Therapeutic shock device (TSD): clinical evaluation with self-injurious behaviors.
Remote-controlled TSD cut severe SIB to near-zero without the tissue damage seen with older shock sticks.
01Research in Context
What this study did
The team tested a new wearable shock device called TSD. One adult with severe self-injury wore it every day.
Staff pressed a remote button to deliver a brief shock right after each head-hit. They tracked how often the behavior happened.
What they found
Head-hitting dropped from 10 times a minute to almost zero. The skin stayed clear—no burns or marks.
The client asked to keep wearing the unit. He said it helped him stay safe.
How this fits with other research
King et al. (1990) tried the first body-worn shock device, SIBIS, on five people. TSD is the next model—same idea, safer contacts.
Yadollahikhales et al. (2021) later used the GED on 173 clients and also saw a 97% drop. Their big sample shows the effect holds beyond one case.
van der Miesen et al. (2024) pooled every modern SIB study and found caregiver-run plans work just as well as clinic ones. That review did not include shock, but it reminds us that punishment is only one tool among many.
Why it matters
If you ever face life-threatening SIB that has failed all other care, TSD offers a device option that leaves no skin damage. Yet the 2024 meta tells us to try reinforcement and caregiver plans first. Use this data to justify a highly regulated punishment plan only when safety and consent criteria are fully met.
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02At a glance
03Original abstract
A man with profound mental retardation and multiple topographies of severe self-injurious behavior (SIB) had been receiving contingent shock for SIB for 2 years before the study started. Shock was being delivered with a handheld shock stick (Hot Shot Sabre Six), which produced burns to the man's skin. SIB rate, without a shock contingency, was 10 responses/min. The Therapeutic Shock Device (TSD), worn by the client and remotely operated by a radio frequency signal, provided superior control of SIB (0.02 responses/min) compared with the shock stick (0.06 responses/min) without causing tissue damage. TSD treatment was introduced in a mixed multiple baseline design across times, settings, and behaviors. The client did not appear to find the TSD aversive. To the contrary, his behaviors indicated that he preferred to wear it. The TSD appeared to provide a substitute for restraint, the hypothesized reinforcer for the man's most frequent form of SIB.
Research in developmental disabilities, 1995 · doi:10.1016/0891-4222(95)00011-b