Current trends in the treatment of self-injurious behavior.

This chapter attempted to outline current trends and recent advances in the treatment of SIB. The major focus has been on the behavioral techniques, since it was obvious that at this stage other approaches have little to offer either diagnostically or therapeutically. It was pointed out, however, that these approaches and drug therapy in particular need further investigation before their role in the treatment of SIB can be adequately assessed. This chapter critically evaluated the current behavioral approaches in some depth and advanced several recommendations for future work. The general impression gained from current research is that significant advances have been made in the last decade in our understanding of the problem and that a small number of well-controlled studies have shown that SIB in certain children can be controlled for up to three years. Yet a concerted research effort is required to overcome the methodological problems that appeared with disconcerting regularity in most of this research. It is sobering to note that no current prevalence studies of SIB report a major decline in the prevalence of SIB in pediatric populations despite our current ability to provide some form of meaningful treatment.