| Treatment of Self-Injurious Behavior Through Behavior Therapy. |
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Bo In Chung1, Jong Soo Kim2, Jae Seung Yang2, Bong Sun Kang3 |
1Department of Rehabilitation, Yonsei University, College of Health Science, Wonju, Korea
2Department of Pediatrics, Yonsei University, College of Health Science, Wonju, Korea
3Department of Psychiatry, Yonsei University, College of Health Science, Wonju, Korea |
| 행동치료 (Behavior Therapy) 를 통한 자해행위의 치료 |
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정보인1, 김종수2, 양재승2, 강봉선3 |
1연세대학교 보건과학대학 재활학과교실
2연세대학교 의과대학 소아과학교실
3연세대학교 의과대학 신경정신과학교실 |
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Received: 9 September 1989 • Accepted: 8 November 1989 |
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| Abstract |
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Three-step guided compliance training and movement suppression time-out technique were used to
treat desruptive, self-injurious, and aggressive behaviors in an 8-years old tuberous sclerosis with
severe mental retardation. In compliance training, the child’s compliance behavior to verval and/or
gestural demand was reinforced with edible and/or social reinforcers and the noncomplied demand
was forcefully carried out through physical prompting. Movement suppression time-out was enforced
whenever any of the 3 problem behaviors occurred. The types of time-out technique used in this study
were chair time-out and floor time-out. The treatment procedure was divided into 2 phases. In phase
I, only disruption was the target of treatment and aggression and self-injurious behavior(SIB) were
ignored, while in phase II，all 3 behaviors were the target of treatment. For the sake of minimizing
the joccurrence of SIB and maximizing the opportunity for positive reinforcement, an arm restraint
was installed while sessions were careied out in the treatment room. The restraint device was
removed in the play room and ward. However, self-restraint phenomenon was not observed in this
child affter the restraint devece was removed. After the 3 problem behaviors were controlled to a
stable and manageable level, token training and a differential reinforcement of other behaviors (DRO)
technique were introduced, which, for the sake of facilitating maaintenance and generalization of
treatment effect, were mostly practiced in the play room and ward, and ward, and at home after the
child'x discharge from the hopital, The results of treatment were as follows: the mean occurrence of
disurption, aggression, and SIB was 50, 5, and 116 times per 15 minutes respectively before trealment
and .8，.l, and 3.0 times respectively after treatment. In the 4-month follow-up study at home, no
disruption or aggression was observed and SIB only sparsely (.1 time per 15 minute). Generalization
of treatment effect across behaviors and settings was studied. However, generalization was not
observed either across behaviors or settings. This strongly indicates that the occurrence of the 3
target behaviors was conditioned on the installment of movement suppression time-out. |
| Key Words:
Self-injurious behavior, Behavior therapy, Behavior modification |
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