Combination of extinction and protective measures in the treatment of severely self‐injurious behavior

Two female adolescents with profound mental retardation and physical disabilities residing in a state facility exhibited self‐injurious behavior (SIB). They had been wearing restrictive mechanical restraints for more than two years to prevent injuries from occurring. By using an indirect method of functional analysis, social attention was found to be the factor reinforcing and maintaining their behaviors. Extinction in combination with non‐intrusive protective measures was selected as the intervention strategy to reduce SIB. The outcomes of the treatment were evaluated with an AB probe design. Incidents of SIB decreased quickly and sharply after the treatment began. Once the incidents had reached a level of zero for three consecutive sessions, a six‐month follow‐up was started. No SIB was observed or reported during the follow‐up. The advantages of using extinction, especially in conjunction with the non‐intrusive protective measures to treat SIB, are discussed. Copyright © 2003 John Wiley & Sons, Ltd.     

Extended analysis and treatment of self‐injurious behavior

In experiment 1, an extended functional analysis of self‐injury was conducted with a 21‐year‐old male diagnosed with autism and profound mental retardation. The multielement phase yielded undifferentiated results. Subsequent blocking of conditions plus the addition of a component allowing access to multiple sensory stimuli suggested that self‐injury was unrelated to programmed positive or negative reinforcement contingencies. The behavior appeared to be automatically reinforced; its occurrence decreased when access to alternative sensory stimuli was provided. Experiment 2 evaluated a treatment condition in which response‐independent access to these sensory stimuli was provided within the participant's everyday environment. Baseline and treatment frequencies of self‐injury were compared in a combined, multiple‐baseline‐across‐settings and ABAB design. The level of self‐injury decreased substantially during treatment. These results support the use of extended analog analyses of aberrant behavior in instances in which undifferentiated responding occurs in the initial analogue analysis. Additionally, a procedure is described for generalizing the intervention derived from the experimental analysis into the participant's everyday environment. Copyright © 2001 John Wiley & Sons, Ltd.     

Identifying predictive behavioral markers: A demonstration using automatically reinforced self‐injurious behavior

Predictive biomarkers (PBioMs) are objective biological measures that predict response to medical treatments for diseases. The current study translates methods used in the field of precision medicine to identify PBioMs to identify parallel predictive behavioral markers (PBMs), defined as objective behavioral measures that predict response to treatment. We demonstrate the utility of this approach by examining the accuracy of two PBMs for automatically reinforced self‐injurious behavior (ASIB). Results of the analysis indicated both functioned as good to excellent PBMs. We discuss the compatibility of this approach with applied behavior analysis, describe methods to identify additional PBMs, and posit that variables related to the mechanisms of problem behavior and putative mechanism of treatment action hold the most promise as potential PBMs. We discuss how this technology could guide individualized treatment selection, inform our understanding of problem behavior and mechanisms of treatment action, and help determine the conditional effectiveness of clinical procedures.     

Treatment of self‐injurious behavior using differential punishment of high rates of behavior (DPH)

The purpose of the current investigation was to explore the effectiveness of differential punishment of high rates of behavior (DPH) to treat the severe self‐injury of a 28‐year‐old man with autism in an adult day program setting. DPH procedures involve the use of an established criterion related to a rate of responding within some time interval at which a punisher is delivered. The implementation of DPH in this study resulted in a substantial long‐term reduction of severe self‐injurious behavior. These findings are significant in that they provide a model for the design and implementation of punishment procedures that can be adopted in applied settings where staff resources are limited. The results of this study have implications for the treatment of severe problem behavior among individuals with autism across settings and age groups.     

Computer aided self‐monitoring to increase academic production and reduce self‐injurious behavior in a child with autism

Self‐monitoring to increase the on‐task behavior of students with learning disabilities has been the focus of numerous studies in the literature. This study examined the effectiveness of computer aided self‐monitoring of academic task completion to reduce self‐injurious behavior in a 13‐year‐old male student with autism. Using an ABAB design, data were collected over 22 sessions in a resource‐reading classroom. Visual and statistical analyses indicated that when self‐monitoring of activity completion was implemented, rates of completion increased and maladaptive behaviors such as self‐injurious behavior and tantruming decreased. Discussion follows for implications for self‐monitoring with students with autism. Copyright © 2009 John Wiley & Sons, Ltd.     

Further evaluation of latency measures in the assessment and treatment of severe self‐injurious behavior

Recent research has demonstrated the utility of latency measures during the functional analysis of problem behavior; however, few studies have evaluated the utility of latency measures during subsequent treatment analyses. The current study seeks to extend the literature on the use of latency measures during the treatment of severe self‐injurious behavior (SIB). Following a latency‐based functional analysis, a treatment analysis was conducted using a hybrid procedure in which baseline sessions were terminated following the first instance of SIB, and test sessions ended after a fixed length of time. Latency to SIB was compared across conditions, whereas latency and rate measures for both SIB and functional communication responses were compared for the functional communication training condition. Results suggest that latency measures may be too sensitive during treatment analyses and that it is beneficial to use a hybrid procedure that allows for both latency and rate comparisons.     

