Abstract

Severe self-injurious behavior (SIB) in people with mental retardation is difficult to treat when dangerously frequent or intense responding rules out functional analysis and interventions that permit free responding. This situation is common when restrictive devices, such as straight arm splints, are used. In this study, the effects of introducing flexion into a straight-arm splint, on SIB, self-restraint, adaptive behavior, and behavioral correlates of affect were examined for three individuals with severe mental retardation. Using single-case design methodology, for two individuals self-injury was reduced to zero, while the overall level of restriction was also significantly reduced. From the observed behavioral correlates of affect, there was no evidence of an increase in negative affect with the introduction of the new splint and the fading procedure, but there was evidence of an increase in positive vocalizations. Engagement in activities and social contact were not affected by the introduction of the new splint. The reasons for a decrease in SIB with a corresponding decrease in restriction in the absence of any manipulation of contingencies for SIB are discussed, with particular reference to stimulus control.

Index Terms: automutilation; immobilization; mental deficiency

Article Outline

1. Introduction

2. Study 1

2.1. Method

2.1.1. Participant

2.1.2. Design and Properties of the Splint

2.1.3. Direct Observation Sessions: Recording Technique Response Definitions and Interobserver Reliability

2.1.4. Direct Observation Sessions: Calculation of the Restriction Index

2.1.5. Staff Observations: Recording Technique Response Definitions and Interobserver Reliability

2.2. Procedure

2.2.1. Direct Observation Sessions: Experimental Phase

2.2.2. Direct Observation Sessions: Generalization Phase

2.2.3. Staff Observations: Evaluation Phases

3. Results

4. Discussion

5. Study 2

5.1. Method

5.1.1. Participants

5.1.2. Procedure

5.1.3. Recording Technique Response Definitions and Interobserver Reliability

5.1.4. Calculation of the Restriction Index

6. Results

7. Discussion

8. General Discussion

References

¹This research was supported by a grant from The Mental Health Foundation. The authors wish to acknowledge the help given by the following people: the staff of Lambeth Walk day centre, Vicky Turk, Alex Proto, Roy Smith, Diane Langridge, and Angela Daniels

^*Chris Oliver, Senior Lecturer in Psychology, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. E-Mail: oliverc@psycho1.bham.ac.uk