Clinical evaluation of the self-injurious behavior inhibiting system (SIBIS).

The team tested a small device called SIBIS. It gives a quick, mild shock right after a person hits their head.

Five people with severe head-banging wore the device. The study used a multiple-baseline design across participants.

Head-banging almost stopped the moment SIBIS turned on. The change was large and immediate.

Benefits lasted with no reported side effects.

Johnson et al. (1994) followed up four years later. They saw the same near-zero head-banging plus a surprise: clients smiled and laughed more after SIBIS was introduced.

Taub et al. (1994) tracked one client for six years. Head-banging stayed low even after shocks ended at 30 months. These two papers extend the 1990 finding by showing long-term maintenance and positive side effects.

van der Miesen et al. (2024) pooled newer SIB studies but did not include this 1990 paper. Their meta still backs the same idea: well-designed decelerative procedures work for severe self-injury.

Stokes et al. (1980) used a water-mist spray instead of shock. Mist also cut SIB fast, offering a less intrusive option when electric punishment is off the table.

If you face dangerous, treatment-resistant head-banging, SIBIS shows that immediate, contingent feedback can work fast. Pair the device with plans for fading and for reinforcing other skills, as later studies did. Always check agency rules, consent, and ethics boards—shock is a last-resort procedure.