The Self-Injurious Behavior Inhibiting System

Summary – Risks Versus Benefits

There are frequently side consequences when punitive methods or unpleasant stimuli are used. There are possible concerns that should be considered while observing the client’s aggressive actions. These behaviors can result in property destruction and provoke aggressive, unexpected behaviors. Since ABA therapies are evidence-based, they can be used when other approaches are failing. Prior to the delivery of the unpleasant stimuli, no additional forms of therapy or ABA treatments were performed. Since the client avoids acting out in socially inappropriate ways while at school, academic learning is now possible.

A rise in the frequency of the test case (extinction burst) and a rise in hostility are two undesirable side effects of operant extinction therapy that are frequently seen (extinction-induced aggression). Although extinction is frequently employed in therapeutic settings to treat problem behavior, few applied researches have looked at the incidence of these adverse effects or how they could be mitigated by other operant techniques. When extinction was used as a component of a treatment plan rather than the only intervention, the frequency of bursting and hostility was significantly reduced.

There has been little study on the use of escape extinction in conjunction with protective equipment for the treatment of escape-sustained self-injurious behavior, despite the fact that escape extinction has been proven to be effective in lowering escape-maintained self-injurious conduct. An 8-year-old kid with autism was the subject of this experiment in order to examine the impact of an escape extinction process combined with the use of protective equipment on his escape-maintained self-injurious conduct (Tereshko & Sottolano, 2017). The findings showed that a safe method to reduce head striking is to escape extinction while wearing protective gear (Tereshko & Sottolano, 2017).

A therapist may draw the conclusion that an automatic function exists when analyzing the findings of a functional analysis because either problem behavior is high in the alone or ignore state relative to other circumstances or it is elevated and homogeneous across many conditions. In the latter case, it might be challenging to tell whether problematic conduct is sustained primarily or additionally by automatic reinforcement. The study used functional analysis contingencies to test for repeatedly sustained self-injurious behavior, while sensory extinction was used to prevent automatic reinforcement (Scheithauer et al., 2017). According to the findings, one participant’s self-harm was sustained by automatic reinforcement alone, whereas another participant’s self-harm was maintained by both showed efficacy and physical attention (Scheithauer et al., 2017).

For example, in the study, the issue behavior of two individuals was assessed and treated after functional analysis revealed that their problem behavior was an attempt to escape from paying attention (Cengher et al., 2022). Functional communication skills were taught as part of the treatment to help patients learn a suitable substitute behavior that results in distraction.

Furthermore, several ethical considerations must be integrated into the framework for applying the proposed therapeutic approach to manage SIBIS in the target environment. For instance, the issue of responsibility in practice, namely, the provision of effective treatment, as specified on paragraph 2.01 of the ethical code, can be regarded as questionable in the case under analysis (“Ethics code for behavior analysts,” 2022). Indeed, given the available evidence concerning the probable lack of efficacy coupled with the use of a rather intrusive approach ought to be considered as a possible violation of the code of ethics, particularly in relation to maintaining the patient’s interest and acknowledging their rights. Furthermore, the likely failure to minimize the associated risks of behavior-change interventions as specified in para. 2.15 should be mentioned as a potential breach of ethical standards. Finally, the fact that the procedure in question could be represented as the violation of the client’s physical integrity due to the administration of what effectively is a shock therapy indicates that it may violate the responsibility to clients, namely, the necessity to “place the client’s care and welfare above all others” (“Ethics code for behavior analysts,” 2022, p. 13). Therefore, certain ethical limitations must be considered carefully before the implementation of the intervention.

Overall, while monitoring the client’s combative behavior, there are certainly potential problems that should be taken into account. Property loss and unexpectedly hostile attitudes may come from these actions. The frequency of bursting and anger was dramatically decreased when extinction was employed as a component of a treatment plan as opposed to the alone intervention. Property loss and unexpectedly hostile attitudes may come from these actions. When other methods are not working, ABA treatments might be employed since they are evidence-based. Extinction was employed as part of a therapy strategy rather than as the only intervention, which greatly decreased the frequency of bursting and animosity.

References

Cengher, M., O’Connor, J. T., & Strohmeier, C. W. (2022). Assessment and treatment of problem behavior maintained by escape from attention. Behavioral Interventions, 37(2), 204-221. Web.

Ethics code for behavior analysts. (2022). Web.

Scheithauer, M. C., Lomas Mevers, J. E., Call, N. A., & Shrewsbury, A. N. (2017). Using a test for multiply-maintained self-injury to develop function-based treatments. Journal of Developmental and Physical Disabilities, 29(3), 443-460. Web.

Tereshko, L., & Sottolano, D. (2017). The effects of an escape extinction procedure using protective equipment on self‐injurious behavior. Behavioral Interventions, 32(2), 152-159. Web.