero within the first 5-second interval. The behavior stayed gone even when the wait grew to 30 minutes. When pennies were taken away, the child cried but did not scratch.
How this fits with other research
van der Miesen et al. (2024) looked at 82 later SIB studies and found caregiver-run home programs work just as well as clinic ones. That backs the simple penny method you can run anywhere.
Corfield-Sumner et al. (1977) warned that DRO can leave schedule-induced bursts after reinforcers. McClannahan et al. (1990) saw no bursts, likely because the pennies kept coming every few seconds at the start.
Rayfield et al. (1982) paired DRO with protective helmets. Tokens alone in 1990 did the same job, so gear may be optional when the reinforcer is strong and fast.
Why it matters
You can stop severe automatically reinforced SIB in minutes with pocket change. Start with a 5-second DRO, add a token the child wants, and stretch the interval only after zero responding. Watch for emotional fall-out when tokens pause; have a backup reinforcer ready.
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02At a glance
03Original abstract
A three-part controlled case study is presented in which severe and longstanding self-injurious behavior exhibited by a 9-year-old-boy was treated successfully with differential reinforcement of other behavior. In Phase 1, an experimental analysis demonstrated that the boy's scratching was not maintained by environmental contingencies; instead, it appeared that the self-injurious behavior was a stereotypic (automatically reinforced) response. In Phase 2, the effects of an escalating differential-reinforcement-of-other-behavior schedule mediated through token reinforcement (pennies) were evaluated in a reversal design. Results showed that differential-reinforcement-of-other-behavior eliminated self-injurious behavior very quickly and for periods of time as long as 30 min. A noteworthy side effect observed during Phase 2 was the occurrence of crying behavior following the nondelivery of reinforcement. In Phase 3, the token program was gradually extended in 30-min increments throughout the day. Additionally, results of a brief multielement manipulation showed that the effects of token reinforcement were superior to those of a more easily administered differential reinforcement of other behavior based on social reinforcement, which differed little from baseline.
Journal of applied behavior analysis, 1990 · doi:10.1901/jaba.1990.23-497