Self-Injurious Behavior (SIB) Study

Overview

• The study examines methods for applying extinction to different functions of self-injurious behavior (SIB).
• Functional variations of extinction were evaluated on 3 children with developmental disabilities
• Head banging was maintained by different conditions, attention from adults, escape from educational tasks, and automatic reinforcement.
• Observed SIB reductions occurred when implementing extinction tied to discontinuing reinforcement previously shown to be responsible for maintaining the behavior.
• The highlighted results show important differences among treatment techniques based on the same behavioral principle when applied to topographically similar but functionally dissimilar responses.
• The study further illustrates the practical implications of a functional analysis of behavior disorders for designing, selecting, and classifying therapeutic interventions.

Background

• Research on the functional analysis of severe behavior disorders has produced interventions based on antecedent events and maintaining consequences.
• Treatments emphasize strengthening new stimulus-response-consequence relationships.
• Eliminating reinforcement that maintained the behavior has received little attention.
• Punishment combined with reinforced cessation, reinforcement of Response B as a replacement for Response A coincides with reinforcement termination for Response A.
• The effects of reinforcement-based interventions may be limited unless extinction is included.
• Interventions based on communicative responses and behavioral momentum may produce mixed results without extinction.

Extinction of Self-Injurious Behavior

• The assessment and treatment of self-injurious behavior (SIB) provides an important context for the examination of extinction because SIB can be maintained through a variety of operant mechanisms.
• "Discontinuation of reinforcement" for behavior problems often involves cessation of ongoing events.
• Some textbooks define extinction solely through reference to "ignoring," time-out, and stimulus termination.
• Procedural time-out and procedural approaches to defining extinction can serve different functions.

Specific Approaches to Extinction

• In cases where SIB gets maintained by social-positive reinforcement, the extinction withholds attention for SIB.
• When SIB is maintained through negative reinforcement in the form of escape from task demands, the extinction prevents escape by continuing the ongoing situation.
• SIB maintained by automatic reinforcement decreases individuals wore equipment attenuated its consequences.
• At least three functional variations of extinction have been used as treatment for SIB, each designed to terminate a different source of reinforcement, amenable to procedural modifications and descriptive labels.
• Extinction procedures are unique from the standpoint of both form and function but not well differentiated through existing terminology.

Terminology Breakdown

• Planned ignoring, the label most often applied to extinction of attention-maintained behavior, provides an adequate description of the therapist's response but does not describe the behavioral process or identify the source of reinforcement being withheld.
• Escape extinction describes extinction of escape-maintained behavior, specifies the process and the reinforcer but not the procedure.
• Sensory extinction refers to techniques designed to attenuate stimulation produced by a response.
• The convention of referring to different functional variations of extinction by using the abbreviation "EXT" followed in parentheses by the source of reinforcement withheld, as in EXT (attention), EXT (escape), and EXT (sensory) emphasizes the behavioral process, with the reinforcer incidental.

Functional Class of Extinction Techniques

• EXT (attention) may take different forms depending on the situational context in which it is applied.
• EXT (attention) requires no response from the therapist and consists of withholding attention that previously followed the behavior if the target behavior occurs in the absence of ongoing social interaction.
• If the target behavior occurs while the therapist is interacting with the client, reinforcement withholding, EXT (attention), would consist of terminating the interaction.
• Similar variations are also characteristic of both EXT (escape) and EXT (sensory).
• Labeling describes any specific procedure through terms such as DRO, time-out, and punishment.

Predictions of Therapeutic Effect

• The study posits that extinction designed for SIB serving one function may have little or no therapeutic effect on ISB serving a different function.
• It is possible to construct a contingency matrix to allow predictions about behavioral outcome.
• For example, elimination of social reinforcement for SIB using EXT (attention) or EXT (escape) will not interfere with the delivery of sensory reinforcement, and EXT (sensory) would have no effect on social sources of reinforcement.
• EXT (attention) applied to escape-maintained SIB and EXT (escape) applied to attention-maintained SIB may be countertherapeutic and seriously exacerbate the behavior problem.
• Evidence supporting these predictions can be found in only a few studies.
• The study provides an empirical evaluation of the key predictions found in Figure 1 by conducting a comparative analysis of extinction techniques.
• Three functional variations of extinction were examined when applied to the same topography of SIB maintained by three different contingencies of reinforcement.

Methodological Details

• Subjects selected for participation based had similar SIB topographies.
• Functional analysis baselines indicated that their SIB was maintained by different sources of reinforcement.
• The study included three children with developmental disabilities who exhibited head banging that produced contusions or lacerations on the head and face.
• Donnie, 7 years old, had severe mental retardation, could feed himself, did not follow vocal instructions, communicated needs by pointing, and had unpredictable levels of SIB. Jack, 12 years old, had severe mental retardation, could move his wheelchair, feed himself, manipulate small objects followed few instructions, and communicated through gestures, and his SIB seemed to occur as part of a tantrum.
• Millie, 8 years old, had moderate mental retardation, was ambulatory, could feed herself, and occasionally followed simple instructions, appeared socially responsive to adults, her SIB occurred "most of the time," and became worse when she did not "get her way".
• Sessions are 15 min in duration, conducted 5 days per week, with four to eight sessions daily with 15 min breaks between sessions in therapy rooms with one-way observation windows.
• SIB was defined as any audible contact between the head or face and data were recorded during continuous 10-s intervals using paper or a hand-held computer
• Experimenter behaviors, instructions, attention, placement, removal of apparatus were also collected for procedural consistency.
• Interobserver agreement was assessed during 23% of all sessions by having a second observer and mean agreement was found to be 92%.

