The early development of self-injurious behaviour: evaluating the role of social reinforcement

Background: The potential role of social reinforcement in the development of self‐injury has not yet been subjected to empirical analysis. In this 2‐year prospective study, the pattern of social interactions related to the early presentation of self‐injury were examined to identify a potential association with an increase in self‐injury.

Methods: The self‐injurious behaviour and social contact with adults of 16 children with intellectual disability (ID) with self‐injury of recent onset were observed at 3‐month intervals over 2 years.

Results: Increase in self‐injury over a 2‐year period was positively correlated with a distribution of social contact relative to episodes of self‐injury that is consistent with a mutual social reinforcement paradigm. When this paradigm was operative, self‐injury was evoked under stable antecedent conditions over time but tended to evoke increasing levels of social interaction.

Conclusions: These results support the hypothesis that increases in the frequency of early self‐injury in children with ID may be determined by social reinforcement with implications for early intervention and proactive identification of children at risk for increases in self‐injury.