Additional Comments on the Use of Contingent Electric Skin Shock

Fisher and colleagues wrote a position paper. They looked at all studies on contingent electric skin shock. They focused on kids and adults with autism or intellectual disability.

The authors asked three questions. Does shock work better than other treatments? Do we need it when less-hurt options exist? Is it ethical to use pain as a punisher?

Shock did not beat less-intrusive tools. Good behavior plans, restraint fading, or skill teaching worked as well or better.

The team also found no proof that shock is safe long term. Burns, PTSD, and loss of trust were reported. They say the risk is too high.

Fields et al. (1991) asked staff how they felt. Staff who could use strong aversives said they felt more in control. Fisher et al. (2023) counters that staff comfort is not the same as client safety. The two papers clash until you see they measure different people.

Morgan et al. (2017) give a real example. They used a soft belt plus arm splints to stop self-hitting. The belt faded and the behavior stayed low. This supports Fisher’s claim that less painful tools can work.

Oliver et al. (2002) warned years ago that punishment science is thin. Fisher’s 2023 paper echoes that call and says stop using shock until we have safer, proven options.

If you write behavior plans, this paper is a stop sign. Electric shock has no extra power over today’s alternatives and carries heavy ethical weight. Choose restraint fading, functional communication, or differential reinforcement first. Document why you picked each tool and keep data. Your clients stay safer and your practice stays current.