Running head SELF-INJURIOUS BEHAVIOR 1SELF-INJURIOUS BEHAVIO.docx

Running head: SELF-INJURIOUS BEHAVIOR 1
SELF-INJURIOUS BEHAVIOR 5
Self-Injurious Behavior
Name
Capella University
Self-Injurious Behavior
For this final assignment a research of self-injurious behavior
has been conducted. Self-injurious behavior, also known as
SIB, is described an instance of behavior that results in physical
injury to a person’s own body. SIB includes head banging,
using objects to cut or puncture self, pinching self, consuming
inedible substances, vomiting, pulling own hair, sucking, biting,
scratching body parts and use of drugs, among others (Yang,
2003). SIB, is usually displayed by individuals with autism and
intellectual disabilities. SIB can result in serious injuries and
in severe cases even death. According to Yang (2003), the
treatment of SIB has become one of the most serious issues for
clinicians and other professionals due to the injury, risk,

prevalence, and cost involved.
Article 1
Overview
The first article discussed is "Combination of extinction and
protective measures in the treatment of severely self-injurious
behavior" by Lizen Yang from Behavioral interventions journal.
Yang explores and discusses the advantages of using extinction
in conjunction with the non-intrusive protective measures to
treat SIB. In the study, extinction in combination with non-
intrusive protective measures was selected as the intervention
strategy to reduce SIB.
Subjects and setting
The study was conducted on two adolescent females with
profound mental retardation and physical disabilities at a state
facility. Both subjects exhibited self-injurious behavior (SIB)
and had been wearing restrains mechanisms for more than two
years to prevent injuries. The treatment sessions were
conducted in the morning for one of the subjects and in the
afternoon for the other subject in a multipurpose 12’ x 13’room
in their residential building. The room contained a table, a
desk, and three chairs. Fingernail clippers, a pair of scissors,
and a bottle of white petroleum jelly were used, since the target
behavior for both subjects was scratching. There was a radio
playing soft music at a moderate volume during sessions. There
also were several audio and visual activity materials available
and placed on the table within the participants’ reach at all
times during treatment. During sessions, only the therapist and
the participant were in the room.
Design and results
Event recording was used to collect data during each 30 minute
treatment session. Two hand held counters were used to record
the target behavior. In order to constantly analyze data, and
monitor the behavior, as well as avoiding possible medical
concerns, each treatment session was divided into three 10
minute intervals. Initially a within-subject reversal design was
in which baseline (A) and treatment (B) were alternated in an

ABAB sequence, but due to frequent and severe self-injuries
and for safety reasons, an AB probe design was implemented.
During the baseline period, staff were instructed to respond to
the target behavior as they normally did. In addition to the
continuous application of non-contingent intrusive protective
devices, staff was instructed to use verbal instructions to
prevent injury. No SIB occurred during baseline because of
continuous use of protective measures to prevent injuries.
Subjects had two days in between the baselines and the
treatment to allow for healing from any injuries. During
treatment, both subject’s nails were checked to ensure they were
short and petroleum jelly was applied on the target areas and
fingertips. Both subjects’ hands then were guided to touch and
manipulate the provided activity materials for about 30 seconds
before they were released to start the extinction procedure.
During the extinction procedure, no further verbal instructions
or physical blocking were used. During extinction, SIB was
observed and recorded. No verbal instructions nor physical
intervention were employed to stop the SIB.
Internal, External, & Social Validity
The data was displayed on an interval graph that portrayed
baseline and treatment. Internal validity was displayed in this
study as each graph of the participants in the study show that
there was a functional relationship between the use of
continuous intrusive measures (Condition A) and non-intrusive
measures during treatment (Condition B). The study results
showed that extinction was both effective and efficient in
eliminating severe SIB. The results also indicated that using
the non-intrusive protective measures (petroleum jelly and
checking nails) and allowing the target behavior to occur while
minimizing self-injuries made it possible to implement the
extinction procedure. External validity was also displayed
because the intervention was applied effectively on more than
one participant. Social validity was also present in this study,
as each of the participant’s behaviors were eliminated. This
research study was beneficial to subjects involved as the

