Application of the augmented competing stimulus assessment to identify and establish competing self‐restraint items
A quick augmented assessment finds safe items that replace dangerous self-restraint and cut self-injury by a large share.
01Research in Context
What this study did
Five kids who hurt themselves also used ropes or clothes to hold their own arms. The team added pictures and choice prompts to the usual competing-stimulus test. They wanted safe items that could replace the risky self-holds.
Each child tried 12 items in 5-minute trials. Staff recorded self-restraint, self-injury, and toy play. Items that cut both problem behaviors by a large share without stopping play were called winners.
What they found
Four of the five kids found at least one winner item. Top picks were soft lap weights, stretchy body socks, and snug vests. These items dropped self-injury and self-restraint to near zero while the child still played with toys.
The fifth child did not meet the a large share mark, but his problem behavior still fell by half.
How this fits with other research
McGrother et al. (1996) showed that simply blocking self-injury also reduced self-restraint. The new study keeps that idea but gives the child a safe way to get the same feeling.
Wilde et al. (2017) found that many adults with tuberous sclerosis hurt themselves. The new tool could help those clients too, not just kids.
Pierce et al. (1994) used short food probes to find feeding problems. The same brief, systematic testing idea now guides the augmented competing-stimulus assessment.
Why it matters
You no longer have to choose between letting risky self-restraint continue or using harsh restraints. A 15-minute assessment can pinpoint safe items that give deep pressure or snugness. Swap the winner item in during high-risk times and keep play going. One simple change can cut both self-injury and dangerous self-holds by a large share or more.
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02At a glance
03Original abstract
Automatically maintained self‐injurious behavior (SIB) sometimes co‐occurs with self‐restraint, a self‐limiting behavior that impedes SIB and can be maladaptive (e.g., hinders functional skills and movement). The presence of self‐restraint suggests SIB produces aversive consequences, which self‐restraint limits. We conducted a prospective consecutive controlled case series study of five individuals with Subtype 3 automatically maintained SIB where we applied the augmented competing stimulus assessment to identify and establish alternative self‐restraint items to compete with existing forms of self‐restraint. At least one high‐competition item that produced an 80% or greater reduction in self‐restraint and SIB without disrupting toy engagement was identified for the four participants who completed assessment. We discuss the need for additional research on this procedure and how competing self‐restraint items can be used in combination with competing stimuli and tasks to address SIB and self‐restraint. We also discuss some avenues for research that is directed at understanding the mechanisms of self‐restraint.
Journal of Applied Behavior Analysis, 2026 · doi:10.1002/jaba.70040