SELF INJURIOUS BEHAVIOR

SELF INJURIOUS BEHAVIOR

Operational definition

Self-injurious behavior is an act involving self-infliction of physical harm to one’s body. Rickie is experiencing episodes of self-injurious behavior, including hand biting. Hand biting is whereby someone uses the teeth to pick his hands, leading to damaging the tissues and inflicting pain on themselves. They feel like they can replace their feelings with the pain they inflict on themselves. Mainly observed on people with intellectual disabilities and autism. Flopping or dropping. This is some protest that is nonviolent and is common to individuals with downs syndrome. It is where someone drops with a lot of force without even minding the hardness of the floor.

Hypothesized function

The primary function of Rockies’ behavior is to get the attention of those around him and to try and evade somethings this using the silent protest of dropping and hand biting.

Section 1. Intervention support plan

Preventive strategies

Antecedent behaviors can help to prevent Rockies SIB. The choice is one of the antecedent behaviors that can help to avoid SIB. If Rickie usually shows the action when he does a sure thing, a chance to choose exactly what he may feel like doing at that specific time will help because he will feel like he is in control of his actions. A high probability sequence also helps. This involves the building of the momentum of specific behavior that Rickie was non-compliant to before. This will help to improve his adherence to instructions without feeling controlled. An extinction-based intervention is also effective whereby whatever was causing the SIB is removed, thus lacking the motivation of triggering the behavior. Reinforcement intervention can also be used to discourage SIB. This is where another different response apart from the SIB or the one triggering the SIB is encouraged. This may include the introduction of toys or other activities to draw Rickie’s attention from hand biting and concentrate on it or even distract him. A punishment intervention like restraint can also be used though it’s not advisable. (Hagopian and Leoni,2017)

Replacement Procedures.

The therapist must know how to justify and validate the feelings of Rickie. This will make him understand that the therapist understands what he is feeling and that he is not alone. Rickie’s behavior can be replaced by the introduction of new activities or toys before or around the time he is known to experience episodes of SIB(Minshawi and Hurwitz,2014). This is to either keep him busy and ultimately stop the behavior from happening at that time or introduction of an activity that is incompatible to the hand biting. Thus, he can’t do them at the same time. The surrounding environment can also be replaced to include things that don’t trigger the SIB.

Consequential procedures

The most preferred method to be used to deal with the target behaviors is giving Rickie a chance to choose what he wants to do to avoid the act of dropping or flopping. Asking him what he wants will make it easy to know exactly how he feels and what he wants to do, thus reducing the protests. Talking to him nicely will also give him a feeling that his emotions and actions are being understood. On the other hand, Hand biting will be easily solved by either altering the environment positively to ensure that objects triggering the behavior are not around him. If this doesn’t work, then the restraint method can be used to provide positive change.

Short term goals

In the short term, Rickie should be able to tell the motive behind the behavior and also acknowledge that they need help. The student should also be able to understand precisely what triggers the response and the stimuli. Rickie should also be able to tell when he doesn’t want something using the specific communication mode. The intervals between the reoccurrence of the episodes of SIB and dropping should be longer, and the frequency should have dropped.

Long term goal

The ultimate goal is for the student to be able to control his emotions even after being presented with the thing that stimulates the behavior. Understanding that harm to oneself is also a long-term goal. He should be able to properly refuse the things he used to protest by dropping in a relaxed way. He should also be compliant to do some of the things he couldn’t do.

Generalization and maintenance

The ABA technique that is most preferred in this case is using communication training that is functional to reduce and ultimately eradicate the Self-injurious behavior. The following are steps to be followed to ensure an effective care process for the affected individual. A functional assessment of the action has to be done to understand the function of the behavior to the patient. Then the identification or choice of the communication mode that is suitable for the child and the particular case. One also has to create situations for teaching and later teach the student how to use the communication instead if SIB. Afterward, the prompts should fade until the student reaches a point of independence. Generalization should follow and finally teaching of new forms of communication. This is where the people around him work together to ensure the durability of the treatment. All the possible types of treatment will be applied to ensure that a general effect is realized at the end of the process.

. Applies behavioral methods.

A therapist should focus on the intention or the motive of the wound instead of putting more attention on the harm itself. This will enable him to know the reason behind the behavior and be able to prevent its reoccurrence. The therapist should also find out the purpose of the response and its function to Rickie. What does Rickie achieve when he hurts himself or when he drops on the floor is a question the therapist should ask himself and the people who live around Rickie to understand the SIB. Making Rickie comprehend that he is not alone and that he is recognized is very important. This can be done by increasing communication with him and making sure he is safe. (Ivanoff and Linehan,2001)

Use of a Reinforcement based strategy. This involves the removal of contingent or presentation of stimuli. It can be used alone or alongside other procedures. Research has shown a lot of success coming from this method. The introduction of an alternative reinforcer plays a significant role in altering the self-injurious behavior of Rickie. Home-based therapy was preferred in the research by Ladd. The study was done on a 9-year-old girl that used to pick her hands, causing damages to the tissues. It was realized that by introducing some objects during playtime, the SIB reduced almost by half, thus proving the effectiveness of the method. The purpose had no compatibility and therefore interfered with the behavior. (Ladd and Luiselli,2009)

Monitoring systems support for the response.

I would use observation and documentation through observing the actions of the child, their responses to the triggers, the intervals between episodes of SIB. This will help in monitoring the progress of the patient so that I can know their reaction to stimuli, whether the intervals at which the episodes occur have become longer, and whether the objects introduced to them have helped to reduce the SIB or if the method is not sufficient enough. All these results will be documented and compared with previous findings. They can also be used to show whether the patient is recovering or whether there is a possibility of more harmful behavior on themselves. In the protesting practice, intervals at which he drops should be observed, when and where to know precisely what prompts him to do so. (Weiner and Graham,2003)