INFORMATION ABOUT THE USE OF CONTINGENT SKIN SHOCK FOR SEVERE PROBLEM BEHAVIOR
Staff scream for help as Jane sheds her protective helmet, throws her iPad, and sinks her teeth into well-formed hand callous (from a decade of biting) drawing blood. Jane moves towards a wall and ruptures the spleen of an approaching staff with a kick. Now against the wall, Jane bends over and throws her head backwards disintegrating drywall not bolstered by 2 x 4’s. Six men sweat, strain, and struggle to contain Jane (now supine on a mat: aka emergency restraint) as she bites, scratches, and screams for an hour. This isn’t a bad day, this is every day….an inevitability unchanged by drugs, love, 15 years of treatment; and yes, unchanged by state-of-the-art function based behavioral treatments.
Jane’s behavior problem required her to leave her home at age 11. By 16, forty residential programs rejected her, dozens of experts evaluated her, and hundreds of staff restrained her thousands of times. The result? Jane is left wearing a helmet 24 hours per day. An attendant hovers over her all night, when she is in the bathroom, and anywhere else she goes to stop Jane from self-inflicted blindness, brain injury, fracture, laceration, or other injury. Jane does not go home. Jane rarely goes into the community. Jane’s development is arrested by her intractable behavior disorder.
Once per month on average, Jane raises her unblemished hand to her mouth to bite. A highly trained and experienced staff member skillfully opens a plastic box and presses a button causing 2 seconds of safe electrical current (one-one-thousand, two-one-thousand) to pass between two nodes of an electrode. Jane stops biting, puts her hand down, and returns to the task presented to her. Yesterday, Jane went the mall and ate at a restaurant. This weekend, Jane is vacationing in Vermont with her family. She is never restrained. She is never injured and never injures. The terrible, pernicious, and pervasive behavior problem that dominated her life is in remission.