Side effects of extinction: prevalence of bursting and aggression during the treatment of self-injurious behavior.
Expect bursts or aggression in about half of self-injury cases—buffer them by embedding extinction in a treatment package, not using it solo.
01Research in Context
What this study did
The team looked back at 41 kids who got extinction for self-injury. They counted how many kids showed a burst or new aggression.
They also checked if adding other parts to treatment lowered these side effects.
What they found
Almost half the kids had a burst or became aggressive when extinction was used alone.
When extinction was wrapped inside a larger plan, the trouble dropped.
How this fits with other research
Muething et al. (2024) saw bursts in only 24 % of 108 cases. The lower number may come from stricter burst rules and more combo plans already in place.
Lerman et al. (1995) first showed the same 24 % burst rate and proved combos cut risk in half. The 1999 set backs this up with self-injury cases.
Shahan et al. (2025) gave rats big alternative rewards and saw smaller bursts. This lab test explains why adding other reinforcers in the 1999 combos helped.
Why it matters
Never run extinction by itself for self-injury. Pair it with reinforcement for a replacement skill or non-contingent attention from the start. Tell staff and parents to expect a possible burst, but show them the data: combos both drop the odds and soften the blow.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Add a dense schedule of reinforcement for a replacement response before you withhold the reinforcer for self-injury.
02At a glance
03Original abstract
Findings from basic and applied research suggest that treatment with operant extinction may produce adverse side effects; two of these commonly noted are an increase in the frequency of the target response (extinction burst) and an increase in aggression (extinction-induced aggression). Although extinction is often used to treat problem behavior in clinical settings, few applied studies have examined the prevalence of these side effects or their possible attenuation with other operant procedures. An analysis of 41 data sets for individuals who received treatment for self-injurious behavior indicated that extinction bursts or increases in aggression occurred in nearly one half of the cases. The prevalence of bursting and aggression was substantially lower when extinction was implemented as part of a treatment package rather than as the sole intervention.
Journal of applied behavior analysis, 1999 · doi:10.1901/jaba.1999.32-1