Adults' responses to self-injurious behavior. An experimental analysis using a computer-simulation paradigm.

Researchers built a computer game for staff. The screen showed an adult with severe ID hitting herself.

Participants chose to give attention, escape, or ignore. Each choice changed future self-injury.

The game secretly switched the rules. Staff had to learn the new payoff by trial and error.

Written rules beat real payoffs. Staff kept following the first rule even when it stopped working.

A small amount of aversive noise also shaped where staff looked. Rules plus mild punishment locked in the first habit.

Lord et al. (1986) showed the same lock-in with college students pressing keys for money. Rules froze choices even when the payoff table flipped.

Nergaard et al. (2021) added a twist: a history of reward for rule-following makes adults stick longer. Together the three studies say, "Once a rule is in, contingencies fight an uphill battle."

Robertson et al. (2013) looks like a clash but isn’t. They found that a tiny response-cost fine kept adults obeying wrong instructions. P et al. used mild noise the same way—small aversive events glue faulty rules in place.

Your training handout is stronger than the natural result. Write the exact step you want staff to do when self-injury happens. State the payoff: "Stay silent for 30 s, attention returns only when hands are down." Rehearse the rule until it is automatic. Check it each month; if the contingency drifts, rewrite the rule before the drift becomes habit.