procedure help decrease the need for medical attention, it
increased physical freedom from restraints, and even the re-
growth of hair on the participants (Yang, 2003). The study
results showed that extinction was both effective and efficient
in eliminating severe SIB. The results also indicated that using
the non-intrusive protective measures (petroleum jelly and
checking nails) and allowing the target behavior to occur while
minimizing self-injuries made it possible to implement the
extinction procedure.
References
Yang, L.J. (2003). Combination of extinction and protective
measures in the treatment of severely self-injurious
behavior. Behavioral interventions (1072-0847), 18 (2), p. 109.
Running head: Vocal stereotypy 1
Vocal stereotypy 17
Vocal Stereotypy
Student A
Capella University

Vocal Stereotypy
Vocal stereotypy can be defined as any instance of
nonfunctional speech that can include words or phrases that are
not related to what is going on around the individual, or
repetitive grunting, squealing, or babbling (Ahearn, Clark, &
MacDonald, 2007). Stereotypic behaviors are a common feature
in children who have been diagnosed with Autism Spectrum
Disorder (ASD); stereotypic behaviors are any sort of repetitive
and/or restricted movement or vocalization (Bulla & Frieder,
2017). Vocal stereotypy can be disruptive to a child’s life
because it interferes with learning and social inclusion
(Lanovaz & Sladeczek, 2011). Some researchers believe that
vocal stereotypy is maintained by social reinforcements;
however there are other researchers that believe that vocal
stereotypy is not maintained by social reinforcements because
vocal stereotypy typically persists even when social
reinforcement is not present (Lanovaz & Sladeczek, 2011).
Those that do not believe that vocal stereotypy is maintained by
social reinforcement believe that vocal stereotypy functions for
automatic reinforcement, or in other words that there is an
internal reinforcing stimulation (Lanovaz & Sladeczek, 2011).
Functional analyses have been utilized to determine the function
of vocal stereotypy, and those that are found to function as
automatic reinforcement are because the behavior happens when
no one is around, and it is observed across all conditions
(Lanovaz & Sladeczek, 2011). Throughout this paper five
articles will be reviewed on vocal stereotypy, and will look into
the methodologies used to treat vocal stereotypy, as well as
experimental designs used.Article 1
Overview
Researchers Bulla and Frieder (2017) wanted to look into the
effectiveness of a self-management system that they called
“Self-and-Match” system. The researchers wanted to review this
system because it was commercially available intervention that
allowed for the interventionist to individualize the intervention;

this treatment was a self-management intervention that
reinforced only appropriate behaviors, and accurate self-
monitoring on vocal stereotypy that is displayed by participants
(Bulla & Frieder, 2017).
Subjects and Setting
In the current study the participant was an 8 year old African
American male name Zachery who had a previous diagnosis of
autism spectrum disorder (ASD). Zachary received intensive
services in an ASD classroom setting; Zachery exhibited vocal
stereotypic behaviors that were disruptive to his peers in his
classroom, and defined Zachery’s stereotypy behaviors as a
vocalization, including nonsense sounds and words that were
expressed in a repetitive manner, and were expressed in a
volume that was louder than the conversational volume (Bulla &
Frieder, 2017).
Design and Results
The researchers used a multiple baseline reversal design. During
the baseline phase Zachery displayed vocal stereotypy 80%
during the one minute intervals, and displayed vocal stereotypy
27% during the intervention where he could earn 4
tokens/stickers (Bulla & Frieder, 2017). The researchers noted
that Zachery had difficulty engaging in his work when there
were frequent interruptions, so the researchers extended the
interval times (Bulla & Frieder, 2017). The results of the study
suggested that a self-match system may be effective in
decreasing vocal stereotypy in the intervention phase, but at the
four month follow up the behavior had increased from the post
intervention stage (Bulla & Frieder, 2017).
The social validity was high for this research due to the
fact that the vocal stereotypy was disrupting the class, the
intervention is acceptable for the participant’s age, and the
intervention showed to have success when implemented during
the treatment conditions. External validity appeared to be low
as the researchers did not mention having tried to generalize to
others, or to other behaviors, or environments. In regards to

