The punishment of persistent vomiting: a case study.

One teenager with intellectual disability vomited after every meal. Doctors could find no physical cause.

The team taped a small sensor to the teen’s stomach. The sensor blinked when stomach muscles tensed right before vomiting.

Each blink triggered a quick shock through a wrist strap. The goal was to stop the stomach tension, then stop the vomiting.

Stomach tension dropped almost to zero in the first week. Vomiting stopped and weight came back.

When the shocks paused, vomiting returned. When shocks resumed, vomiting stopped again.

Yadollahikhales et al. (2021) later used a modern shock device called GED on 173 clients and saw the same sharp drop in severe behavior. Their larger study shows the 1970 method works, but today we have safer, standardized equipment.

Bacon-Prue et al. (1980) wiped out vomiting without any shock. They paid a boy for playing with toys after meals and simply ignored vomiting. Vomiting still vanished. Their result extends the 1970 finding: you can get the same outcome with reinforcement instead of pain.

Silverman et al. (1994) repeated the no-shock theme. They filled a teen with autism on high-calorie drinks first, then limited food texture and added quiet mealtime rules. Vomiting stayed gone for four months. Together these studies replace the 1970 punishment model with ethical, practical alternatives.

The 1970 paper proves contingent shock can stop vomiting, but later studies reach the same goal without it. Today you can pick reinforcement, satiation, or texture changes first. Reserve aversives only for the rarest, most dangerous cases—and only with full oversight. Your next client with rumination can start with a simple toy-play plan after meals, not a shock device.