Decreasing self‐injurious behavior associated with awakening in a child with autism and developmental delays

Direct observation data revealed that self‐injurious behavior (SIB) emitted by a young boy with autism occurred primarily within one hour after waking versus all other times of the day. Experimentally manipulated scheduled awakenings supported the hypothesized relation between waking and SIB. A faded‐bedtime procedure was then implemented to stabilize his sleep patterns, which reduced awakenings by 81% and post‐waking SIB by 82%. Copyright © 2004 John Wiley & Sons, Ltd.     

Body posture effects on self‐evaluation: A self‐validation approach

Building on the notion of embodied attitudes, we examined how body postures can influence self‐evaluations by affecting thought confidence, a meta‐cognitive process. Specifically, participants were asked to think about and write down their best or worse qualities while they were sitting down with their back erect and pushing their chest out (confident posture) or slouched forward with their back curved (doubtful posture). Then, participants completed a number of measures and reported their self‐evaluations. In line with the self‐validation hypothesis, we predicted and found that the effect of the direction of thoughts (positive/negative) on self‐related attitudes was significantly greater when participants wrote their thoughts in the confident than in the doubtful posture. These postures did not influence the number or quality of thoughts listed, but did have an impact on the confidence with which people held their thoughts. Copyright © 2009 John Wiley & Sons, Ltd.     

The control of contextual extinction effects during a fear-incubation procedure

The role of contextual (apparatus) cues upon baseline control groups in a fear-incubation procedure was examined. Using a suppression-of-licking measure, it was determined that infrahuman demonstrations of fear incubation have not clearly demonstrated an enhanced fear response (fear incubation) following brief unreinforced CS exposures. Adequate control for background apparatus exposures for the baseline-control group indicated that a facilitation of extinction for the no-CS-exposure group may, in fact, account for group differences. Results were interpreted within the context of existing theoretical models of fear extinction and incubation.     

Treatment of escape-maintained aberrant behavior with escape extinction and predictable routines

We evaluated the effects of two daily activity schedules on 2 participants' rates of aberrant behavior and their compliance. Functional analysis identified the operant function of the participants' aberrant behaviors to be escape from tasks. Participants were taught to use stimuli contained in daily schedules, and were tested based on a modified stimulus-equivalence model that consisted of flash cards and activity schedules comprised of words or photographs that corresponded to the participants' daily activities. On pretests, the participants demonstrated simple and conditional discriminations with the photographs but not with the printed stimuli. A time-delay procedure was used to teach the participants to name the flash cards. Following training, the printed activity schedules corresponded to lower rates of problem behavior and higher rates of compliance than the photographic activity schedules. Performance on posttests indicated the establishment of functional classes of stimuli involving the flash cards and activity schedules even though this type of correspondence was not directly trained.     

The effects of selective schooling and self‐concept on adolescents' academic aspiration: An examination of Dweck's self‐theory

Background. Dweck has emphasized the role of pupils' implicit theories about intellectual ability in explaining variations in their engagement, persistence and achievement. She has also highlighted the role of confidence in one's intelligence as a factor influencing educational attainment. Aim. The aim of this paper is to develop a model of achievement aspiration in adolescence and to compare young people who are educated at a selective grammar school with those who attend a non‐selective ‘secondary modern’ school. Sample. The sample consisted of 856 English secondary school pupils in years 7 and 10 from two selective and two non‐selective secondary schools. Method. Questionnaires were completed in schools. Results. The findings are consistent with the model, showing that achievement aspiration is predicted directly by gender, school type and type of intelligence theory. Importantly, school type also affects aspirations indirectly, with effects being mediated by confidence in one's own intelligence and perceived academic performance. Intelligence theory also affects aspirations indirectly with effects being mediated by perceived academic performance, confidence and self‐esteem. Additionally, intelligence theory has a stronger effect on aspirations in the selective schools than in the non‐selective schools. Conclusions. The findings provide substantial support for Dweck's self‐theory, showing that implicit theories are related to aspirations. However, the way in which theory of intelligence relates to age and gender suggests there may be important cross‐cultural or contextual differences not addressed by Dweck's theory. Further research should also investigate the causal paths between aspirations, implicit theories of intelligence and the impact of school selection.     

Mindset effects on information search in self‐evaluation

Research on mindset theory (Gollwitzer & Bayer, 1999 ) observed that people in an implemental mindset show an orientation towards positive illusionary self‐evaluations, whereas people in a deliberative mindset opt for accurate self‐evaluations. In the present study, we tested whether these self‐evaluative orientations and the associated search for certain types of self‐relevant information (feedback) are moderated by low versus high self‐views. With high self‐view participants we observed the hypothesized mindset effects on information search, but we obtained the reverse pattern for low self‐view participants. The latter finding points to self‐defensiveness in low self‐view individuals. Implications are discussed in terms of the consequences of accurate versus positive illusionary self‐evaluations for the successful control of goal pursuits, and individual differences in mindset effects. Copyright © 2005 John Wiley & Sons, Ltd.