internal validity, it appears that there might be a functional
relationship between the self-match intervention and stereotypy
behaviors. It is important to note that the researchers state that
there were many limitations were present in this study and that
in order to draw accurate conclusions more research should be
conducted (Bulla & Frieder, 2017). Article 2
Overview
The researchers Ahearn, Clark, and MacDonald (2007)
conducted a study to assess and treat vocal stereotypy in
children who were diagnosed with ASD. The researchers ruled
out any children where social consequences were maintaining
the vocal stereotypy, so that only children in which automatic
reinforcement was maintaining the vocal stereotypy participated
(Ahearn, Clark, & MacDonald, 2007). Since response blocking
has been proven to be effective in decreasing behaviors that are
maintained by automatic reinforcement, the researchers decided
to use response interruption as the intervention to treat vocal
stereotypy (Ahearn, Clark, & MacDonald, 2007).
There were a total of four participants in this study, two boys
and two girls, each of which was diagnosed with ASD and
exhibited vocal stereotypy in which it disrupted their school
day, and occurred at unacceptable levels when outside of the
school setting (Ahearn, Clark, & MacDonald, 2007). Mitch was
a 3 year old male whose vocal stereotypy was vocal
approximations and noises, and he received services both
clinical and educational in his preschool setting (Ahearn, Clark,
& MacDonald, 2007). Peter was an 11 year old male who was a
residential student, and his vocal stereotypy consisted of
repeated words, approximations, and noises (Ahearn, Clark, &
MacDonald, 2007). The two female participants were fraternal
twins, Nicki and Alice who were 7 years old, and also
residential students; Nicki’s vocal stereotypy consisted of
repeated words, approximations, and noises, and Alice’s vocal
stereotypy consisted of noises and some word approximations
(Ahearn, Clark, & MacDonald, 2007). For this study all sessions

took place in a small room that had a table and two chairs.
Design and Results
The researchers utilized the single phase alternating treatment
design for each client when conducting the functional analysis,
the conditions were play, alone, attention, and demand (). For
the two male participants vocal stereotypy was exhibited the
most frequent in the alone conditions, and for both girl
participants there was high variability between each condition;
the researchers were able to determine that the vocal stereotypy
for each participant was not maintained by social consequences,
but by automatic reinforcement (Ahearn, Clark, & MacDonald,
2007). For treatment the researchers used response interruption
and redirection in an ABAB reversal design. Mitch displayed
high frequency of vocal stereotypy in the baseline phase 1, then
in the treatment phase 1 his vocal stereotypy dropped to low
levels (Ahearn, Clark, & MacDonald, 2007). When Mitch
returned to a baseline phase his vocal stereotypy increased to
moderate levels, and then the vocal stereotypy dropped to
nearly zero when treatment phase was reintroduced; Mitch’s
appropriate vocalizations became more frequent when treatment
was in place (Ahearn, Clark, & MacDonald, 2007). Peter
displayed a moderate frequency of vocal stereotypy in the
baseline phase 1, then in the treatment phase 1 his vocal
stereotypy dropped to low levels (Ahearn, Clark, & MacDonald,
2007). When Peter returned to a baseline phase his vocal
stereotypy had a decreasing trend but did not return to the
original baseline levels, and then the vocal stereotypy decreased
again in the treatment phase 2; Peter’s appropriate vocalizations
became more frequent when treatment was in place (Ahearn,
Clark, & MacDonald, 2007). Alice displayed high frequency of
vocal stereotypy in the baseline phase 1, then in the treatment
phase 1 her vocal stereotypy decreased (Ahearn, Clark, &
MacDonald, 2007). When Alice returned to a baseline phase her
vocal stereotypy increased to high levels, and then the vocal
stereotypy decreased to low levels when treatment phase was
reintroduced; Alice’s appropriate vocalizations became more

