Matson Johnny L, Lovullo Santino V
Department of Psychology, Louisiana State University, Baton Rouge, USA.
Behav Modif. 2008 Jan;32(1):61-76. doi: 10.1177/0145445507304581.
Autism spectrum disorders (ASD) are considered to be among the most serious of the mental health conditions. Concomitant with many cases of ASD is intellectual disability. Further compounding the disability is the fact that both conditions are known risk factors for self-injurious behavior (SIB). To date, the most effective intervention methods, based on the available data, appear to be variants of behavior modification. This article provides an overview of the current status of learning-based interventions for SIB in ASD and provides a review of specific studies. Although most studies describe some combination of reinforcement and punishment procedures, efforts are under way to develop more positively oriented strategies, such as functional assessment, to decrease the use of punishment. However, almost all the treatment studies employ single case designs, thus preventing a comparison of treatment efficacy. These issues are discussed along with other strengths, weaknesses, and future directions for clinical practice and treatment.
自闭症谱系障碍（ASD）被认为是最严重的心理健康状况之一。许多自闭症谱系障碍病例伴有智力残疾。这两种状况都是已知的自伤行为（SIB）风险因素，这进一步加剧了残疾程度。迄今为止，根据现有数据，最有效的干预方法似乎是行为矫正的变体。本文概述了针对自闭症谱系障碍中自伤行为的基于学习的干预措施的现状，并对具体研究进行了综述。尽管大多数研究描述了强化和惩罚程序的某种组合，但目前正在努力开发更积极的策略，如功能评估，以减少惩罚的使用。然而，几乎所有的治疗研究都采用单病例设计，因此无法比较治疗效果。本文将讨论这些问题以及临床实践和治疗的其他优点、缺点和未来方向。
