On The Use of Electric Shock in ABA
I've been in the field for decades specializing in high intensity, high risk individuals both children and adults and have never had to use shock or other such intrusive non-functional punitive procedures. I spent 5 years in the Department of Behavior Psychology at The Kennedy Krieger Institute; almost one year in-patient the rest out patient and have never seen or used shock or other such severely intrusive non-functional punishment strategies for even the most severe behavior.
Keys to authentic success are driven by a comprehensive ecological Functional Behavioral Assessment/Analysis to include extensive history, contact across primary caregivers and providers and previous archival records ranging from school to other related services. Etiological variables to include poor and abusive previous treatment attempts along with misuse of medication must also be considered.
Active observation of and interaction with the child in their world is another high priority. We can't help people we don't know. Behavior manifestation is not the person. Analogs are then created, probes initiated and extensive data collected based on specific hypotheses. Functional Communication Training is always prioritized and highly individualized.
Reduction - punishment - strategies, are not irrelevant but must always be minimally intrusive and fully justified with instruction on functionally aligned appropriate alternative behaviors prioritized. Environmental reorganization and prescriptive training of primary caregivers and providers are additional and key components in this process.
Punishment/extinction effectively reduces behavior only when it denies reinforcement to that which is maintaining the behavior (the function). Punishment and extinction do not mean ignoring the person but to replace and make the interfering behavior(s) ineffective, irrelevant and inefficient.
Shock as punishment is abusive, extremely intrusive and most often used involuntarily on the target person (would the target person agree to such an intervention on themselves?). Shock doesn't generalize, can create extreme reactivity and PTSD like responses. It's often misrepresented to families and caregivers who don't understand and aren't advised of the depth and nature of the field of Applied Behavior Analysis.
Shock treatments are also often misrepresented as the last alternative available. Any family/caregiver told electric shock is the last alternative for their child's severe behavior needs have clearly gone to the wrong agency and/or provider.
I can't even count how many times I've been told 'we've tried everything' and/or 'S/he doesn't have any reinforcers.' I also can't count how many times, no matter how honestly believed, these are inaccurate statements with plenty of combined person/family-centered alternatives regularly available. And such circumstances still would not include more intrusive, decontextualized and non-functional interventions to include shock
The FDA's permission to the use of electric shock therapy was a sad reversal of the original correct decision to permanently ban its use. This decision also allows a continued, tragic and severe misrepresentation of the field of Applied Behavior Analysis. There is no need for shock therapy other than as a choice by clinicians who will not do the work needed one person at a time; who do not know what else to do.
