Elimination of Self-Injurious Behavior in a Profoundly Retarded Adolescent Using Intermittent Time-Out, Restraint, and Blindfold Procedures

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Abstract
Alternative strategies for reducing self-injurious behavior are needed in order to provide effective service to clientele for whom such behavior is a serious problem. A procedure involving the intermittent presentation of time-out, restraint, and blindfolding produced complete suppression of self-slapping in a profoundly retarded adolescent. A variable-ratio two schedule of time-out and physical restraint contingencies was effective in reducing and maintaining a low level of self-abusive behavior. While some of the treatment effect was lost during and after exposure to a variable-ratio six schedule, the addition of a blindfold procedure to the variable-ratio two resulted in complete suppression of self-slapping. A punishment contrast effect observed during the initial return to baseline conditions was eliminated through complete suppression of the self-abusive behavior during the final intervention procedure. This behavior suppression generalized across time and settings in which the contingencies had never been applied. In addition, this suppression was associated with an increase in adaptive behavior and did not produce any undesirable collateral responding. Two-year follow-up data indicate that complete response suppression has been maintained.