The functions of self-injurious behavior: an experimental-epidemiological analysis.
Escape leads self-injury functions, but always rerun “automatic” results with protective gear to catch hidden attention pay-offs.
01Research in Context
What this study did
The team ran 152 separate functional analyses on kids and adults who hurt themselves.
Each person got the standard test rooms: alone, attention, demand, and play.
All had developmental delays and lived in a big hospital unit.
What they found
The test nailed the reason for the self-injury 95 times out of 100.
Escape from tasks topped the list at 38%.
Attention and automatic reinforcement tied for second at 26% each.
How this fits with other research
Kahng et al. (2015) later checked the same 152 records for injuries. They found hurts were rare and mild, so the 1994 protocol is safe when you use guards.
Frank-Crawford et al. (2024) counted later studies and saw safety reporting jump from almost zero to 70%. The old data still hold; we just write down pads and helmets now.
Johnson et al. (2009) showed that some “automatic” cases were really attention-driven once helmets blocked the bite. If your FA says automatic, rerun it with gear before you trust the 26%.
Why it matters
You now have a quick map of why most clients hurt themselves. Start with an escape test first—it wins the base-rate race. If that fails, run attention and alone, but add a helmet round to catch masked social pay-offs. This order saves you sessions and keeps clients safe.
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02At a glance
03Original abstract
Data are summarized from 152 single-subject analyses of the reinforcing functions of self-injurious behavior (SIB). Individuals with developmental disabilities referred for assessment and/or treatment over an 11-year period were exposed to a series of conditions in which the effects of antecedent and consequent events on SIB were examined systematically by way of multielement, reversal, or combined designs. Data were collected during approximately 4,000 experimental sessions (1,000 hr), with the length of assessment for individuals ranging from 8 to 66 sessions (M = 26.2) conducted over 2 to 16.5 hr (M = 6.5). Differential or uniformly high responding was observed in 145 (95.4%) of the cases. Social-negative reinforcement (escape from task demands or other sources of aversive stimulation) accounted for 58 cases, which was the largest proportion of the sample (38.1%). Social-positive reinforcement (either attention or access to food or materials) accounted for 40 (26.3%) of the cases, automatic (sensory) reinforcement accounted for 39 (25.7%), and multiple controlling variables accounted for 8 (5.3%). Seven sets of data (4.6%) showed either cyclical or inconsistent patterns of responding that were uninterpretable. Overall results indicated that functional analysis methodologies are extremely effective in identifying the environmental determinants of SIB on an individual basis and, subsequently, in guiding the process of treatment selection. Furthermore, an accumulation of assessment data from such analyses across a large number of individuals provides perhaps the most rigorous approach to an epidemiological study of behavioral function.
Journal of applied behavior analysis, 1994 · doi:10.1901/jaba.1994.27-215