title: The use of noncontingent reinforcement and contingent restraint to reduce physical aggression and self-injurious behaviour in a traumatically brain injured adult.
abstract: Many different intervention programmes for reducing undesirable behaviour with people with traumatic brain injury (TBI) have been investigated in recent years. The purpose of this study was to examine the potential of using noncontingent reinforcement (NCR) in combination with contingent restraint to reduce severe behaviour. The subject (E.L.) was a 40-year-old male with TBI admitted to a rehabilitation long-term care programme. E.L. had a history of physical aggression (PA) and self-injurious behaviour (SIB). Assessment conditions included a descriptive analysis, response scatterplot and Self-Injury Trauma (SIT) Scale. Attention was identified as the maintaining positive reinforcement for PA and SIB. Treatment conditions were compared using a reversal (ABAB) design. Attention (NCR) was delivered on a fixed-time schedule that was not dependent on the subject's behaviour. Contingent restraint was applied when E.L. exhibited PA or SIB that was dangerous to himself or others. During treatment, PA occurred over 4 times less often and SIB over 2.5 times less often. Results demonstrated that PA and SIB were sensitive to NCR. NCR can be an effective procedure for reducing severe behaviour maintained by socially-mediated positive reinforcement.
authors.affiliation: Department of Research and Development, Centre for Neuro Skills, Bakersfield, California 93306, USA.
authors.forename: C S
authors.initials: CS
authors.lastname: Persel
authors.forename: C H
authors.initials: CH
authors.lastname: Persel
authors.forename: M J
authors.initials: MJ
authors.lastname: Ashley
authors.forename: D K
authors.initials: DK
authors.lastname: Krych
mesh_terms: D000328:Adult; D000374:Aggression; D001930:Brain Injuries / Q000150:complications* / Q000534:rehabilitation; D006801:Humans; D008297:Male; D012056:Reinforcement, Social; D012149:Restraint, Physical / Q000523:psychology*; D016728:Self-Injurious Behavior / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D012720:Severity of Illness Index