Use of negative reinforcement in the treatment of self-injurious behavior.
Let kids escape grooming by pressing a switch to slash self-injury, but plan thinning and follow-ups so the fix sticks.
01Research in Context
What this study did
Two children who hurt themselves during grooming were taught to press a switch instead.
Pressing the switch let them escape the grooming for a short break.
The team watched if the new escape rule kept self-injury away later.
What they found
Both kids almost stopped hitting or biting once the switch gave them a quick exit.
For one child the fix lasted; for the other the gains slipped away after the sessions ended.
How this fits with other research
Einfeld et al. (1995) later showed that making escape hinge on a clear task (DNRA) beats giving escape for any other behavior (DNRO).
Campos et al. (2017) added functional communication and schedule thinning and still saw some loss of control, matching the 1990 maintenance problem.
Emmelkamp et al. (1986) and Gutierrez et al. (1998) cut self-injury by slowly removing arm splints instead of offering escape, showing two roads to the same goal.
Why it matters
You can curb escape-driven self-injury right now by letting the client earn breaks with a simple incompatible act.
Build in thinning and booster sessions early so the new skill survives after you close the case.
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02At a glance
03Original abstract
Behavioral assessment procedures were used to determine the maintaining conditions of self-injury exhibited by 2 children with severe multiple handicaps. For both children, negative reinforcement (escape from grooming activities) was determined to be the maintaining reinforcer for self-injury (hand/arm biting) within an alternating treatments design. The treatment packages involved the use of negative reinforcement (brief escape from grooming activities) contingent upon a behavior that was incompatible with self-injury (reaching and pressing a microswitch that activated a pre-recorded message of "stop"). Treatment was evaluated with a reversal design for 1 child and with a multiple baseline across grooming activities for the 2nd child. The treatment led to a marked decrease in self-injury for both children. At follow-up, high rates of self-injury were reported for the 1st child, but low rates of self-injury and an increase in task-related appropriate behavior were observed for the 2nd child.
Journal of applied behavior analysis, 1990 · doi:10.1901/jaba.1990.23-459