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.