Further analysis of the relationship between self-injury and self-restraint.

Three adults with severe intellectual disability lived on a hospital ward. All hit themselves hard enough to bruise. All also wrapped their arms in clothes or held furniture to stop the hits.

Staff blocked every arm movement that looked like a hit. They used two-inch foam hand pads. Sessions lasted 10 minutes and repeated across days.

Blocking cut self-hits to almost zero in every participant. Self-restraint also dropped by about half. When blocking stopped, both behaviors returned.

The pattern shows self-restraint is not its own reward. It is escape from the pain that self-injury causes.

Frank‐Crawford et al. (2026) extends this idea. They added safe items that give the same sensory feedback as wrapping or holding. Four of five clients cut SIB and self-restraint by a large share without staff blocking every hit.

Wilde et al. (2017) and Meuret et al. (2001) give the big picture. Around one in three adults with ID in services show self-injury. Blocking works, but you cannot shadow every arm forever. Combining brief blocking with competing items scales better.

There is no contradiction. W et al. proved blocking works. Frank‐Crawford et al. show how to make the effect last after you walk away.

You now have two levers. First, block every hit for fast suppression. Second, use the quiet moment to find safe items that give the same squeeze, stretch, or pressure. Train those items as replacement self-restraint. The 1996 data tell you blocking is safe and effective. The 2026 data tell you how to hand the job to an object instead of your hands.