Self-Injurious Behaviour in People with Learning Disabilities: Determinants and Interventions

Despite nearly three decades of empirical research, self-injurious behaviour (SIB) in people with learning disabilities remains poorly understood and difficult to ameliorate. This paper reviews the relevant findings from prevalence studies and the proposed theories of aetiology and presents an integrated model of operant and organic factors as determinants of SIB. The evidence for the model is reviewed and the impact made by theories of aetiology on the nature of interventions is evaluated. It is suggested that intervention efficacy is currently assessed without regard to the determinants of SIB and that such an outcome-led approach has not enhanced understanding or aided clinical decision-making. Future directions for research are proposed which stress the need for further consideration of the potential determinants of SIB and their relationship to intervention efficacy.