Assessment & Research

Delineating subtypes of self-injurious behavior maintained by automatic reinforcement.

Hagopian et al. (2015) · Journal of applied behavior analysis 2015
★ The Verdict

Automatically reinforced self-injury comes in three flavors—use FA plus self-restraint signs to pick the flavor and the fix.

✓ Read this if BCBAs who assess automatically maintained SIB in any setting.
✗ Skip if Clinicians who only treat socially reinforced problem behavior.

01Research in Context

01

What this study did

The team ran functional analyses on clients whose self-injury seemed to run on automatic reinforcement.

They watched for self-restraint—times the person held their own body or clothes to stop the hit.

By pairing FA patterns with self-restraint data they sorted the clients into three clear groups.

02

What they found

Automatically reinforced self-injury is not one block; it splits into three subtypes.

Each subtype showed a different mix of response rate, self-restraint, and response to brief alone sessions.

Early tests showed the groups also reacted differently to the same treatment package.

03

How this fits with other research

LeSage et al. (1996) first proved self-restraint can reward self-injury, making it a key marker.

Dawson et al. (2025) later used the same three-subtype lens to craft a plan that cut both hits and mechanical restraints for one teen.

Putnam et al. (2003) showed FA works in toddlers, while this paper refines FA for the harder automatic cases.

04

Why it matters

If your client’s self-injury keeps going when no one is around, run a full FA and log every moment they wrap their arms or sit on their hands.

Match the pattern to one of the three subtypes before you pick sensory toys, restraint fading, or response blocking.

Starting with the right subtype can spare weeks of trial-and-error and lower injury risk for you and your client.

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During your next alone condition note if the client wraps their arms or clothes—tag it as possible self-restraint and factor it into your subtype call.

02At a glance

Intervention
functional behavior assessment
Design
other
Sample size
52
Population
mixed clinical
Finding
not reported

03Original abstract

Self-injurious behavior (SIB) is maintained by automatic reinforcement in roughly 25% of cases. Automatically reinforced SIB typically has been considered a single functional category, and is less understood than socially reinforced SIB. Subtyping automatically reinforced SIB into functional categories has the potential to guide the development of more targeted interventions and increase our understanding of its biological underpinnings. The current study involved an analysis of 39 individuals with automatically reinforced SIB and a comparison group of 13 individuals with socially reinforced SIB. Automatically reinforced SIB was categorized into 3 subtypes based on patterns of responding in the functional analysis and the presence of self-restraint. These response features were selected as the basis for subtyping on the premise that they could reflect functional properties of SIB unique to each subtype. Analysis of treatment data revealed important differences across subtypes and provides preliminary support to warrant additional research on this proposed subtyping model.

Journal of applied behavior analysis, 2015 · doi:10.1002/jaba.236