Experimental Design Variations

• During the initial baseline, subjects were exposed to assessment conditions in a multielement design to identify variables maintaining their SIB.
• Subjects were exposed to variations of extinction by way of reversal or multiple baseline designs determined by the subjects' baseline performances.
• Subjects were exposed to 4 conditions based on Iwata, Dorsey, Slifer, Bauman, and Richman (1982).

Experimental Conditions

• The Attention condition examined positive reinforcement for SIB.
• The experimenter ignored the subject and expressed concern upon SIB occurrence.
• The Demand condition was a test for negative reinforcement (escape from demands).
• Experimenter presented academic tasks and praise contingent on correct responses, with a time-out contingent on SIB.
• The Alone condition restricted access to social and material sources of stimulation to test for SIB maintained by nonsocial (automatic) reinforcement.
• The Play condition served as a control with continuous access to toys, praise, and ignored occurrences of SIB.

Extinction Methodology

• Three extinction variations were evaluated to discontinue a different source of reinforcement for SIB and each type of extinction was implemented with each subject.
• The extinction variations includes not being possible to prevent escape from tasks, withholding negative reinforcement, with no tasks presented initially.

Variations Detailed

• EXT (attention) discontinued positive reinforcement by the experimenter.
• EXT (attention) consisted of ignoring contingent on SIB and delivered attention on a DRO schedule.
• EXT (escape) discontinued negative reinforcement and was implemented during the demand condition by continuing learning trials and physically guiding instead of terminating for SIB.
• Physical guidance in this intervention may represent a punishment contingency.
• EXT (sensory) attenuated sensory consequences by fitting subjects with an oversized helmet.
• An extension of this "noncontingent" helmet condition was implemented for Donnie

Observed Behaviors

• Donnie exhibited SIB across baseline conditions suggesting Donnie's SIB was maintained by factors independent of the social and physical environment.
• EXT (sensory) implemented in a reversal (ABAB) design showed decreases in SIB associated with the helmet intervention.
• Play materials were introduced and the protective helmet was applied contingent on SIB during the final condition on the alone baseline.
• Results indicate a decrease in SIB with contingent helmet conditions.
• The introduction of EXT (sensory) on the demand baseline was associated with a rapid and large decrease in Donnie's SIB and EXT (escape) resulted in an increase in SIB.
• During the attention baseline, the introduction of EXT (attention) had no effect on Donnie's SIB however during the next condition was EXT (sensory), SIB decreased.
• No decrease in SIB was observed during the play baseline until EXT (sensory) was introduced.

Jack Results

• Jack exhibited very little or no SIB however; During the demand condition of SIB was observed which contained two distinctive features of the presentation of task demands and a brief time out.
• EXT (sensory) and EXT (escape) were implemented concurrently during all subsequent manipulations
• He obtained an immediate return to baseline. It appeared that the out component served functionally attention for behavior.

Millie Results

• SIB occurred almost exclusively during the attention condition, for the results obtained for Millie.
• Extinction and results occurred during the assessment. Millie's assessment data showed no reinforcement and during the attention condition and an extinction effect.
• Millie's SIB decreased throughout the alone condition decreasing through time

Synthesis

• A DRO schedule was introduced concurrent with EXT (sensory) and caused a large loss. Millie.
• EXT was also then taken to extinction while the central component did not have a great effect on behavior and had no increase from levels. During this condition Millie maintained low behavior levels.

Key Comparisons

• The data is presented using reductions or increases of is B is made with expressed mean percentage of baseline responding by EXT mean or is the mean? The most relevant the baseline means are made.

Data Outcomes

• Donnie's mean percentage of SIB was during five sessions through .5% of the mean during sessions a long baseline on the percentage was the main baseline Donnie mean to the mean of demand.
• These comparisons show a series of all subjects used lower than 15% of baseline.

Follow-Up

• A treatment program was designed per subject after the completion of the study
• For Donnie, free access to choice provided preventive the contingent protocol with attention to escape the training exercise and activities while Jack escape was identical to that he should show.
• Millie, attention was for the attention of the 5 second interval to keep from gaining tension.
• Parents and teachers were shown to be more efficient with the procedures.

Discussion

• The results of these studies show that the therapeutic literature shows the reduction from attention through attention seeking.
• Extinction is tied to an identification through behaviors and continue is made.
• These all provide the complete analysis of results with function and variations of extinction. Was more or less as Jack of.
• The was not also had little effect when trials decrease those show during trials with

Keypoints

• With respect to all reinforcements the relevant those data main targets could also serve both

Conclusion

• DRO results could be evaluated with results. There is a lack of results of a given level. A difference could be the difference in function a negative interaction for both and a second.

Questions about a study on self-injurious behavior (SIB) in individuals. The questions cover experimental design, exacerbating circumstances, interventions, therapy session duration, and the role of attention in functional analysis. Also cover methods of extinction.