Abstract
What do a roller-coaster harness, boxing gloves, a parachute, and a football helmet all have in common? They are all forms of protective equipment or restraints that allow individuals to safely engage in responses that would otherwise be quite dangerous. For example, a parachute allows a person to jump out of a plane flying 10,000 ft above the earth and, in almost all cases, reach the ground safely. In fact, Captain Joe Kittenger jumped from a gondola that was 102,800 ft (19.5 miles) above the earth and lived to tell about it. This amazing feat illustrates the extent to which protective equipment can reduce the health risks associated with dangerous or risky behavior.
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References
Aman, M. G., Singh, N. N., Stewart, A. W., & Field, C. J. (1985). The aberrant behavior checklist: A behavior rating scale for the assessment of treatment effects. American Journal of Mental Deficiency, 89, 485–491.
Bodfish, J. W., Symons, F. J., Parker, D. E., & Lewis, M. H. (2000). Varieties of repetitive behavior in autism: Comparisons to mental retardation. Journal of Autism and Developmental Disorders, 30, 237–243.
Borrero, S. W., & Borrero, J. C. (2008). Descriptive and experimental analyses of potential precursors to problem behavior. Journal of Applied Behavior Analysis, 41, 83–96.
Borrero, J. C., Vollmer, T. R., Wright, C. S., Lerman, D. C., & Kelley, M. E. (2002). Further evaluation of the role of protective equipment in the functional analysis of SIB. Journal of Applied Behavior Analysis, 35, 69–72.
Children’s Health Act of 2000, HR 4365, 106th Cong. (2000).
Contrucci Kuhn, S. A., & Triggs, M. (2009). Analysis of social variables when an initial functional analysis indicates automatic reinforcement as the maintaining variable for SIB. Journal of Applied Behavior Analysis, 42, 679–683.
Craigen, L. M., Healey, A. C., Walley, C. T., Byrd, R., & Schuster, J. (2010). Assessment and self-injury: Implications for counselors. Measurement and Evaluation in Counseling and Development, 43, 3–15.
Deaver, C. M., Miltenberger, R. G., & Stricker, J. M. (2001). Functional analysis and treatment of hair twirling in a young child. Journal of Applied Behavior Analysis, 34, 535–538.
Dorsey, M. F., Iwata, B. A., Reid, D. H., & Davis, P. A. (1982). Protective equipment: Continuous and contingent application in the treatment of SIB. Journal of Applied Behavior Analysis, 15, 217–230.
Favell, J. E., McGimsey, J. F., & Jones, M. L. (1978). The use of physical restraint in the treatment of self-injury and as positive reinforcement. Journal of Applied Behavior Analysis, 11, 225–241.
Fisher, W. W., Piazza, C. C., Bowman, L. G., Hanley, G. P., & Adelinis, J. D. (1997). Direct and collateral effects of restraints and restraint fading. Journal of Applied Behavior Analysis, 30, 105–120.
Irvin, D. S., Thompson, T. J., Turner, W. D., & Williams, D. E. (1998). Utilizing increased response effort to reduce chronic hand mouthing. Journal of Applied Behavior Analysis, 31, 375–385.
Iwata, B. A., Dorsey, M. F., Slifer, K. J., Bauman, K. E., & Richman, G. S. (1994). Toward a functional analysis of self-injury. Analysis and Intervention in Developmental Disabilities, 2, 3–20. (Reprinted from Analysis and Intervention in Developmental Disabilities, 2, 3–20, 1982)
Iwata, B. A., Pace, G. M., Cowdery, G. E., & Miltenberger, R. G. (1994). What makes extinction work: An analysis of procedural form and function. Journal of Applied Behavior Analysis, 27, 131–144.
Iwata, B. A., Pace, G. M., Kissel, R. C., Nau, P. A., & Farber, J. M. (1990). The Self-Injury Trauma (SIT) Scale: A method for quantifying surface tissue damage caused by self-injurious behavior. Journal of Applied Behavior Analysis, 23, 99–110.
