A Systematic Review of Behavioral Interventions to Reduce Restricted or Repetitive Behavior of Individuals with Visual Impairment

Restricted or repetitive behavior (RRB) is common for individuals with visual impairment (VI), autism spectrum disorder (ASD), and intellectual disability. Previous reviews have suggested that VI may moderate the effectiveness of behavioral interventions to decrease RRB. A search of the single case literature resulted in 30 studies and 40 experiments involving participants with VI to test behavioral interventions to reduce RRBs. Nearly all participants had significant intellectual disability, half were deafblind, and only two had an ASD diagnosis. Success rates were higher for participants with low vision (88.9%) than for participants with blindness (68.4%) and to reduce non-self-injurious behavior (81%) than for self-injurious behavior (68.4%). Although most interventions in this review involved punishment and more research on reinforcement-based interventions is needed, multi-component interventions combining differential reinforcement with brief restraint or specific response contingent on RRB appear to hold the most promise for reducing RRBs for individuals with VI.