Experimental analysis and extinction of self-injurious escape behavior.
Removing escape after self-injury quickly ends the behavior and lifts compliance, but later studies show you should plan for bursts and can speed gains by adding instructional fading.
01Research in Context
What this study did
The team worked with people who hit or bit themselves to get out of tasks. First they ran a short functional analysis. Demands went on until self-injury happened, then the task stopped. Self-injury always won a break, so the team knew escape was the payoff.
Next they used escape extinction. The staff never stopped the task after self-injury. They used a multiple-baseline design across participants to show control.
What they found
Self-injury dropped fast once escape was removed. For most participants the behavior vanished. Compliance with the same tasks shot up. The gains spread to new staff and even to a doctor’s exam room.
How this fits with other research
Castañe et al. (1993) added instructional fading to the same extinction plan. They started with super-easy tasks, then slowly returned to full work. Self-injury fell even faster, showing the 1990 procedure can be sharpened.
Matson et al. (1994) tracked the first weeks of escape extinction in adults. They saw brief response bursts and lots of variability before the drop. Their data warn you to stay the course; the 1990 study had already passed that noisy phase.
Hatton et al. (1999) looked at 41 cases and found bursts or new aggression in about half when extinction was used alone. This seems to clash with the quiet drop seen in Iwata et al. (1990). The gap is sample size: the 1990 paper shows what can happen, the 1999 paper shows how often side effects pop up in larger clinical use. Plan for bursts even if they do not always appear.
Why it matters
If your functional analysis shows escape-maintained self-injury, blocking the escape route remains the quickest lever. Expect possible bursts and have protective gear or extra staff ready. Pair the extinction with strong reinforcement for compliance, and track data daily so you do not quit during the first noisy week.
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02At a glance
03Original abstract
Three studies are presented in which environmental correlates of self-injurious behavior were systematically examined and later used as the basis for treatment. In Study 1, 7 developmentally disabled subjects were exposed to a series of conditions designed to identify factors that maintain self-injurious behavior: attention contingent on self-injurious behavior (positive reinforcement), escape from or avoidance of demands contingent on self-injurious behaviour (negative reinforcement), alone (automatic reinforcement), and play (control). Results of a multielement design showed that each subject's self-injurious behavior occurred more frequently in the demand condition, suggesting that the behavior served an avoidance or escape function. Six of the 7 subjects participated in Study 2. During educational sessions, "escape extinction" was applied as treatment for their self-injurious behavior in a multiple baseline across subjects design. Results showed noticeable reduction or elimination of self-injurious behavior for each subject and an increase in compliance with instructions in all subjects for whom compliance data were taken. The 7th subject, whose self-injurious behavior during Study 1 occurred in response to medical demands (i.e., physical examinations), participated in Study 3. Treatment was comprised of extinction, as in Study 2, plus reinforcement for tolerance of the examination procedure, and was evaluated in a multiple baseline across settings design. Results showed that the treatment was successful in eliminating self-injurious behavior and that its effects transferred across eight new therapists and three physicians. General implications for the design, interpretation, and uses of assessment studies are discussed.
Journal of applied behavior analysis, 1990 · doi:10.1901/jaba.1990.23-11