Interruption and DRI in the treatment of self-injurious behavior among mentally retarded and autistic self-restrainers.

Two teenagers with severe ID and autism kept hitting themselves while wrapped in jackets or towels. The authors tried a two-step plan: block each hit with a quick arm-tap, then pay the boys with snacks and praise for keeping hands on a table toy for 10 seconds.

Sessions ran in a quiet room at their school. Staff counted hits and self-restraint time. The design was simple: baseline, then the block-and-reward package, then back to baseline to be sure the package was really working.

One boy stopped hitting almost completely; his arm-wrap time dropped too. The other boy kept hitting at the same high rate no matter what. Same plan, opposite results.

Both kids still wrapped towels around their arms, showing the interruption-plus-DRI did not fully replace the self-restraint habit for either teen.

Chen et al. (2022) later showed the redirection part is the active piece. They worked with adults who repeated words aloud; brief arm-taps alone did nothing until staff added a demand to do a different task. That finding supports the DRI half of the 1989 package and explains why interruption alone failed the second teen.

Pilgrim et al. (2000) looks like a contradiction. They used brief electric shocks to stop life-threatening self-injury and saw big drops in restraint use. The difference is intensity: mild arm-tap plus snacks versus painful shock. Mild worked for one boy only; strong aversives worked for every adult in the 2000 study.

Einfeld et al. (1995) tried other reinforcement tricks. They paid preschoolers for taking breaks (DNRO) or for finishing tasks (DNRA) and both choices cut self-injury. Their data remind us that reinforcement schedules matter; the 1989 study never tested whether escape from work kept the hits going.

If you run into a client who self-restrains while hitting, know that a quick block plus toy time may help some, but not all. Track each learner separately. If hits stay high after one week, add a stronger redirection like Chen’s task demand or switch to a negative-reinforcement plan from L et al. Always pair any physical prompt with rich rewards for the incompatible calm hands.