| Abstract: | Describes the long-term treatment program and follow-up of a case of chronic, severe, multiple self-injurious behavior. The intensity, frequency, and multiplicity of self-injurious behavior in a boy 1st seen at age 61/2 yrs is unparalleled in the literature. Treatment spanned 10 mo and more than 1,000 therapy hrs. Contingent electric shock and differential reinforcement of other behavior were the primary techniques utilized. The specifics of the punishment and reinforcement contingencies were modified throughout the program as a function of the behavior, thereby allowing for evaluation of the various components of the treatment procedures. Although initial results were only partially successful, total suppression was eventually achieved in the laboratory setting. The procedures described for extending this control to the natural environment proved only moderately successful. The technical, ethical, and theoretical issues concerning the treatment of severe self-injurious behavior are discussed. It is suggested that the extrapolation of laboratory evidence to the natural setting is premature in the case of severe self-injurious behavior. Suggested criteria for the assessment of successful clinical treatment of self-injurious behavior are offered. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved) |
