The use of aversive stimulation in the treatment of chronic self-injurious behavior.

Chronic self-injurious behavior is a dramatic form of psychopathology which is seen both in severely retarded and in psychotic children. It consists of relatively repetitive self-hitting which may occur in the absence of obvious environmental determinants giving it, thereby, the quality of stereotyped behavior. Examples of selfinjurious activity are hard head banging, slapping and punching of face and head, and kicking, scratching and biting one's self. A number of workers have sought to explain this bizarre manifestation which has been variously labeled as self-destructive behavior and as masochism, autoaggrcssion, and self-aggression (Cain, 1961; Berkson, in press; Collins, 1%5; Dizmang, I!Hj(); Dollard et a!., I!):l!); A. Freud, 1!)54; Goldfarb, 1!)45; Grccnacre, 1954; Hartmann et a!., l!J1!l; l\fahIcr et a!', I!l:')!); Sandler, 1%1; Zuk, 1%0). Our own preference is for the term "self-injurious behavior" (Tate and Baroff, I!Hj(j) because it is descriptive rather than interpretive. The term denotes behavior which results in physical injury and it does not imply an attempt to hurt the self. Self-injurious behavior presents formidable management problems as it may prevent the therapist from providing the child with