Self-injurious behavior (SIB) is maintained by automatic reinforcement in roughly 25% of cases. Automatically reinforced SIB typically has been considered a single functional category, and is less understood than socially reinforced SIB. Subtyping automatically reinforced SIB into functional categories has the potential to guide the development of more targeted interventions and increase our understanding of its biological underpinnings. The current study involved an analysis of 39 individuals with automatically reinforced SIB and a comparison group of 13 individuals with socially reinforced SIB. Automatically reinforced SIB was categorized into 3 subtypes based on patterns of responding in the functional analysis and the presence of self-restraint. These response features were selected as the basis for subtyping on the premise that they could reflect functional properties of SIB unique to each subtype. Analysis of treatment data revealed important differences across subtypes and provides preliminary support to warrant additional research on this proposed subtyping model.

Functional communication training (FCT) is an empirically supported treatment for problem behavior displayed by individuals with intellectual disabilities. Hagopian, Fisher, Sullivan, Acquisto, and LeBlanc (1998) analyzed 25 applications of FCT and showed that extinction was a necessary component of FCT, but sometimes punishment was needed to maintain low levels of problem behavior. The current consecutive case series summarized data from 58 applications of FCT in more recent cases. This analysis extended and updated Hagopian et al. by examining FCT when used in combination with alternative reinforcement (noncontingent and differential reinforcement) and multiple schedules during schedule thinning. Although it is difficult to make direct comparisons with the 1998 study, the results of the current case series analysis suggest that FCT can be enhanced when used in combination with alternative reinforcement and when multiple schedules are used during schedule thinning.

Hagopian, Rooker, and Zarcone (2015) evaluated a model for subtyping automatically reinforced self-injurious behavior (SIB) based on its sensitivity to changes in functional analysis conditions and the presence of self-restraint. The current study tested the generality of the model by applying it to all datasets of automatically reinforced SIB published from 1982 to 2015. We identified 49 datasets that included sufficient data to permit subtyping. Similar to the original study, Subtype-1 SIB was generally amenable to treatment using reinforcement alone, whereas Subtype-2 SIB was not. Conclusions could not be drawn about Subtype-3 SIB due to the small number of datasets. Nevertheless, the findings support the generality of the model and suggest that sensitivity of SIB to disruption by alternative reinforcement is an important dimension of automatically reinforced SIB. Findings also suggest that automatically reinforced SIB should no longer be considered a single category and that additional research is needed to better understand and treat Subtype-2 SIB.