title: Effects and side effects of DRO as treatment for self-injurious behavior.
abstract: A three-part controlled case study is presented in which severe and longstanding self-injurious behavior exhibited by a 9-year-old-boy was treated successfully with differential reinforcement of other behavior. In Phase 1, an experimental analysis demonstrated that the boy's scratching was not maintained by environmental contingencies; instead, it appeared that the self-injurious behavior was a stereotypic (automatically reinforced) response. In Phase 2, the effects of an escalating differential-reinforcement-of-other-behavior schedule mediated through token reinforcement (pennies) were evaluated in a reversal design. Results showed that differential-reinforcement-of-other-behavior eliminated self-injurious behavior very quickly and for periods of time as long as 30 min. A noteworthy side effect observed during Phase 2 was the occurrence of crying behavior following the nondelivery of reinforcement. In Phase 3, the token program was gradually extended in 30-min increments throughout the day. Additionally, results of a brief multielement manipulation showed that the effects of token reinforcement were superior to those of a more easily administered differential reinforcement of other behavior based on social reinforcement, which differed little from baseline.
authors.affiliation: Spectrum Center, Berkeley, California.
authors.forename: G E
authors.initials: GE
authors.lastname: Cowdery
authors.forename: B A
authors.initials: BA
authors.lastname: Iwata
authors.forename: G M
authors.initials: GM
authors.lastname: Pace
mesh_terms: D001521:Behavior Therapy / Q000379:methods*; D002648:Child; D005500:Follow-Up Studies; D005793:Generalization, Psychological; D006760:Hospitalization; D006801:Humans; D008607:Intellectual Disability / Q000523:psychology; D008297:Male; D012055:Reinforcement Schedule; D012652:Self Mutilation / Q000517:prevention & control* / Q000523:psychology; D014040:Token Economy