Recent research on aetiology, development and phenomenology of self‐injurious behaviour in people with intellectual disabilities: a systematic review and implications for treatment

Abstract

One dynamic in the development of SIB may be Pavlovian conditioning of aggression, originally elicited by aversive events or frustrative non-reward, to stimuli associated with such situations. Integration into operant technology of interventions based on Pavlovian principles such as graduated exposure (with or without counterconditioning) to aversive stimuli may enhance the effectiveness of behavioural interventions.

Self-injurious behavior among individuals with intellectual and developmental disabilities

“…SIB is often described in individuals with severe or profound intellectual disabilities, in those with autism, and in persons diagnosed with a variety of genetic disorders [6][7][8]. The most common forms of SIB reported in the literature include head banging, head hitting, and selfbiting [9]; these are reported in approximately 40% of all cases.…”

“…SIB and other problem behavior is also source of great of stress for families, and incurs high costs to society for treatment and placement [17,18]. If untreated or if the treatment is not effective, SIB usually persists or worsen [6,19,20].…”

“…These reactions may inadvertently reinforce SIB through operant learning processes, increasing its future probability and establishing a maladaptive behavioral repertoire that persists. Ultimately, SIB is the product of interactions stemming from deficits secondary to the developmental disability and experiences that occasion and reinforce SIB through operant learning processes [6,29,30]. Although the processes that lead to the emergence of SIB are not fully known in general, nor can they be identified in any a given case, the variables that currently maintain SIB through reinforcement can be identified through functional behavioral assessment in the majority of cases.…”

Increased Exposure to Rigid Routines can Lead to Increased Challenging Behavior Following Changes to Those Routines

“…Importantly, this preference for predictability can manifest as challenging behavior following changes to routines or expectations (Gomot & Wicker, 2012;Furniss & Biswas, 2012;Richards, Oliver & Allen, 2010;Sabaratnam, Murthy, Wijeratne, Buckingham, Payne, 2003;Woodcock, Oliver & Humphreys, 2009a). In Prader-Willi syndrome, this resistance to change is particularly prevalent; and associated with temper outbursts, which have been measured in experimental settings by tracking outburst component behaviors Woodcock, Oliver & Humphreys, 2011).…”

The treatment of severe self-injurious behavior through sensory stimulation: A case report

“…These behaviors may first result in the development of homeostatic functions that regulate the overall degree of stimulation. Repetitive behavior may further be shaped into selfinjurious behavior through socially mediated or automatic operant reinforcement (Furniss & Biswas, 2012). What is common in many of these explanations is the hypothesis that self-injurious behavior is maintained by the sensory stimulation it provides (Edelson, 1984).…”