For What Behaviors Are Aversive Procedures Used?For What Behaviors Are Aversive Procedures Used?
Aversive procedures are inappropriately used, not only to control dangerous behaviors, but also to modify behaviors that are simply idiosyncratic (moaning or twisting one's hair), unusual (tics or rocking) or are inconvenient to caregivers (getting out of one's assigned seat or refusing to perform a task).
The typical rationale for the use of aversive procedures is that they are necessary to stop people from hurting themselves or hurting others. Most commonly, aversive procedures are used for self-injurious behaviors (e.g. slapping self, biting self, head banging, eye poking), aggression toward others, and disruptive behaviors. There are examples in the literature of aversive procedures being used for such non-dangerous and non-disruptive behaviors as:
RockingHand clappingFinger movementsStaring out of the windowThumb suckingStutteringSaying "and-um", "uh", or "you know" Attempting to leave the room without permission Getting out of one's seat without permission Echolalic speech (repeating the last words said to an individual) GrimacingInattentive behaviorAvoiding eye contact As an example of the application of aversive procedures for non-dangerous and non-disruptive behavior, one study described the use of white noise at 95 decibels to punish forty children, ages 7-21, all of whom were described as having severe or profound mental retardation, for incorrect responses to a visual discrimination task. Another study, by Kirchner, et al. used electric shock to punish two young children who were diagnosed as having severe or profound mental retardation, for inattention to a picture naming task.
A study by the New York State Commission on Quality of Care for the Mentally Disabled found numerous instances in which individuals with mental retardation were restrained or subjected to punishment for behaviors which "did not pose a threat of serious injury to self or others and which, in some cases were innocuous". The authors characterized many of the behaviors for which aversives were applied as "common responses to everyday life situations". The following is an example from that study:
One student had a behavioral program which called for her to earn tokens for periods of silence and to use the tokens she earned to purchase time to talk. If she talked out of turn and refused to pay her tokens, her hands were placed in restraints behind her back. She would be released from the restraints only after twenty minutes of silence.
The behavior program of a student at another private, residential school provides the following instructions to staff:
When ___ gestures toward self injurious behavior, he should be made to assume the control position. The control position consists of the individual on his knees, hands grasped behind his back, forehead on ground. He is to maintain this position for fifteen minutes.
Note that this program is to be implemented when the student "gestures toward" rather than when he exhibits self injurious behavior. The wording asks staff to predict the individual's behavior. Such ambiguous instructions are likely to result in the application of aversive consequences in some instances when the self injurious behavior would not have been exhibited.