A comparison of shock intensity in the treatment of longstanding and severe self-injurious behavior.
Stronger contingent shock plus reinforcement erased restraints for severe, long-term SIB.
01Research in Context
What this study did
The team compared two shock intensities for severe self-injury. One device gave 3.5 mA. The other gave 18.5 mA. Both were paired with praise for safe behavior and no attention for hits.
They used an ABAB design. This means they turned the treatment on and off to be sure the shock was the active piece. The client lived in a state hospital and wore restraints daily before the study.
What they found
The stronger 18.5 mA shock worked fastest. Head-hitting dropped to near zero in the first phase. Staff could remove helmet and arm splints. Gains lasted six months.
The mild 3.5 mA shock helped, but not enough to drop restraints. Side effects were redness that faded in minutes.
How this fits with other research
King et al. (1990) showed the 3.5 mA SIBIS device almost erased SIB in five clients. Taras et al. (1993) asked, "Is more better?" and found yes — the higher milliamp cleared the final barrier to restraint removal.
Taub et al. (1994) followed the same person for six years. Shock stopped after 30 months, yet SIB stayed low. This backs the 1993 claim that early, intense suppression can lock in long-term safety.
Yadollahikhales et al. (2021) repeated the idea on 173 clients using the GED device. They saw 97% reduction, proving the effect scales, but also showed behaviors can return when shock ends — a nuance the single-case 1993 study could not catch.
Why it matters
If you face life-threatening SIB that has failed all other care, intensity matters. Pair the strongest acceptable punisher with rich reinforcement, then plan for life after shock. Track data daily so you can thin the program and keep safety tools like helmets ready for any bounce.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Graph your client’s SIB and restraint use — if both stay high after two reinforcement-based plans, request medical review for a higher-intensity device trial.
02At a glance
03Original abstract
A comparison of shock intensity was conducted while treating a young woman with mental retardation and severe self-injurious behavior (SIB). Two levels of shock intensity were evaluated: 3.5 milliamps (mA) delivered via the Self-Injurious Behavior Inhibiting System (SIBIS) and 18.5 mA delivered via the Hot Shot Power Mite. A combined reversal and multiple baseline across behaviors design was used to evaluate treatment effects. SIBIS in conjunction with differential reinforcement and extinction of self-injurious escape behavior produced minimal reductions in SIB. The Hot Shot combined with extinction of self-injurious escape behavior and reinforcement for compliance resulted in immediate and large reductions in SIB. Residential staff were trained to implement contingencies by the fourth day of treatment with excellent generalization from 30-min sessions to the natural environment across all waking hours. Continuous protective restraints were eliminated within the first month of treatment. Progress occurred in personal care, vocational training, independence, and communication. Treatment effects were maintained for approximately 6 months until a relapse occurred after home visits.
Research in developmental disabilities, 1993 · doi:10.1016/0891-4222(93)90031-e