Jones, E., Allen, D., Moore, K., Phillips, B., & Lowe, K. (2007). Restraint and self-injury in people with intellectual disabilities. Journal of Intellectual Disabilities, 11, 105–118.
Kuhn, D. E., DeLeon, I. G., Fisher, W. W., & Wilke, A. E. (1999). Clarifying an ambiguous functional analysis with matched and mismatched extinction procedures. Journal of Applied Behavior Analysis, 32, 99–102.
Le, D. D., & Smith, R. G. (2002). Functional analysis of self-injury with and without protective equipment. Journal of Developmental and Physical Disabilities, 14, 277–290.
Lindberg, J. S., Iwata, B. A., & Kahng, S. W. (1999). On the relation between object manipulation and stereotypic SIB. Journal of Applied Behavior Analysis, 32, 51–62.
Lovaas, O. I., & Simmons, J. Q. (1969). Manipulation of self-destruction in three retarded children. Journal of Applied Behavior Analysis, 2, 143–157.
Luiselli, J. K. (1986). Analysis of contingently applied protective equipment in the modification of self-injurious behavior. Behavior Modification, 10, 191–204.
Luiselli, J. K. (1989). Contingent glove-wearing for the treatment of self-excoriating behavior in a sensory impaired adolescent. Behavior Modification, 13, 65–73.
Mazaleski, J. L., Iwata, B. A., Rodgers, T. A., Vollmer, T. R., & Zarcone, J. R. (1994). Protective equipment as treatment for stereotypic hand mouthing: Sensory extinction or punishment effects? Journal of Applied Behavior Analysis, 27, 345–355.
Moore, J. W., Fisher, W. W., & Pennington, A. (2004). Systematic application and removal of protective equipment in the assessment of multiple topographies of self-injury. Journal of Applied Behavior Analysis, 37, 73–77.
Pace, G. M., Iwata, B. A., Edwards, G. L., & McCosh, K. C. (1986). Stimulus fading and transfer in the treatment of self-restraint and SIB. Journal of Applied Behavior Analysis, 19, 381–389.
Parrish, J. M., Iwata, B. A., Dorsey, M. F., Bunck, T. J., & Slifer, K. J. (1985). Behavior analysis, program development, and transfer of control in the treatment of self-injury. Journal of Behavior Therapy and Experimental Psychiatry, 16, 159–168.
Piazza, C. C., Adelinis, J. D., Hanley, G. P., Goh, H., & Delia, M. D. (2000). An evaluation of the effects of matched stimuli on behaviors maintained by automatic reinforcement. Journal of Applied Behavior Analysis, 33, 13–27.
Powers, K. V., Roane, H. S., & Kelley, M. E. (2007). Treatment of self-restraint associated with the application of protective equipment. Journal of Applied Behavior Analysis, 40, 577–581.
Rojahn, J., Matson, J. L., Lott, D., Esbensen, A. J., & Smalls, Y. (2001). The Behavior Problems Inventory: An instrument for the assessment of self-injury, stereotyped behavior, and aggression/destruction in individuals with developmental disabilities. Journal of Autism and Developmental Disorders, 31, 577–588.
Rooker, G. W., & Roscoe, E. M. (2005). Functional analysis of self-injurious behavior and its relation to self-restraint. Journal of Applied Behavior Analysis, 38, 537–542.
Roscoe, E. M., Iwata, B. A., & Goh, H. (1998). A comparison of noncontingent reinforcement and sensory extinction as treatments for SIB. Journal of Applied Behavior Analysis, 31, 635–646.
Silverman, K., Watanabe, K., Marshall, A. M., & Baer, D. M. (1984). Reducing self-injury and corresponding self-restraint through the strategic use of protective clothing. Journal of Applied Behavior Analysis, 17, 545–552.
Smith, R. G., Lerman, D. C., & Iwata, B. A. (1996). Self-restraint as positive reinforcement for self-injurious behavior. Journal of Applied Behavior Analysis, 29, 99–102.
