Generalization and maintenance of the reduction of self-injurious behavior maintained by two types of reinforcement

The self-injurious forehead-gouging behavior that had resulted in blindness for a profoundly retarded 27-yr-old male was successfully treated using a combination of differential reinforcement of incompatible behavior during unstructured situations and prevention of escape during compliance situations. After self-injurious behavior was reduced to a low frequency, a reduction of his daily dose of chloral hydrate was accompanied by a large increase in self-injury, but the behavior gradually returned to its previous low level. A large increase in self-injury also occurred following transfer to another living unit, but the behavior again decreased to a low frequency. Treatment gains were maintained following transfer to another residential facility with follow-up observations occurring at 1, 2, 8, 15, 22, 27 and 35 months. The multiple determination of self-injurious behavior in this one S highlights the behavioral complexity of some of these behaviors.     

Ten-year follow-up of a successful treatment of self-injurious behavior

Ten years ago, self-injurious behavior that produced blindness in a man with profound mental retardation was treated through behavioral intervention. This person's behavioral history was reviewed for 12 years prior to the intervention through examination of his clinical record and for 10 years following the intervention through examination of his clinical record, direct observation, and interviews with staff. Physical injury occurred only once in the last 46 months; physical restraint has not been used in 10 years; and for the past 9 years, no more than one medication has been prescribed for the control of behavior or seizures. Suggestions are presented for designing behavioral interventions at the beginning of treatment to maintain reductions in behavior.