Contingent electric shock (SIBIS) and a conditioned punisher eliminate severe head banging in a preschool child

We report a case in which a Self‐Injurious Behavior Inhibiting System (SIBIS) device and a conditioned punisher were utilized to decrease and maintain suppression of severe head hitting/banging in a preschool child. After an experimental evaluation conducted at the hospital, SIBIS was implemented at home. The originality of this particular SIBIS case study is that programmed and systematic effort at establishing conditioned punishment was included in the intervention. Results indicate that a zero‐level response was rapidly reached, and that the conditioned punisher (i.e. verbal prompt + movement towards the place where SIBIS was kept) was sufficient to maintain treatment effects. Continuous assessment after treatment and formal observation session at 7 months follow‐up revealed that SIBIS could be removed from the natural environment of the child while maintaining a therapeutic effect. These results were interpreted as the effects of the explicit pairing between the delivery of electric stimulations and previously neutral stimuli, which were initially ineffective to elicit any response, or to suppress SIB. Close and extended monitoring during and after treatment failed to reveal the presence of negative side effects associated with SIBIS, whereas a number of positive effects were observed. Copyright © 2004 John Wiley & Sons, Ltd.