Treating chronic aggression. Effects and side effects of response-contingent ammonia spirits.

The team worked with one child who had an intellectual disability and chronic, severe aggression.

They used a simple ABAB reversal design. When the child hit, bit, or kicked, staff immediately broke a small ammonia capsule under his nose.

They also tracked how much the child joined classroom activities and how often he yelled out.

The first whiff of ammonia stopped the aggression cold. Each time they removed the smell, the hitting came back. Each time they brought it back, the hitting stopped again.

Bonus wins: the child started joining more classroom tasks and yelled less. These gains were still there 14 months later.

Rincover et al. (1975) did the same thing eight years earlier with adults who hit themselves. Their data showed the smell worked only while staff kept using it on the ward. Wallander et al. (1983) now shows the effect can last over a year, so the earlier worry about quick relapse may fade with longer follow-up.

Adams (1980) used ammonia on hair-pulling aggression in another youth. Both single-case studies got fast suppression, adding weight to the idea that the smell works across different kinds of severe behavior.

Lancioni et al. (2008) took the opposite road. They spent weeks testing what social pay-offs kept two kids aggressive, then fixed those pay-offs. L et al. skipped that step and went straight to punishment. The papers do not clash; they simply show two tools—one fast and aversive, one slower and function-based—for the same tough problem.

If you face life-threatening aggression and need it stopped today, a quick ammonia contingency is worth considering. Pair it with later functional work so you do not rely on smell forever. Track side benefits like more participation; they may show up without extra planning.