Stimulus control and resistance to extinction in attention-maintained SIB.
A functional analysis of the self-injurious behavior (SIB) of a young man diagnosed with severe mental retardation demonstrated that SIB was sensitive to social attention as reinforcement. In addition, lower but consistent rates of SIB occurred in sessions where a person was present (Demand and Toy Play), and a gradual decrease in SIB was observed across sessions where a person was not present (Alone). Evaluation of the within-session trends of SIB during the functional analysis demonstrated that SIB maintained throughout each Social Attention session and declined within and across Alone sessions. This pattern of responding suggested that the presence of a person may have differentially affected rates of SIB independent of the programmed consequences for SIB. In a subsequent analysis, SIB was reduced to near-zero levels in the absence of a person, but maintained in the presence of a person even when attention was withheld, suggesting that the response was highly resistant to extinction. The results of these assessments then were used to develop a treatment to reduce the client's SIB. During treatment, a person was present and delivered attention only when the client appropriately communicated. SIB resulted in the removal of the antecedent stimulus that exerted control over the response (i.e., the person left the room). The findings of this investigation are discussed in terms of the differential effects of stimuli on interpretation of functional analysis results and the subsequent development of treatment.
Hanley
G P
GP
Neurobehavioral Unit, Kennedy Krieger Institute, Baltimore, MD 21205, USA.
Piazza
C C
CC
Fisher
W W
WW
Adelinis
J D
JD
D000293:Adolescent; D001288:Attention; D001521:Behavior Therapy / Q000379:methods*; D003142:Communication; D005108:Extinction, Psychological; D006801:Humans; D008607:Intellectual Disability / Q000523:psychology / Q000628:therapy*; D008297:Male; D012056:Reinforcement, Social; D016728:Self-Injurious Behavior / Q000517:prevention & control* / Q000523:psychology; D012934:Social Isolation