Multiple considerations in the long-term treatment of self-injurious behavior with contingent electric Shock: a case illustration Thomas R. Linscheid The Ohio State University, USA The use of contingent electric shock to dramatically reduce the rates of self-injurious behavior (SIB) is well documented. However, the utility of this treatment on a long term basis has yet to be studied in detail. Questions as to fading of the treatment or methodologies to insure continued effectiveness beyond the initial suppression are of great importance. This presentation will describe the long term use of the Self-Injurious Inhibiting System (SIBIS), a device for administering contingent electric shock, in five cases. One case, illustrating the numerous considerations necessary to insure continued effectiveness of the treatment will be presented in detail. The importance of considering concomitant pharmacological interventions, medical conditions, and social and environmental factors will be discussed. Five years of data will reveal the importance of these factors in overall suppression and it will be shown that mild increases in the rate of SIB can be used diagnostically to predict medical states such as ear infections or medication errors. Considerations for long term use and indications for fading the treatment, and positive side effects will be discussed and illustrated Keywords: developmental disabilities, self-injurious behaviour, SIBIS, contingent electric shock, positive side effects

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