Understanding Self-Restraint in Neurodevelopmental Conditions: A Primer for Assessment and Treatment

Self-restraint, characterized by self-initiated restriction of movement (e.g., intertwining limbs, sitting on hands), is most commonly observed in individuals with neurodevelopmental conditions who also engage in self-injurious behavior (SIB). These behaviors may serve to prevent SIB but can also cause injury and interfere with everyday functioning. Findings from past research suggest that self-restraint encompasses a heterogeneous class of behaviors and may serve multiple operant functions. We review conceptual models and empirical studies of the structural and functional dimensions of self-restraint, including procedures for identifying controlling contingencies and reducing the occurrence or impact of self-restraint on daily life. Available interventions, such as noncontingent reinforcement, differential reinforcement, functional communication training, and restraint fading, are discussed in the context of their limitations and successes. We conclude with recommendations for future research aimed at clarifying the functional properties of self-restraint and developing systematic approaches to its assessment and treatment.