Intervention for Self-Injurious Behavior

Individuals with intellectual and developmental disabilities are at a heightened risk of engaging in self-injurious behavior (SIB) that can result in significant harm to their physical health. This is especially true for automatically maintained SIB that is not sensitive to social reinforcement. This chapter discusses considerations for addressing SIB, particularly when automatically maintained. Treating clinicians should engage a multidisciplinary team and define appropriate safeguards for assessment and treatment to reduce the occurrence and likelihood of injuries due to SIB. A thorough assessment is needed to inform essential components of treatment to produce long-lasting and therapeutic reductions in SIB. It is similarly critical to monitor safeguards to ensure SIB or mitigation strategies (e.g., protective equipment) do not cause additional harm. To avoid possible side effects, clinicians should begin with reinforcement-based procedures before considering more restrictive procedures in collaboration with the larger treatment team.