Long-term use of electrical aversion treatment with self-injurious behavior.

Duker et al. (1996) tracked twelve adults with severe intellectual disability who hit or bit themselves. Each person wore a small shock device on the waist. Staff pressed a remote button to deliver a quick shock right after self-injury.

The team followed everyone for two to forty-seven months. They counted how often restraints were needed to keep each person safe.

Seven people stopped almost all self-injury and no longer needed restraints. Three people improved but still needed restraints some days. Two people showed little change and kept daily restraints or shocks.

In plain numbers: the shock worked fully for just over half, partly for a quarter, and failed for a sixth.

Staddon et al. (2002) used the same shock method on one man and kept him near zero self-injury for five years. Their longer follow-up shows the 1996 mixed results can turn into steady success when medical, medication, and staff factors are watched daily.

Ahlborn et al. (2008) looked for side effects like fear or withdrawal in similar clients. They found none and even saw some social gains. This answers the worry raised by C et al. that shocks might harm quality of life.

C et al. (1996, reinforcement paper) treated covert self-injury without any shock. They got almost perfect reduction by rewarding clear skin found at nurse checks. The contrast shows you can sometimes swap punishment for reinforcement and still win.

If you work with severe self-injury, this paper tells you two things. First, electric aversion can remove restraints for many clients, so it stays in the toolbox for life-threatening cases. Second, success is not guaranteed: plan for medical checks, staff retraining, and a back-up restraint protocol for the one-in-six who do not respond. Always pair the shock plan with reinforcement for safe behavior and review ethics often.