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A Review of Behavioral Treatments for Self-Injurious Behaviors of Persons With Autism Spectrum Disorders
Abstract
Autism spectrum disorders (ASD) are considered to be among the most serious of the mental health conditions. Concomitant with many cases of ASD is intellectual disability. Further compounding the disability is the fact that both conditions are known risk factors for self-injurious behavior (SIB). To date, the most effective intervention methods, based on the available data, appear to be variants of behavior modification. This article provides an overview of the current status of learning-based interventions for SIB in ASD and provides a review of specific studies. Although most studies describe some combination of reinforcement and punishment procedures, efforts are under way to develop more positively oriented strategies, such as functional assessment, to decrease the use of punishment. However, almost all the treatment studies employ single case designs, thus preventing a comparison of treatment efficacy. These issues are discussed along with other strengths, weaknesses, and future directions for clinical practice and treatment.
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“These self-injurious behaviours, which have been the focus of autism research in children and adults [12–14], appear to differ in nature from NSSI in the typically developing populations: they occur in front of others without attempts to disguise them, being most commonly associated with intellectual disability and severe receptive and expressive language deficits.”
From A 'choice', an 'addiction', a way 'out of the lost': Exploring self-injury in autistic people without intellectual disability (2019) · cites this paper as [14]
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Self-citationRetractedDiagnostik und Therapie von Autismus-Spektrum-Störungen im Kindesalter
Kamp‐Becker, I., Duketis, E., Sinzig, J., Poustka, L., & Becker, K. (2010) · Kindheit und Entwicklung · doi:10.1026/0942-5403/a000019 · Cited by 18
What worries parents of a child with Autism? Evidence from a biomarker for chronic stress
Bitsika, V., Sharpley, C. F., Andronicos, N. M., & Agnew, L. L. (2017) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2017.02.003 · Cited by 22
“The presence of intellectual disabilities may confound the prevalence rates of SIB in children with ASD (Matson & LoVullo, 2008) but this is yet to be definitively determined.”
BackgroundPeer-mediated discrete trial training within a school setting
Radley, K. C., Dart, E. H., Furlow, C. M., & Ness, E. J. (2014) · Research in Autism · doi:10.1016/j.rasd.2014.10.001 · Cited by 23
An investigation of self-injurious behaviors in adults with severe intellectual disabilities
Tureck, K., Matson, J. L., & Beighley, J. S. (2013) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2013.05.022 · Cited by 21
“These restricted, repetitive behaviors (RRBs) are central to ASD (Matson & LoVullo, 2008; Matson & Wilkins, 2008b; Matson, Wilkins, et al., 2008; Volkmar & Klin, 2005).”
Self-citationClay, C. J., Bloom, S. E., & Lambert, J. M. (2018) · American Journal on Intellectual and Developmental Disabilities · doi:10.1352/1944-7558-123.3.254 · Cited by 18
Ethical Implications for Providers Regarding Cannabis Use in Children With Autism Spectrum Disorders
Duvall, S. W., Lindly, O. J., Zuckerman, K. E., Msall, M. E., & Weddle, M. (2019) · PEDIATRICS · doi:10.1542/peds.2018-0558 · Cited by 18
Waters, P., & Healy, O. (2012) · Autism Research and Treatment · doi:10.1155/2012/156481 · Cited by 18
“The topography of SIB varies from case to case, head hitting against objects or hands and hand biting, skin scratching, and hitting other parts of the body being the most common [6, 7].”
BackgroundChezan, L. C., Gable, R. A., McWhorter, G. Z., & White, S. D. (2017) · Journal of Behavioral Education · doi:10.1007/s10864-017-9269-4 · Cited by 18
“For example, Matson and LoVullo (2008) concluded that interventions implemented to address SIB were more likely to include invasive procedures.”
BackgroundResultInfluentialSallows, G. O., & Graupner, T. D. (2012) · Wiley eBooks · doi:10.1002/9781118156391.ebcp001009 · Cited by 18
Candon, M. K., Barry, C. L., Epstein, A. J., Marcus, S. C., Kennedy‐Hendricks, A., Xie, M., & Mandell, D. S. (2017) · Medical Care · doi:10.1097/mlr.0000000000000863 · Cited by 17
Goldin, R. L., Matson, J. L., Beighley, J. S., & Jang, J. (2013) · Developmental Neurorehabilitation · doi:10.3109/17518423.2013.839585 · Cited by 17
Self-citationInvestigation of the Rates of Comorbid Symptoms in Children with ADHD Compared to Children with ASD
Tureck, K., Matson, J. L., May, A. C., Davis, T. E., & Whiting, S. E. (2012) · Journal of Developmental and Physical Disabilities · doi:10.1007/s10882-012-9320-2 · Cited by 21
Self-citationBehavioural interventions for self injurious behaviour: a review of recent evidence (1998–2008)
Prangnell, S. J. (2009) · British Journal of Learning Disabilities · doi:10.1111/j.1468-3156.2009.00598.x · Cited by 16
White, P. J., O’Reilly, M. F., Fragale, C. L., Kang, S., Muhich, K., Falcomata, T. S., Lang, R. B., Sigafoos, J., & Lancioni, G. E. (2010) · Research in Autism · doi:10.1016/j.rasd.2010.09.006 · Cited by 16
Matson, J. L., Hess, J. A., Neal, D., Mahan, S., & Fodstad, J. C. (2009) · Journal of Developmental and Physical Disabilities · doi:10.1007/s10882-009-9167-3 · Cited by 16
“However, long term follow-up of treatment effectiveness has yet to be conducted (Downs et al. 2008; Matson and LoVullo 2008; Naoi et al. 2008).”
