Environmental antecedents which affect management and maintenance of programs for self-injurious behavior

This paper reports the effects of several environmental variables on the management and maintenance of a treatment program for self-injurious behavior (SIB) in residents in a state facility for retarded persons. Fifteen of the clients who participated in a developmental day-care program were compared across the final four months of the program and then at follow-up two years later. Twelve additional clients who were treated in the overall SIB program did not receive the day-care component, but were included in the follow-up study. Regarding program management, the effects of time, staff-initiated interactions, the presence of a newcomer or disruptive client, and medication changes on the behaviors of the 15 clients in the day-care program were assessed from an ecobehavioral approach. Participants in the follow-up study were compared with respect to the type of SIB program they received, the staff-patient ratio in their program, their visual impairment, use of self-protective devices, presence of stimulating material, and time-of-day observed. These issues are discussed in relation to program maintenance.