The effects of an escape extinction procedure using protective equipment on self‐injurious behavior

Tereshko et al. (2017) worked with an 8-year-old boy with autism who hit his head to get out of schoolwork. They kept the helmet on during every task. The child could not escape. This is escape extinction plus protective equipment.

The team watched him for 18 months to see if the low head-hitting lasted.

Head drops fell fast once the helmet stayed on. Rates stayed low for a year and a half. No new bumps or bruises appeared.

The boy also started to finish more schoolwork.

Iwata et al. (1990) already showed that plain escape extinction cuts self-injury and lifts compliance. Tereshko adds a safety twist: keep the helmet on so the child cannot hurt himself during the burst.

Hatton et al. (1999) saw bursts or new aggression in about half of kids when extinction was used alone. The 2017 case side-steps that risk by padding the client up front.

Matson et al. (1994) thought contingent mitts work as punishment. Tereshko frames the same gear as part of extinction. Same tool, two views: one blocks the reinforcer, the other adds a small cost.

If you run escape extinction for head hitting, keep protective equipment on from day one. You shield the child, skip the big burst, and still get the long drop in behavior shown by Iwata et al. (1990). Check helmet fit each session, then fade the gear only after rates stay flat.