title: Effects of intermittent punishment on self-injurious behavior: an evaluation of schedule thinning.
abstract: Although the use of punishment often raises ethical issues, such procedures may be needed when the reinforcers that maintain behavior cannot be identified or controlled, or when competing reinforcers cannot be found. Results of several studies on the effects of intermittent schedules of punishment suggest that therapists must use fairly rich schedules of punishment to suppress problem behavior. However, residential caretakers, teachers, and parents often have difficulty implementing programs that require constant monitoring of the client's behavior. In this study, we examined the feasibility of gradually thinning the delivery of punishment from a continuous schedule to an intermittent schedule during the course of treatment for self-injurious behavior (SIB). Results of functional analyses for 5 individuals who had been diagnosed with profound mental retardation indicated that their SIB was not maintained by social consequences. Treatment with continuous schedules of time-out (for 1 participant) or contingent restraint (for the other 4 participants) produced substantial reductions in SIB. When they were exposed to intermittent schedules of punishment (fixed-interval [FI] 120 s or FI 300 s), SIB for all but 1 of the participants increased to levels similar to those observed during baseline. For these 4 participants, the schedule of punishment was gradually thinned from continuous to FI 120 s or FI 300 s. For 2 participants, SIB remained low across the schedule changes, demonstrating the utility of thinning from continuous to intermittent schedules of punishment. Results for the other 2 participants showed that intermittent punishment was ineffective, despite repeated attempts to thin the schedule.
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: D C
authors.initials: DC
authors.lastname: Lerman
authors.forename: B A
authors.initials: BA
authors.lastname: Iwata
authors.forename: B A
authors.initials: BA
authors.lastname: Shore
authors.forename: I G
authors.initials: IG
authors.lastname: DeLeon
mesh_terms: D000328:Adult; D004989:Ethics; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000523:psychology; D008297:Male; D011678:Punishment; D012055:Reinforcement Schedule; D016728:Self-Injurious Behavior / Q000523:psychology*