Motivational Assessment: A Potential Means of Enhancing Treatment Success of Self-Injurious Individuals

Abstract

In general, procedures used to modify self-injurious behavior have had limited success. As a result of the poor reliability of effect, many procedures (e.g., differential reinforcement, timeout, response-contingent shock, lemon juice, aromatic ammonia) have been advocated. All of these procedures focus on changing the consequences of self-injurious behavior. In 1977 Carr wrote a seminal article that represented a new direction. He recommended that we conduct more careful analyses of the motivation for engaging in SIB thereby enabling clinicians to fine tune their procedures in light of the function SIB was performing for the individual. The present paper documents the pervasive impact of this new direction. Specifically, Carr's five motivational hypotheses related to the onset and maintenance of SIB are reviewed. Recent studies supporting each hypothesis are discussed and the clinical implications emanating from each hypothesis are enumerated. The conclusions drawn from the review suggest that a thorough assessment of pertinent variables (i.e., the function(s) SIB serve(s) for the individual) may enhance treatment success.