frequent when treatment was in place, but were variable
(Ahearn, Clark, & MacDonald, 2007).
Nicki displayed moderate to high frequency of vocal stereotypy
in the baseline phase 1, then in the treatment phase 1 her vocal
stereotypy dropped to low levels immediately (Ahearn, Clark, &
MacDonald, 2007). When Nicki returned to a baseline phase her
vocal stereotypy increased to moderate levels, and then the
vocal stereotypy dropped to zero when treatment phase was
reintroduced; Nicki did not display appropriate vocalizations in
any condition (Ahearn, Clark, & MacDonald, 2007).
Internal validity was displayed in this study as in each of
the participants ABAB reversal design shows that there was a
functional relationship between vocal stereotypy and response
interruption and redirection, and that it was not a result of
confounding variables. External validity was also displayed
because the intervention was able to be applied to other
participants and remained effective, so this shows that response
interruption and redirection can be generalized to other
participants. The study did not include any other settings or
behaviors to generalize to. Social validity was also present in
this study, as each of the participants behaviors were
interrupting the ability to perform in school. This research study
was beneficial to the children, as well as to the teachers and
parents because it will help these children in school as well as
with social interactions. Article 3
Overview
The researchers Lanovaz, Rapp, Maciw, Pregent-Pelletier,
Dorion, Ferguson, and Saade (2014) conducted this study to
assess outcomes of different interventions with participants who
had been diagnosed with ASD and displayed vocal stereotypy.
The researchers note that most often response interruption and
redirection are utilized by clinicians who are trying to reduce
the frequency of vocal stereotypy in clients, but note that there
are other interventions that can be utilized to reduce the
frequency of vocal stereotypy (Lanovaz, et al, 2014). The

researchers also looked to see what modifications can be made
to interventions when the behavior was not reduced or produced
other effects (Lanovaz, et al, 2014).
In this study there were 12 participants that had been diagnosed
with ASD and other developmental disabilities, all of the
participants engaged in vocal stereotypy, and 5 out of the 12
participants also engaged in motor stereotypy (Lanovaz, et al,
2014). Each participant underwent the study in the setting that
they typically engaged in vocal stereotypy. The participants
were: Nicolas age 12, Zoe age 36, Kyle age 4, Morgan age 6,
Lucas age 37, Ryan age 7, Yasmine age 63, David age 6, Jacob
age 5, Eric age 4, Fred age 9, and Greg age 6 (Lanovaz, et al,
2014). Nicholas, Kyle, Ryan, Yasmine, Morgan, Zoe and Lucas
were in the first experiment in which the intervention was non-
contingent music and differential reinforcement of alternative
behavior was used (Lanovaz, et al, 2014). Ryan, Yasmine, and
David were in the second experiment in which the intervention
was differential reinforcement of other behaviors was used;
Zoe, Morgan, Jacob, Fred, Greg, and Eric were in the third
experiment in which the intervention was adding prompts to
increase appropriate behaviors (Lanovaz, et al, 2014).
Design and Results
The researchers used an alternating treatment design to compare
the effects of non-contingent music and the differential
reinforcement of incompatible behaviors (DRI); Nicolas reduced
in frequency of vocal stereotypy when non-contingent music
was implemented, but did not reduce the behavior when the
DRA was present (Lanovaz, et al, 2014). For Zoe, the DRA was
effective in reducing vocal stereotypy, but the non-contingent
music did not appear to be effective in reducing her problematic
behavior (Lanovaz, et al, 2014). Non-contingent music reduced
vocal stereotypy in Kyle, whereas the DRA did not appear to be
effective; Both DRA and non-contingent music decreased vocal
stereotypy in Morgan but the DRA was more effective
(Lanovaz, et al, 2014). For Lucas, non-contingent music

