Multiple factors in the long-term effectiveness of contingent electric shock treatment for self-injurious behavior: a...

This report describes the effective treatment of self-injurious behavior (SIB) using contingent electric shock in an adolescent. Data are presented to document the initial dramatic reduction in SIB and the ongoing effectiveness of the treatment over a 5-year period. Positive side effects of the intervention are documented, as is information on the interaction of a medical condition (e.g., ear infections, fever), psychoactive medication status, and staff changes that served to effect the rate of SIB across 4 years of treatment. Recognizing and attending to these various factors has served to insure the success of the aversive intervention with very low rates of SIB and, consequently, very low rates of the administration of electric shock. Keeping the rate of administration of shock low serves to decrease the chances of habituation to the shock thereby emphasizing the importance of attending to the individual's total medical, social, and administrative environments.