Bio‐behavioral diagnosis and treatment of self‐injury

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Abstract
Self‐injurious behavior(SIB) in individuals with mental retardation is a severe behavioral disorder that has significant social and medical consequences. Although considerable research evidence indicates that SIB can be maintained by either environmental contingencies or biologic conditions, integrative diagnostic and treatment models have yet to be developed. We have piloted a bio‐behavioral diagnostic and treatment model to classify and subtype cases of SIB, leading to the selection of specific behavioral or pharmacologic treatments. A functional analysis defines SIB as operant, possibly biologic, or mixed operant and possibly biologic. Subtyping within these classes is based on the delineation of specific operant functions and the clinical characteristics of the individual patient. Our preliminary research suggests that this empirical decision‐making model can lead to specific treatments that are effective and that reduce the incidence of nonresponders to behavioral intervention and medication.