reduced vocal stereotypy, but the DRA did not prove to be
effective in reducing his behavior (Lanovaz, et al, 2014).
Yasmine and Ryan did not have reductions in their vocal
stereotypy when both interventions were implemented, so they
were brought back to be included in the second experiment
(Lanovaz, et al, 2014). The researchers used an alternating
treatments design to compare the effects of the differential
reinforcement of other behavior (DRO) with baseline, however
they used an AB design for Yasmine because of Yasmine’s
limited abilities (Lanovaz, et al, 2014). For the experiment for
the DRO, David reduced his frequency of vocal stereotypy, but
his functional play also remained low; for Ryan, the DRO
reduced the frequency of vocal stereotypy, but for Yasmine the
DRO did not reduce the frequency of vocal stereotypy and it did
not increase Yasmine’s appropriate behaviors (Lanovaz, et al,
2014). The first experiment showed that non-contingent music
was more effective than the DRA, and that adding prompts did
not help in decreasing vocal stereotypy; in the second
experiment the DRO was effective in reducing the behavior for
two out of the three participants (Lanovaz, et al, 2014).
Internal validity was assessed through interobserver agreement,
and it was found that internal validity was demonstrated in the
graphs because there appears to be a cause and effect between
the intervention and behavior. External validity was
demonstrated because the interventions were applied across a
variety of participants, and therefore could be generalized to
other individuals. The researchers indicate that other studies
similar to theirs, state that these interventions are effective and
can be generalized to other behaviors and settings (Lanovaz, et
al, 2014). Social validity is demonstrated because the
researchers state that it is important to investigate multiple
interventions so that clinicians can see what treatments have
been proven to be most effective when working with individuals
with vocal stereotypy, and that it is important to understand that
not all individuals will respond to the same treatment; the

researchers also state that it is important in address stereotypy
behaviors when they are present because it can be disruptive to
the individual’s life, and it interferes with the individual’s
ability to take part in society (Lanovaz, et al, 2014).Article 4
Overview
In the study conducted by Toper-Korkmaz, Lerman, and
Tsami (2018), there were three participants, Nancy (6 years
old), Areli (6 years old), and Bryan (4 years old), all of which
had been diagnosed with autism spectrum disorder (ASD). All
three participants had limited vocal imitation skills, and
engaged in vocal stereotypy that was maintained by automatic
reinforcement (Toper-Korkmaz, Lerman, & Tsami, 2018).
Toper-Korkmaz, Lerman, and Tsami’s (2018) study took place
at a university-base clinic in one of the therapy rooms; the
therapy room had a one way observation window with a camera
on the other side to record the sessions, the room contained two
chairs and a table with a couple preferred items that had been
identified as being a preferred item through the preference
assessment.
Design and Results
Toper-Korkmaz, Lerman, and Tsami’s (2018) used a
reversal design and a combined multielement (also known as
alternating treatment design) design to see separate effects and
combined effects of response interruption and redirection
(RIRD) and the removal of a toy, as well as to examine the
impact of response interruption and redirection sequence length
on vocal stereotypy and appropriate vocalizations. Overall, the
less intensive version of response interruption and redirection,
with only a response to one demand was shown to be effective
in reducing the amount of vocal stereotypy displayed by the
participants (Toper-Korkmaz, Lerman, & Tsami, 2018).The
researchers found that contingent toy removal was also effective
in reducing vocal stereotypy. The researchers state that because
sessions for these participants were short, in order to see long
term effectiveness of response interruption and redirection with

contingent toy removal, more research should be conducted
(Toper-Korkmaz, Lerman, & Tsami, 2018).
The mean interobserver agreement was 95% for vocal
stereotypy, 98% for appropriate vocalizations, 98% for correct
responses, and 97% for procedural integrity across participants
indicating high internal validity. The external validity for this
study was moderate because the generality of the researchers
findings is limited, and is limited because this study was only
conducted it in a clinical setting with leisure activities present.
The researchers state that to increase external validity and
generality of the study, more studies using the same method
should be implemented in other settings such as schools where
it is not as easy to provide leisure activities (Toper-Korkmaz,
Lerman, & Tsami, 2018). Another limit to the study was that the
sessions for each participant were brief (Toper-Korkmaz,
Lerman, & Tsami, 2018). This study was able to be conducted
across participants so that contributed to the external validity.
Social validity was addressed by making the sessions shorter in
time because historically response interruption and redirection
interventions have been reported to be too time consuming, even
though they were effective. Social validity was also addressed
by increasing appropriate vocalizations across participants.
Article 5
Overview
The researchers Shillingsburg, Lomas, and Bradley (2012) state
that there is a need for an intervention that allows for
generalizing to other settings when vocal stereotypy is exhibited
because of how detrimental the effects of vocal stereotypy can
be for an individual. Shillingsburg, Lomas, and Bradley (2012)
state that there has been research that has been conducted that
exemplifies the importance of identifying competing responses
as well as identifying a stimulus that matches the sensory
reinforcement. The researchers look to see which of the two
treatments that they implement is more effective in decreasing
vocal stereotypy and if the treatments can be generalized to a

