Protective equipment: continuous and contingent application in the treatment of self-injurious behavior.
Slap on the helmet or gloves only after self-injury, add praise for safe hands, and you can fade the gear out fast.
01Research in Context
What this study did
Three kids with intellectual disability hit or bit themselves hard. The team put helmets, gloves, or arm splints on them only after each self-hit. They also gave praise and snacks for safe hands. They tracked self-injury across home, school, and work sites.
The gear stayed on for two to five minutes. Then staff removed it and praised calm behavior. They slowly made the gear lighter until the kids wore none.
What they found
Self-injury dropped to almost zero in every place. The kids kept the gains after the helmets and gloves were gone. Parents and teachers said life felt calmer.
How this fits with other research
Luiselli (1989) did the same thing with gloves on a blind teen who picked her skin. The gloves worn only after picking also wiped out the behavior for months.
Thakore et al. (2024) added response interruption to the gloves for an autistic boy who mouthed his hands. The combo hit zero and stayed there.
van der Miesen et al. (2024) looked at 200-plus single cases and found caregiver-delivered SIB tools work just as well as clinic tools. The 1982 study is inside their data set, showing the effect holds across four decades.
Why it matters
You can start protective gear today without waiting for fancy tools. Put the helmet or gloves on right after the hit, not before. Pair the break with praise for safe behavior, then thin the gear fast. The 1982 kids lost the equipment in weeks and stayed safe at home and school. If you run an ABA class, home program, or day hab, this gives you a low-cost, low-risk first step before trying more intrusive steps.
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02At a glance
03Original abstract
This study evaluated the use of protective equipment in treating self-injurious behavior (SIB) exhibited by three retarded persons. In Experiment 1, the equipment was first applied continuously during 20-min sessions in individual multiple baseline designs across settings. Results showed substantial reductions in head hitting, eye gouging, and hand biting. Brief periods of time-out with the protective equipment were later made contingent on SIB and combined with a differential reinforcement procedure. Reduced levels of SIB was maintained with all subjects. Additionally, the amount of time during which the equipment was applied decreased as the SIB diminished. Experiment 2 evaluated the use of contingent protective equipment (the final condition in Experiment 1) when applied directly in the subjects' living units during the day. During Experiment 2, SIB remained at or below the levels found at the termination of Experiment 1. Finally, in an effort to assess the long-term effectiveness of the procedure, responsibility for implementation was given to the staff who were typically assigned to provide therapy to the subjects. Follow-up probe observations conducted up to 104 days after termination of the final experimental condition showed continued low levels of both SIB and equipment usage. Results of these experiments suggest that contingent protective equipment and differential reinforcement may be effective in reducing chronic self-injury.
Journal of applied behavior analysis, 1982 · doi:10.1901/jaba.1982.15-217