Using decelerative contingencies to reduce the self-injurious behavior of people with multiple handicaps: the effects of response satiation?
Making clients keep playing with leisure items while self-injury continues can cut the behavior by two-thirds without any punishment.
01Research in Context
What this study did
Two adults with profound intellectual disability hit or bit themselves dozens of times per hour. Staff let the self-injury continue, but added a new rule: the clients had to keep playing with leisure items the whole time.
The team ran an ABAB reversal. In the satiation phases, each client had to hold or manipulate toys, magazines, or a radio while self-injury stayed at baseline levels. In the return-to-baseline phases, the extra activity stopped.
What they found
When the satiation rule was on, self-injury dropped 68–82 percent for both adults. The effect moved with them: it held in different rooms and with different staff.
During the second baseline, the behavior bounced back. When satiation returned, the cuts happened again. No new punishment or restraint was used.
How this fits with other research
Hayes et al. (1975) wiped out self-injury with a strong punishment package. Taras et al. (1993) matched the size of the drop, but did it without any aversive. The later study shows you can get big suppression while staying fully non-aversive.
Rayfield et al. (1982) and Luiselli (1989) also cut SIB by adding protective equipment plus reinforcement. E et al. swapped the gear for extra leisure, proving the active ingredient is the added response requirement, not the helmet or gloves.
van der Miesen et al. (2024) pooled 11 years of SIB studies and found caregiver-run home treatments work as well as clinic ones. Taras et al. (1993) is one of the early bricks in that wall, showing a simple satiation plan can travel across staff and settings.
Why it matters
If a client’s self-injury is maintained by its own sensory payoff, you can dilute that payoff by flooding the moment with another activity. No need to take toys away after SIB; make them stay available and in use. Start with items you already have, measure baseline rates, and run a quick reversal to be sure the drop is real. The procedure is cheap, safe, and ready for parents or aides to carry out at home.
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02At a glance
03Original abstract
The response satiation model of instrumental performance was used to establish contingencies to reduce the self-injurious behavior (SIB) of two adults with profound mental retardation and multiple handicaps. In Experiment 1, withdrawal designs indicated behavior reductions of 68% and 82%, respectively, when contingencies were implemented that required the participants to engage in leisure activities at greater than baseline levels if they continued to perform the SIB at their baseline level. Experiment 2 involved the transfer of the treatment to the participants' respective living areas using staff as trainers. The largest reductions in behavior were associated with treatment packages that contained response satiation contingencies, and generality of the treatment packages across locations and trainers occurred. The limitations of this study as an analysis of response satiation theory were noted; however, it was concluded that the response satiation approach to establishing contingencies for reducing SIB was worthy of future investigation.
Research in developmental disabilities, 1993 · doi:10.1016/0891-4222(93)90008-8