Response patterns for individuals receiving contingent skin shock aversion intervention to treat violent self-injurious and assaultive behaviours.

The team looked back at 173 adults and teens with autism or intellectual disability. All had life-threatening self-hitting, head-banging, or attacks on others.

Each person wore a graduated electronic decelerator (GED). The device gives a brief skin shock right after a dangerous act. Staff kept daily behavior counts for months or years.

Problem behavior dropped 97% when the GED was active. Four clear response patterns showed up: quick drop, slow drop, up-and-down, and no change.

When the device was removed, most people regressed. The shocks worked fast, but the gain vanished without them.

Taub et al. (1994) tracked one man for six years after SIBIS shocks stopped. His self-injury stayed low, unlike the 2021 group who relapsed. The 1994 case added months of reinforcement and practice without shock—likely why gains held.

Hatton et al. (1999) found that plain extinction caused bursts or new aggression in half of 41 cases. GED’s instant shock side-steps that burst, giving the 97% drop C et al. could not reach.

Rayfield et al. (1982) and Luiselli (1986) used contingent helmets or mittens instead of shock. They also cut SIB, but gear is easier to fade than a device that must stay on to keep the effect.

If you face extreme, court-ordered cases, GED can give rapid suppression. Yet the data scream one lesson: plan for maintenance from day one. Pair the device with rich reinforcement, replacement skills, and caregiver training so you can fade the shock safely. Without that plan, the behavior will come back the moment the GED comes off.