A non-aversive behavioral-pharmacological intervention for severe self-injury in an adult with dual sensory impairment.

The severe and high-rate self-injurious (face slapping) behavior of a woman who was deaf and legally blind was reduced to near-zero levels following implementation of a multicomponent treatment program in combination with psychotropic medication. Behavioral treatment incorporated the noncontingent wearing of a protective helmet, rearrangement of social contingencies, and gradual fading of the helmet in a transfer of stimulus control paradigm. The client was prescribed lithium shortly after the introduction of the behavioral program and the dosage was increased over the course of treatment. A six-month follow-up revealed a near-absence of self-injury. Several explanations for the therapeutic control from the behavioral-pharmacological intervention are presented.