The use of brief restraint plus reinforcement to treat self‐injurious behavior

Abstract

This study evaluated the use of brief arm restraint plus differential reinforcement of alternative behavior to treat the self-injurious behavior of two residents with multiple handicaps and profound mental retardation. The study took place in a nursing home and sessions were conducted for 15 minutes, Monday through Friday. The design contained both multiple baseline and reversal components. Mean levels of self-injurious behavior and stripping for one client were reduced from 92 to 16% and 81 to 2%, respectively, by the treatment. Her appropriate behavior increased from a mean of 18% in baseline to 100% in treatment. The second client's self-injurious behavior averaged 39% in baseline, but was reduced to a mean of 9% in treatment. His throwing decreased from a mean of 54% prior to treatment to a mean of 2%, while appropriate object manipulation increased from 26 to 99%. These data support the use of brief restraint plus reinforcement for decelerating severe self-injurious behaviors and accelerating appropriate behaviors in adults with profound mental retardation. The advantages of this treatment are that it appears to be less intrusive and to offer more educational benefits than other commonly used techniques.

Successful Treatment of Severe Self Injury Incorporating the Use of DRO, a Snoezelen Room and Orientation Cues

“…use of verbal instruction to interrupt a behaviour) restraint. Konarski & Johnson (1989) found that use of DRA alongside restraint was successful in reducing both SIB and inappropriate behaviours. A recent study by Johnson et al (1994) also gives strong support to the concept of multi-modal interventions.…”

Self‐injurious Behaviour: An Overview of Recent Trends in Epidemiological and Behavioural Research

“…The importance of this study is underlined by the sample size, the severity of the self-injurious behaviours treated, the variety of hypothesised functions served by the individual's self-injury, the practicality of the intervention procedure and the maintenance of treatment gains for up to four years. The effectiveness of this treatment package has also been demonstrated for selfinjury apparently maintained by sensory reinforcement (Day et al, 1988;Saloviita, 1988) or of unknown motivation (Konarski & Johnson, 1989).…”

“…Azrin et al (1988), for example, report that a DRI plus response interruption and brief restraint procedure was, in general, considerably more effective in reducing the severe selfinjury shown by eight severely or profoundly handicapped adults and one autistic girl than DRO, DRI or response interruption procedures alone. The effectiveness of this treatment package has also been demonstrated for selfinjury apparently maintained by sensory reinforcement (Day et al, 1988;Saloviita, 1988) or of unknown motivation (Konarski & Johnson, 1989). The effectiveness of this treatment package has also been demonstrated for selfinjury apparently maintained by sensory reinforcement (Day et al, 1988;Saloviita, 1988) or of unknown motivation (Konarski & Johnson, 1989).…”