Manipulation of self-destruction in three retarded children.

Three young children with severe intellectual disability hit or bit themselves hard. The researchers turned their self-harm on and off like a light switch. They used three quick phases: first they ignored the kids (extinction), then they gave a brief electric shock after each hit, last they gave hugs and praise after each hit.

The team ran an ABAB reversal design. When shock followed self-harm, the behavior almost stopped. When adult attention followed the hits, the behavior shot back up.

Self-injury dropped to near zero during shock phases. It jumped back to high levels when adults gave attention for the same behavior. The pattern repeated in every reversal, showing clear environmental control.

Miller et al. (2022) now shows you can get the same drop without any pain. Their modern extinction-thinning protocol uses careful schedule changes and fun competing items. The 1969 study proved the principle; the 2022 study gives you a toolbox you can use today.

Pilgrim et al. (2000) followed adults for three years and found electric aversion cut restraint use in half. Their data extend the 1969 lab result to real-world institutions, but they also warn that painful procedures are rarely allowed now.

Rosenthal et al. (1980) seems to disagree. They found that physical restraints also stop self-harm but cost social interaction. The 1969 paper did not report social side effects, so the two studies highlight a trade-off: punishment may work faster, yet restraints can isolate clients.

This paper is a landmark proof that self-injury is learned, not inevitable. You can weaken it by removing its payoff. Today you would skip the shock and use modern extinction plus reinforcement, but the core lesson remains: change the contingencies and you change the behavior. Run a quick reversal probe if you need to show parents or payers that the environment, not mysterious brain forces, drives the problem.