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A Functionally Based Approach to the Treatment of Self-Injurious Behavior

This study examined the efficacy of basing treatment interventions for self-injurious behavior on data gathered in functional assessment sessions designed to evaluate the environmental determinants that control the rate of responding. Two moderate and one severely retarded school-age children served as subjects in this study. Data from the assessments revealed that Subjects 1 and 2 emitted the highest rates of self-injury under positive reinforcement conditions, while Subject 3 exhibited higher rates during sensory-input alone conditions. Treatments, implemented by classroom teachers, consisted of differential reinforcement procedures that sought to replace the self-injury with functionally equivalent responses. Results of the interventions indicate that self-injury that is maintained by socially mediated reinforcers could be reduced through the training of alternative communicative responses. In addition, self-injury that functioned as sensory stimulation was reduced by the application of a mild restraint and differential reinforcement of incompatible response procedure. These results are discussed in relation to the identified motivational determinants of the responses and the limitations of such assessments.