A maintenance strategy for discontinuing aversive procedures: a 52-month follow-up of the treatment of aggression.

A strategy for systematically discontinuing aversive treatment components is illustrated with a 52-month follow-up of the treatment of severe aggression by an institutionalized, dually diagnosed deaf male. Phase 1 lasted 28 months and included: (a) contingent electric shock, (b) a high density positive reinforcement, (c) compliance training, (d) transfer of programmatic responsibility to others, and (e) a relaxation procedure. Phase 2 has lasted for 24 months and features (a) replacing shock with decreasing durations of nonexclusionary timeout and (b) naturally occurring reinforcers. Aggression has remained very low for over 4 years. The client is in an all day workshop, visits home frequently, and accompanies his parents on vacation. A social validity questionnaire revealed that he has become more sociable and less dangerous.