THE USE OF PHYSICAL RESTRAINT IN THE TREATMENT OF SELF‐INJURY AND AS POSITIVE REINFORCEMENT

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Abstract
Two experiments investigated the effects of a treatment package on the self‐injurious behavior of three profoundly retarded persons who appeared to enjoy the physical restraints used to prevent their self‐injury. The treatment package included physically restraining subjects contingent on increasing periods of time during which no self‐injury occurred, and providing them with toys and attention during intervals between restraints. A reversal and multiple‐baseline analysis documented that the rapid and complete reduction in self‐injury by all subjects was due to this treatment package. Because these results suggested that physical restraint might function as a positive reinforcer, in a third experiment physical restraint was applied contingent on a marble placement response with one subject. A reversal design demonstrated that toy play systematically increased when each response resulted in restraint. The experiments have implications for the nonaversive remediation of self‐injury in individuals who are restrained, as well as for the development and maintenance of self‐injury in natural settings.