Examining the influence of social-environmental variables on self-injurious behaviour in adolescent boys with fragile X syndrome.
S S Hall, K M Hustyi, R P Barnett
PMID 29693293WHAT IT FOUND
In adolescent boys with fragile X who showed self-injury, social functions were identified for 10 of 14, especially escape from demands, transitions, social interaction, or access to items.
This helps target environmental changes based on what maintains the behaviour.
Key findings
01Social functions for self-injury were identified for 10 of the 14 boys who displayed self-injury during the functional analyses.
02For boys who displayed self-injury, six had multiple social functions involving tangible items and escape from social, demand, or transition conditions; two had tangible reinforcement; one had demand escape; one had attention; two had automatic reinforcement; and two were undifferentiated.
03Social functions for aggression were identified for 7 of the 8 boys who displayed aggression during the functional analyses.
STILL TO COME
How it was doneWhat they found
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What it does not show
For over a third of participants, self-injury did not occur during the functional analyses or occurred at extremely low rates, so the function was unclear. The functional analyses were done in a research centre, not at home or school, and caregivers were not coached, so more self-injury might have appeared in natural settings. Seven functional analysis conditions were used, which is not common in clinical practice and may have made it harder to tell which condition mattered. Participants had to travel to Stanford, so the sample may not represent all boys with fragile X syndrome who show problem behaviour. No treatment was tested, so the study does not show that function-based treatment reduced self-injury or aggression. Repeating the condition sequence created safety concerns, and the termination rule was needed in one case.
Declared interests
The article is marked as supported by NIH extramural research. The supplied text does not report author conflicts of interest.
The easy way to misread this
Do not read these functional analysis results as evidence that a treatment worked. The study did not test treatment, and some boys did not show self-injury during the analysis.