United States Government Accountability Office. (2009, May 19). Seclusions and restraints: Selected cases of death and abuse at public and private schools and treatment centers. Retrieved from http://www.gao.gov/assets/130/122526.pdf.
Urban, K. D., Luiselli, J. K., Child, S. N., & Parenteau, R. (2011). Effects of protective equipment on frequency and intensity of aggression-provoked staff injury. Journal of Developmental and Physical Disabilities, 23, 555–562.
Van Houten, R., Axelrod, S., Bailey, J. S., Favell, J. E., Foxx, R. M., Iwata, B. A., et al. (1988). The right to effective behavioral treatment. Journal of Applied Behavior Analysis, 21, 381–384.
Vollmer, T. R., & Vorndran, C. M. (1998). Assessment of self-injurious behavior maintained by access to self-restraint materials. Journal of Applied Behavior Analysis, 31, 647–650.
Wallace, M. D., Iwata, B. A., Zhou, L., & Goff, G. A. (1999). Rapid assessment of the effects of restraint on self-injury and adaptive behavior. Journal of Applied Behavior Analysis, 32, 525–528.
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Appendix
Appendix
UNMC-MMI’s Center for Autism Spectrum Disorders
Destructive Behavior Severity Scale
Patient’s Name: UNH#:
DOB: DOE:
INJURY RISK BEHAVIOR involves frequently engaging in destructive behavior without recognizing the potential hazards, such as: (a) climbing on objects where falling is probable; (b) running into a street without watching for cars; (c) pulling down objects onto oneself; (d) touching electrical wires, stoves or other dangerous items; (e) drinking or eating dangerous fluids or items (e.g., cleaners, medicines, fertilizer); (f) placing a bag over one’s head; or (g) getting ropes or cords tangled around one’s neck.
For each of the four levels of injury risk behavior listed below, circle how often this type of behavior occurs, ranging from never (N) to over 10 times per hour (+10).
N = Never M = Monthly W = Weekly H = Hourly +5 = Over 5 per hour +10 = Over 10 per hour
FREQUENCY
N M W H +5 +10 Level 1 = INJURY RISK BEHAVIOR resulting in: (a) no marks on body, (b) no burns, (c) no gagging, (d) no vomiting, or (e) no choking.
N M W H +5 +10 Level 2 = INJURY RISK BEHAVIOR resulting in: (a) reddening of skin or mild swelling; (b) a 1st degree burn; and/or (c) mild gagging.
N M W H +5 +10 Level 3 = INJURY RISK BEHAVIOR resulting in: (a) light scratches, small or shallow breaks in skin, moderate to severe swelling; (b) a 2nd degree burn; (c) vomiting or significant choking.
N M W H +5 +10 Level 4 = INJURY RISK BEHAVIOR resulting in: (a) scars, lasting tissue damage, disfigurement; (b) a 3rd degree burn; (c) poisoning; or (d) loss of consciousness.
AGGRESSION involves forceful pushing or striking others with body parts (e.g., pushing, hitting, kicking, head-butting); hitting others with objects; or scratching, pinching or biting others.
For each of the four levels of aggression listed below, circle how often this type of behavior occurs, ranging from never (N) to over 10 times per hour (+10).
N = Never M = Monthly W = Weekly H = Hourly +5 = Over 5 per hour +10 = Over 10 per hour
FREQUENCY
N M W H +5 +10 Level 1 = AGGRESSION resulting in (a) no marks on body and (b) no blows close to or contacting the eyes.
N M W H +5 +10 Level 2 = AGGRESSION resulting in (a) reddening of skin, and/or (b) mild swelling.
N M W H +5 +10 Level 3 = AGGRESSION resulting in (a) light scratches, (b) small or shallow breaks in skin, and/or (c) moderate to severe swelling.
N M W H +5 +10 Level 4 = AGGRESSION involving blows close to or contacting the eyes or resulting in (a) scratches that leave scars, (b) breaks in skin that leave scars, and/or (c) trauma resulting in broken bones or lasting tissue damage or disfigurement.
