Michael F. Dorsey

Toward a functional analysis of self-injury

This study describes the use of an operant methodology to assess functional relationships between self-injury and specific environmental events. The self-injurious behaviors of nine developmentally disabled subjects were observed during periods of brief, repeated exposure to a series of analogue conditions. Each condition differed along one or more of the following dimensions: (1) play materials (present vs absent), (2) experimenter demands (high vs low), and (3) social attention (absent vs noncontingent vs contingent). Results showed a great deal of both between and within-subject variability. However, in six of the nine subjects, higher levels of self-injury were consistently associated with a specific stimulus condition, suggesting that within-subject variability was a function of distinct features of the social and/or physical environment. These data are discussed in light of previously suggested hypotheses for the motivation of self-injury, with particular emphasis on their implications for the selection of suitable treatments.

Reliability analysis of the motivation assessment scale: A failure to replicate

The Motivation Assessment Scale (MAS) has been proposed as an efficient questionnaire for identifying the source of reinforcement for an individuals self-injurious behavior (SIB). A previous reliability analysis of the MAS (Durand & Crimmins, 1988) reported interrater correlation coefficients ranging from .66 to .92, based on a comparison of responses provided by classroom teachers. In this study, the reliability of the MAS was reexamined with two independent groups of developmentally disabled individuals who exhibited SIB (N = 55). For the institutional sample (n = 39), the MAS was given to two staff members (a supervisor and therapy aide) who work with the individual daily. For the school sample (n = 16), the MAS was given to the teacher and teachers aide who taught the student. The correlational analyses completed by Durand and Crimmins (1988) were repeated; in addition, a more precise analysis of interrater reliability was calculated based on the actual number of scoring agreements between the two raters. Results showed that only 16 of the 55 raters agreed on the category of reinforcement maintaining their clients or students SIB, that only 15% of the correlation coefficients obtained were above .80, and that none of the reliability scores based on percent agreement between raters was above 80%.

Behavior analysis, program development, and transfer of control in the treatment of self-injury

This case study illustrates an empirical approach to the diagnosis, treatment, and controlled follow-up of self-injurious clients. Following an assessment period, during which environmental factors associated with a severely retarded adolescents self-injury were identified, the contingent application of protective equipment was combined with a differential reinforcement procedure (DRO) and implemented in a multiple baseline design across two hospital settings. Results showed a marked decrease in the rate of self-injury. Upon discharge from the hospital, the program was successfully replicated at the adolescents residential center, again using a multiple baseline design across settings.

Reduction of eye gouging using a response interruption procedure

A profoundly retarded male with severe congenital impairment of vision and hearing was treated for self-inflicted eye gouging. Prior to intervention, continuous mechanical restraint was required to prevent the response, precluding participation in educational and play activities. The response topography, the nature of the clients deficits, and a preliminary behavioral and medical assessment suggested that the response functioned as a source of sensory self-stimulation. Presentation of toys plus differential reinforcement of other behavior (DRO) as alternate sources of stimulation during baseline had no impact on eye gouging. The introduction of a contingent response interruption procedure reduced eye gouging and decreased the amount of time spent in restraints. Treatment effects were replicated in a group setting, and in the natural environment. Parents and school personnel were trained to use the treatment, and eye gouging remained infrequent at a 9-month follow-up.