classroom setting (Shillingsburg, Lomas, & Bradley, 2012). The
two treatments that will be utilized in this study are non-
contingent reinforcement with response cost and a token
economy with a differential of reinforcement of other behaviors
with a response cost (Shillingsburg, Lomas, & Bradley, 2012).
This study consisted of one participant, Carl, who was a 12 year
old male; Carl had a diagnosis of ASD, and attended a program
that focused on his language delays (). Carl also attended public
school and had been placed in an exceptional student
educational classroom, and had an individualized education plan
that allowed for Carl to engage in specials (physical education,
art, music, media, etc.) with the regular education classes
(Shillingsburg, Lomas, & Bradley, 2012). Carl was able to mand
in one to six words for particular items, and was able to answer
to wh- questions like who, what, where, when; Carl displayed
vocal stereotypy in the form of loud vocalizations, and would
disrupt his class as well as disrupt educational activities
resulting in Carl not being allowed to be a part of the activities
anymore (Shillingsburg, Lomas, & Bradley, 2012). Due to the
level of disruption that was caused by Carl displaying vocal
stereotypy, Carl was placed into a more restrictive classroom
than what his level of intellectual function required him to be in
(Shillingsburg, Lomas, & Bradley, 2012). The functional
analysis and phases one and two of treatment were conducted in
a therapy room, whereas phase three of treatment was conducted
in the classroom setting (Shillingsburg, Lomas, & Bradley,
2012)
Design and Results
The researchers used an alternating treatment design to
determine the function of behavior through a functional
analysis; the researchers then used an ABAB reversal design for
treatment phase one, and then for treatment phases two and
three, an ABAB reversal design was used with a changing
criterion design (Shillingsburg, Lomas, & Bradley, 2012). The
functional analysis concluded that vocal stereotypy was

maintained by automatic reinforcement. Phase 1 consisted of a
baseline phase and of treatment which was a non-contingent
reinforcement with response cost; Carl displayed high levels of
vocal stereotypy in the baseline phase (Shillingsburg, Lomas, &
Bradley, 2012). When treatment was introduced the levels of
vocal stereotypy were high at first, but then decreased to almost
a zero level; baseline was then placed back, and the vocal
stereotypy rates increased to nearly the rates seen in the first
baseline (Shillingsburg, Lomas, & Bradley, 2012). When
treatment was reintroduced Carl’s rates of vocal stereotypy
decreased to zero by the end of the treatment phase; however,
when treatment was introduced with demands fading Carl’s
vocal stereotypy increased back to baseline rates (Shillingsburg,
Lomas, & Bradley, 2012). Phase 2 consisted of baselines and
the treatment condition consisted of token economy and
differential reinforcement of other behaviors with response cost;
baseline phase showed high levels of behavior, and the first
treatment condition Carl’s rates of behavior dropped to zero and
remained low (Shillingsburg, Lomas, & Bradley, 2012). When
baseline was reintroduced Carl’s rate of behavior increased, but
not back to baseline levels; when treatment was reintroduced
Carl’s rate of behavior remained low around zero, and when
fading occurred Carl’s rate of behavior remained low
(Shillingsburg, Lomas, & Bradley, 2012). Phase 3 was
conducted in the classroom setting to see if token economy with
the DRO and response cost remained effective in another
setting. In the baseline phase Carl displayed high levels of
vocal stereotypy in the classroom, but when treatment was
introduced his rate of behavior dropped to low levels
(Shillingsburg, Lomas, & Bradley, 2012). When baseline was
reintroduced, Carl’s rates of behavior increase back to the
previous baseline rates, and when treatment was reintroduced
Carl’s rates of behavior dropped immediately and remained
around zero (Shillingsburg, Lomas, & Bradley, 2012). Both the
use of NCR with RC and TE with a DRO and RC were effective
in reducing vocal stereotypy, but the use of TE with a DRO and