PICA involves the repetitive and persistent ingestion of inedible items (i.e., items that should not be eaten) such as bark, bugs, cigarette butts, clothing, coins, dirt, food dropped on the floor or ground, grass, leaves, paint chips, pet hair, etc.
For each of the four levels of pica listed below, circle how often this type of behavior occurs, ranging from never (N) to over 10 times per hour (+10).
N = Never M = Monthly W = Weekly H = Hourly +5 = Over 5 per hour +10 = Over 10 per hour
FREQUENCY
N M W H +5 +10 Level 1 = PICA involving: (a) no solid items larger than 1/2 inch in diameter (e.g., coins, large buttons), (b) no sharp items (e.g., pins, staples), (c) no contaminated items (e.g., items from garbage can or ash tray, paint chips), and (d) no toxic or poisonous items (e.g., medicines, glue).
N M W H +5 +10 Level 2 = PICA involving (a) solid items larger than 1/2 inch in diameter (e.g., coins, large buttons), but not sharp, contaminated, or toxic or poisonous items.
N M W H +5 +10 Level 3 = PICA involving sharp, contaminated, or toxic or poisonous items, but not requiring emergency medical attention (e.g., called physician for advice).
N M W H +5 +10 Level 4 = PICA involving sharp, contaminated, or toxic or poisonous items and requiring emergency medical attention.
PROPERTY DESTRUCTION involves banging, kicking, throwing, overturning, tearing, cutting, defacing, burning or stomping on objects not made for that purpose.
For each of the four levels of property destruction listed below, circle how often this type of behavior occurs, ranging from never (N) to over 10 times per hour (+10).
N = Never M = Monthly W = Weekly H = Hourly +5 = Over 5 per hour +10 = Over 10 per hour
FREQUENCY
N M W H +5 +10 Level 1 = PROPERTY DESTRUCTION resulting in disruption of property but no permanent damage to paper items, toys, teaching materials, furniture, vehicles or buildings.
N M W H +5 +10 Level 2 = PROPERTY DESTRUCTION resulting in damage to paper items or other light objects.
N M W H +5 +10 Level 3 = PROPERTY DESTRUCTION resulting in (a) breakage of pencils, plastic toys, glassware, or other breakable items, and/or (b) scratches or permanent marks on furniture, walls, cars, etc.
N M W H +5 +10 Level 4 = PROPERTY DESTRUCTION resulting in structural damage to furniture, cars, walls, etc.
SELF INJURIOUS BEHAVIOR (SIB)– forceful striking, scratching, rubbing, poking or biting own body parts such that repetition of the behavior over time has or will cause bodily injury (e.g., hitting, kicking, pinching, scratching or biting self; eye-poking); banging body parts against objects (e.g., head-banging).
For each of the four levels of SIB listed below, circle how often this type of behavior occurs, ranging from never (N) to over 10 times per hour (+10).
N = Never M = Monthly W = Weekly H = Hourly +5 = Over 5 per hour +10 = Over 10 per hour
FREQUENCY
N M W H +5 +10 Level 1 = SIB resulting in (a) no visible marks on body and (b) no blows close to or contacting the eyes.
N M W H +5 +10 Level 2 = SIB resulting in (a) reddening of skin, and/or (b) mild swelling.
N M W H +5 +10 Level 3 = SIB resulting in (a) light scratches, (b) small or shallow breaks in skin, and/or (c) moderate to severe swelling.
N M W H +5 +10 Level 4 = SIB involving blows close to or contacting the eyes or resulting in (a) scratches that leave scars, (b) breaks in skin that leave scars, and/or (c) trauma involving broken bones or lasting tissue damage or disfigurement.
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Fisher, W.W., Rodriguez, N.M., Luczynski, K.C., Kelley, M.E. (2013). The Use of Protective Equipment in the Management of Severe Behavior Disorders. In: Reed, D., DiGennaro Reed, F., Luiselli, J. (eds) Handbook of Crisis Intervention and Developmental Disabilities. Issues in Clinical Child Psychology. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6531-7_6
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