Linscheid, Iwata, Ricketts, Williams, & Griffin (1990) “Clinical Evaluation of SIBIS”
Advantages of Shock as an Aversive Stimulus:
Parameters can be precisely quantified (e.g., vs. physical contact)
Parameters can be selected to minimize risk
Stimulation can be delivered quickly (not delayed or paired with social interaction)
Does not interfere with ongoing activity (e.g., vs. timeout)
Discrete event that does not linger (e.g., vs. tastes)
Novelty
Disadvantages of Shock
Socially objectionable
Often confused with electroconvulsive therapy (ECT)
Experiences with shock are limited
SIBIS
Principals:
Leslie Grant (father): invented prototype
Robert Fischel (JHU, Applied Physics Lab): designed SIBIS
Thomas Linscheid (Georgetown): Treated most of patients
Brian Iwata (JHU): Designed clinical trial
Primary Functions:
Automatic detection of forceful blows
Response-contingent delivery of stimulation
Automatic recording of stimulus delivery
Additional Functions:
Remote feature
Tone delivered w/ shock
Intermittent feature
DRO interval timer: Therapist cueing device or automated DRO delivery
Procedures
Participants: N=4 (CA = 11-24)
DV: SIB (head hitting or banging), Responses / min
# Shocks
Other SIBs (Marie)
“Affective” behaviors (Johnny)
Conditions:
Control:
Baseline: No interaction
Helmet Baseline (Johnny, Michael)
SIBIS Inactive: Stimulus module inoperative
Treatment:
SIBIS
SIBIS Remote (Michael, Diane, due to false negatives)
SIBIS Remote + DRO (Diane)
Summary of Findings
Marie Johnny Donna Michael Diane
Short-Term + + + + +
Maintenance + + + + +
Generalization + + + + +
Indirect Pos Alt SIB ∆- Alt App ∆+ Anecdotal Positive Results
Indirect Neg False Neg ø ø False Pos ø
Follow-Up SIBIS Supervis. Restraint Fading Drugs
Discont’d Reduced Reduced Initiated Reduced
Implications and Extensions
Major contributions:
Demonstration of automated, safe form of shock
Generality across clients, experimenters, settings
Inclusion of additional measures of effectiveness
Limitations:
False positives and negatives
Limited fading of shock
Conditioned punishment and Automated DRO / TO functions?
Extensions:
Shock fading, conditioned punishment, DRO / TO
Extension to other stimuli and/or behaviors
Rapp, Miltenberger, & Long (1998): “Awareness enhancement device” (noise)
Automated reprimands?