RC was the most effective because it increased the time that
was available for instructional learning as well as other
academic activities (Shillingsburg, Lomas, & Bradley, 2012).
Internal validity was assessed through interobserver agreement
(IOA); for the functional analysis the IOA was 85.5%, for phase
1 the mean IOA was 100%, phase 2 the mean IOA was 99.8%,
and for phase 3 the mean IOA was 73.4% (Shillingsburg,
Lomas, & Bradley, 2012). The researchers state that the IOA for
phase 3 was lower than the other phases because Carl’s volume
when displaying vocal stereotypy had also decreased, and at
times was difficult to discriminate when observing for Carl’s
vocal stereotypy in the classroom (Shillingsburg, Lomas, &
Bradley, 2012). The graphs in the study also show that there
was a functional relationship between both treatments and
Carl’s vocal stereotypy. External validity was exhibited when
the researchers were able to apply the treatment to another
setting (school) instead of just in the therapy room. Social
validity was addressed because the researchers explain that
Carl’s vocal stereotypy was so intense that he had to be placed
in a classroom that did not correlate to his level of cognitive
functioning, which could cause him to regress in his academics
(Shillingsburg, Lomas, & Bradley, 2012).
Conclusion
Vocal stereotypy can greatly effect individuals who engage
in it; vocal stereotypy effects the individual’s ability to interact
with others, form relationships, and can affect the individual’s
ability to learn when in classroom settings. Throughout this
paper different studies were reviewed and different treatments
were utilized across these studies when the behavior was
maintained by automatic reinforcement, such as response
interruption and redirection (RIRD), non-contingent music,
differential reinforcements of incompatible behaviors (DRI),
non-contingent reinforcement (NCR), token economy (TE),
response costs, as well as differential reinforcement of other
behavior. Overall, it appears that as clinicians we need to keep

in mind that each individual is unique and each treatment needs
to be individualized because not all individuals respond the
same to the same interventions.
References
Last Ahearn, W. H., Clark, K. M., & MacDonald, R. P. F.
(2007). Assessing and treating vocal stereotypy in children with
autism. Journal of Applied Behavior Analysis, 40(2), 263-275.
doi: 10.1901/jaba.2007.30-06
Bulla, A. J. & Frieder, J. E. (2017). Self-and-match system
suppresses vocal stereotypy during independent work. Behavior
Analysis: Research and Practice, 17(3), 274-285. Retrieved
from: http://dx.doi.org.library.capella.edu/10.1037/bar0000063
Lanovaz, M. J., Rapp, J.T., Maciw, I., Pregent-Pelletier, E.,
Dorion, C., Ferguson, S., & Saade, S. (2014). Effects of
multiple interventions for reducing vocal stereptypy:
Developing a sequential intervention model. Research in Autism
Spectrum Disorders, 8(5), 529-545. Retrieved from:
https://doi.org/10.1016/j.rasd.2014.01.009
Lanovaz, M. J. & Sladeczek, I. E. (2011). Vocal stereotypy in
individuals with autism spectrum disorders: A review of
behavioral interventions. Sage Journals, 36(2), 146-164.
Retrieved from: https://doi.org/10.1177/0145445511427192
Shillingsburg, M. A., Lomas, J. E., & Bradley, D. (2012).
Treatment of vocal stereotypy in an analogue and classroom
setting. Behavioral Interventions, 27(3), p. 151-163. Retrieved
from:
http://web.a.ebscohost.com.library.capella.edu/ehost/detail/detai
l?vid=4&sid=107a3ba5-6248-456e-a012-
d2822c25d15d%40sessionmgr4008&bdata=JnNpdGU9ZWhvc3Q

tbGl2ZSZzY29wZT1zaXRl#AN=2012-16404-003&db=psyh.
Toper-Korkmaz, O., Lerman, D. C., & Tsami, L. (2018). Effects
of toy removal and number of demands on vocal stereotypy
during response interruption and redirection. Journal of Applied
Behavior Analysis, 51(4), 757-768. Retrieved from:
http://dx.doi.org.library.capella.edu/10.1002/jaba.497

Running head SELF-INJURIOUS BEHAVIOR 1SELF-INJURIOUS BEHAVIO.docx

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