BackgroundSelf-citationMatson, J. L., Rivet, T. T., & Fodstad, J. C. (2008) · Journal of Developmental and Physical Disabilities · doi:10.1007/s10882-008-9125-5 · Cited by 15
“Pharmacotherapy and behavioral treatments for challenging behaviors and symptoms of psychopathology are common in persons with developmental disabilities (Matson and Dempsey 2008; Matson and LoVullo 2008; Matson and Wilkins 2008).”
BackgroundSelf-citationRieske, R. D., Matson, J. L., Davis, T. E., Konst, M. J., Williams, L. W., & Whiting, S. E. (2012) · Developmental Neurorehabilitation · doi:10.3109/17518423.2012.705909 · Cited by 17
Self-citationSipes, M., Furniss, F., Matson, J. L., & Hattier, M. A. (2011) · Journal of Developmental and Physical Disabilities · doi:10.1007/s10882-011-9261-1 · Cited by 15
Self-citationTurygin, N. C., Matson, J. L., & Tureck, K. (2013) · Developmental Neurorehabilitation · doi:10.3109/17518423.2013.846947 · Cited by 17
Self-citationMontgomery, J. M., Martin, T. L., Shooshtari, S., Stoesz, B., Heinrichs, D. J., North, S., Dodson, L., Senkow, Q., & Douglas, J. (2014) · Exceptionality Education International · doi:10.5206/eei.v23i1.7701 · Cited by 16
“Matson and Lovullo (2008) reviewed behavioural treatments for self-injurious behaviours in persons with ASD, finding that variants of behaviour-based treatments (e.”
Neil, N. M., Amicarelli, A. R., Anderson, B. M., & Liesemer, K. (2021) · American Journal on Intellectual and Developmental Disabilities · doi:10.1352/1944-7558-126.2.114 · Cited by 14
Matson, J. L., & Goldin, R. L. (2013) · Research in Autism · doi:10.1016/j.rasd.2013.11.005 · Cited by 14
Self-citationWhat is the future of assessment for autism spectrum disorders: Short and long term
Matson, J. L., & Goldin, R. L. (2014) · Research in Autism · doi:10.1016/j.rasd.2013.01.007 · Cited by 16
“Cerebral palsy, behavior problems and psychopathology are some of these problems (LoVullo & Matson, 2009; Matson & LoVullo, 2008; Matson & Rivet, 2008; Smith & Matson, 2010a, 2010b, 2010c).”
BackgroundSelf-citationEducational Interventions for Young Children with Autism Spectrum Disorders
Eikeseth, S., & Klintwall, L. (2013) · Springer eBooks · doi:10.1007/978-1-4614-4788-7_128 · Cited by 15
Metadata
- Authors
- Matson, J. L., & LoVullo, S. V.
- Affiliations
- Louisiana State University (US)
- ORCID
- Matson, Johnny L.
- Venue
- Behavior Modification
- Publisher
- SAGE Publications
- Published
- 2008-01
- Volume
- 32
- Issue
- 1
- Pages
- 61-76
- ISSN
- 0145-4455 (ISSN-L)
- 1552-4167
- OpenAlex
- W2023686336
- Cited by
- 198
- References
- 92
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 5 · 2023: 8 · 2022: 5 · 2021: 10 · 2020: 4 · 2019: 10 · 2018: 10 · 2017: 13 · 2016: 5 · 2015: 6 · 2014: 26 · 2013: 24 · 2012: 19
- FWCI
- 2.19
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Behavior Modification (publishedVersion)
- PubMed (publishedVersion)
- Civil War Book Review (submittedVersion)
- Topics
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Keywords
- self-harm, autism spectrum disorder, intellectual disability, behavioral interventions, reinforcement, punishment, functional assessment, positive reinforcement, single-case experimental design, treatment efficacy
- MeSH terms
- Autistic Disorder, Behavior Therapy, Humans, Intellectual Disability, Punishment, Reinforcement, Psychology, Self-Injurious Behavior, Evidence-Based Medicine
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