Reducing covert self-injurious behavior maintained by automatic reinforcement through a variable momentary DRO procedure.

Covert self-injurious behavior (i.e., behavior that occurs in the absence of other people) can be difficult to treat. Traditional treatments typically have involved sophisticated methods of observation and often have employed positive punishment procedures. The current study evaluated the effectiveness of a variable momentary differential reinforcement contingency in the treatment of covert self-injury. Neither positive punishment nor extinction was required to produce decreased skin picking.