On the relation between object manipulation and stereotypic self-injurious behavior.
Toys and praise alone can’t suppress automatically reinforced SIB—you must block the behavior or use protective equipment while enrichment happens.
01Research in Context
What this study did
The team worked with three children who had severe delays. Each child hurt themselves by hitting or biting. The study asked: can we cut this self-injury by giving them fun toys and praise?
Sessions ran in a small room. Toys were on a table. Staff said "play" and praised any touch. Sometimes they also blocked the child’s hands or used soft arm splints. They counted how often the child played and how often the child hurt themselves.
What they found
Toy play only went up when the child could not hurt themselves. Splints or gentle hand blocks worked. Praise and toys alone did nothing. Self-injury stayed the same in every other test.
The results say the behavior was automatic. The kids did it for the feeling, not for attention or escape. Enrichment alone cannot beat that kind of reinforcement.
How this fits with other research
Osnes et al. (1986) saw sensory toys cut stereotypy in profoundly delayed kids. Their toys lit up or vibrated right away. The 1999 study used plain toys and got no drop in SIB. The quick sensory payoff seems to matter.
Hawkins (1982) showed prompt plus praise raised play in autistic-like kids. The 1999 study used the same recipe but got no play rise and no SIB drop. The difference: the 1982 kids did not have long, painful self-injury. Automatic SIB needs stronger medicine.
Golonka et al. (2000) enriched escape breaks and cut problem behavior. They succeeded because the behavior was escape-maintained. The 1999 SIB was automatically reinforced, so enrichment alone failed. Function drives the fix.
Why it matters
If a client’s self-injury feels good to them, don’t expect new toys or praise to wipe it out. Plan to block the behavior or use protective gear while you teach play. Pair the gear with toys so play rises only when the SIB is safe. Check function first—enrichment works best when the behavior is backed by attention or escape, not by its own sensation.
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02At a glance
03Original abstract
Results from a number of studies have shown an inverse relationship between stereotypic behavior and object manipulation. The purposes of this study were to determine whether techniques similar to those used previously (prompting and reinforcement) would be effective in increasing object manipulation under both prompted and unprompted conditions, and to ascertain whether increases in object manipulation would result in decreases in stereotypic self-injurious behavior (SIB). Two individuals with developmental disabilities who engaged in SIB maintained by automatic reinforcement participated. Results showed that object manipulation increased from baseline levels when experimenters prompted participants to manipulate leisure items, but that object manipulation was not maintained under unprompted conditions, and rates of SIB stayed within baseline levels. We then attempted to increase object manipulation further by (a) reinforcing object manipulation, (b) blocking SIB while reinforcing manipulation, and (c) preventing SIB by applying protective equipment while reinforcing object manipulation. Reinforcing object manipulation alone did not affect levels of object manipulation. Blocking effectively reduced attempts to engage in SIB for 1 participant but produced no increase in object manipulation. When the 2nd participant was prevented from engaging in SIB through the use of protective equipment, rates of object manipulation increased dramatically but were not maintained when the equipment was removed. These results suggest that stimulation derived from object manipulation, even when supplemented with arbitrary reinforcement, may not compete with stimulation produced by stereotypic SIB; therefore, direct interventions to reduce SIB are required.
Journal of applied behavior analysis, 1999 · doi:10.1901/jaba.1999.32-51