Self-Injurious Behavior

Self-injurious behavior (SIB) has the potential to inflict severe bodily harm on an individual who exhibits a particularly worrisome challenging behavior. The best practice for treating SIB involves a process of identifying environmental contributors to problem behavior (i.e., functional assessment) and presenting those identified contributors in a manner that eliminates any contingent relation between SIB and reinforcement. Although multiple behavioral treatment strategies exist for reducing problem behavior, the most successful outcomes have been associated with a comprehensive strategy that includes teaching a range of skills to replace SIB, such as communication skills, tolerance skills, and cooperation skills. Special considerations are necessary for SIB sensitive to automatic reinforcement and the pervasiveness of those who exhibit SIB to experience trauma. We discuss how a trauma-informed framework can be incorporated with comprehensive strategies for reducing SIB.