Air splints applied to control self-injurious finger sucking in profoundly retarded individuals

We conducted several manipulations of mechanical restraint properties during the course of treatment for two profoundly retarded adolescents who exhibited both self-restraint and self-injurious behavior. In study 1, a combination of prompting, differential reinforcement, and stimulus fading reduced one subject's self-restraint, which consisted of holding rigid tubes on his arms. Subsequently, stimulus control of both self-restraint and self-injurious behavior was transferred to tennis wrist bands. In study 2, a second subject's self-restraint-placing his hands in his pants-was immediately eliminated by the use of air splints. Additionally, differential reinforcement and airpressure fading resulted in the complete mobility of his arms and a substantial increase in appropriate behaviors. Results of this investigation suggest that stimulus fading and transfer may be valuable components in the elimination of self-restraint.

Section: Studymentioning

confidence: 99%

“…They extended from Bart's shoulders to his wrists. The splints were inflated with a rubber blood pressure bulb, and air pressure was monitored with a sphygmomanometer (Ball et al, 1980). All measures of air pressure were taken with the arms at fill extension.…”

Section: Apparatusmentioning

confidence: 99%

Stimulus Fading and Transfer in the Treatment of Self‐restraint and Self‐injurious Behavior

Pace

Iwata

Edwards

et al. 1986

“…Although restraint fading has been demonstrated to be a clinically useful method for reducing self-restraint (Lerman, Iwata, Smith, & Vollmer, 1994;Pace et al, 1986), restraints and restraint fading have been used less frequently as treatment for SIB in the absence of self-restraint. Ball, Campbell, and Barkemeyer (1980) applied air splints to reduce the chronic finger sucking of a profoundly mentally retarded woman. Finger sucking was decreased initially; however, as the pressure of the air splints was reduced, finger sucking increased.…”

mentioning

confidence: 99%

Direct and Collateral Effects of Restraints and Restraint Fading

Fisher

Piazza

Bowman

et al. 1997

Mechanical restraints are commonly used to reduce the risks associated with severe self-injurious behavior (SIB), but may result in movement restriction and adverse side effects (e.g., bone demineralization). Restraint fading may provide a method for decreasing SIB while increasing movement and reducing these side effects. In the current investigation, rigid arm sleeves and restraint fading (gradually reducing the rigidity of the sleeves) were used with 3 clients who engaged in hand-to-head SIB. Restraints and fading reduced the hand-to-head SIB of all clients. However, for 1 client, the addition of a water mist procedure further reduced SIB to near-zero levels. For a 2nd client, another form of SIB developed that was not prevented by the rigid sleeves. For a 3rd client, a topography of SIB that was not physically prevented by the rigid sleeves was also reduced when restraints and fading were introduced.

“…hand biting in that the former does not result in laceration of the hands caused by the teeth. Tissue damage produced by hand mouthing usually results in skin breakdown and lesions, which subsequently may result in infection (Ball, Campbell, & Barkemeyer, 1980), loss of motor dexterity (Dorsey, Iwata, Ong, & Mc-Sween, 1980), and interference with the performance of adaptive skills (Rast & Jack, 1992). In addition, hand mouthing is considered to be socially inappropriate due to its offensive odor and the presence of saliva in areas external to the oral cavity, both of which pose a barrier to social integration (McClure, Moss, McPeters, & Kirkpatrick, 1986).…”

mentioning

confidence: 99%

An Analysis of the Reinforcing Properties of Hand Mouthing

Goh

Iwata

Shore

et al. 1995

100

Hand mouthing often has been described as a stereotypic response that is maintained by nonsocial (automatic) reinforcement; however, data supporting this conclusion can be found in relatively few studies. This series of studies presents an experimental analysis of conditions associated with the maintenance of hand mouthing. In Experiment 1, a functional analysis was conducted for 12 individuals who engaged in chronic hand mouthing, to determine whether the behavior is usually maintained independent of social contingencies. Results obtained for 10 subjects were consistent with an automatic reinforcement hypothesis; the remaining 2 subjects' hand mouthing was maintained by social-positive reinforcement. Based on these results, Experiment 2 was designed to identify the specific reinforcing properties of hand mouthing. Each of 4 subjects was provided with a toy that substituted for hand mouthing, and preference for a specific topography of toy manipulation (hand-toy contact or mouth-toy contact) was measured. Results indicated that hand stimulation was the predominant reinforcer for all subjects. Experiment 3 provided an extension of Experiment 2 in that the same responses were measured across a variety of toys presented to each of 5 subjects. Results again indicated that hand stimulation was the predominant reinforcer for all subjects. Implications of these results are discussed with relevance to treatment.