learn to self-injure in body locations that produce the greatest neurochemical release and receptor binding (Symons and Thompson, 1997; Thompson et al., 1995). Schroeder and colleagues (Schroeder et al., 1995) reviewed animal studies of neonatal dopamine depletion relevant to the prevention of self-injurious behavior and recently used an animal model to demonstrate primary prevention of self-injurious behavior using operant conditioning (Tessel et al., 1995).
Epidemiological studies indicate that a substantial minority of all young children, with or without developmental disorders, exhibit problem behaviors at some time that might benefit from intervention (McDougal and Hiralall, 1998; Emerson, 1995). Young children with poor social skills or limited communication, including children with autistic spectrum disorders, are especially at risk for such problems (Borthwick-Duffy, 1996; Koegel et al., 1992). An analysis of five reviews of intervention approaches for the general population of individuals with developmental disabilities, conducted between 1976 and 2000, found that the target behaviors most often addressed in intervention studies were aggression, destruction of property, disruption of activities, self-injury, stereotypic behavior, and inappropriate verbal behavior (Horner et al., 2000). Horner and colleagues’ review of applied behavior analysis studies that were published since 1990 and restricted to children with autism between birth and age 8 found that the behavior problems most frequently addressed were tantrums, including crying and shouting (six studies); aggression (four studies); stereotypic behavior (two studies); and self-injury (one study).
No single intervention has been shown to deal effectively with problem behaviors for all children with autism. However, there is an increasing consensus among developmental, psychosocial, applied behavior, and legal experts that prevention of such problems should be a primary focus, particularly during the early childhood and preschool years (Berkson and Tupa, 2000; Schroeder at al., 1986; Dunlap and Fox, 1999; Schopler et al., 1995). There is also a growing consensus that the most effective form of prevention of problem behaviors is the provision and implementation of an appropriate individualized education plan (IEP) based on proven interventions that have some scientific evidence supporting their value. The New York State Department of Health panel that developed The Clinical Practice Guideline for Autism/Pervasive Developmental Disorders (New York State Department of Health, 1999) went further: “The use of an ineffective assessment or intervention method [is] a type of indirect harm