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Five cases involving the treatment oflongstanding, severe, and previously unmanageable self-injurious behavior are presented. In each case, the behavior was forceful contact with the head or face, and treatment consisted of mild and brief contingent electrical stimulation, delivered automatically or by a therapist, via the Self-Injurious Behavior Inhibiting System. Results of reversal and/or multiple baseline designs, in which sessions ranged in duration from 10 min to all day across a variety of settings, showed that the effects of the system were immediate and produced almost complete elimination of the self-injurious behavior. Controlled and anecdotal follow-up data for four of the five cases suggest continuing benefits and the absence of detrimental side effects associated with treatment. Potential applications of the device, as well as extensions and limitations, are discussed.DESCRIPTORS: self-injurious behavior, electrical stimulation, punishmentWe express our deepest appreciation to the parents and guardians of those who participated as subjects in this study for their support and cooperation. We also thank the following individuals for their invaluable work on the development of SIBIS (Robert Fischell, Leslie and Mooza Grant, Arnold Newman, and Gary Pace) and their assistance in conducting various aspects of the research

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The self-injurious behavior (SIB) of a blind, profoundly retarded male was observed within a field setting as multiple forms of punishment were applied. The effects of hairtug punishment were first systematically examined, then hair-tug and electric shock punishment were administered in varing ratios (of punishment deliveries per SIB response) supplemented by continuous restraint contingencies and made contingent on recurrent antecedents of SIB cycles. Treatments were applied over six months of consecutive daily sessions ranging from 30 min to 8 hr duration. Posttreatment followup observations were taken 12, 24, and 34 months after treatment. Partial suppression was produced as a direct function of hair-tug punishment in the initial phase. A generally progressive decrement was produced on already lowered SIB rates with the succeeding components of the treatment package. Extended periods of total SIB suppression occurred as punishment was rendered contingent on antecedent components of each SIB response cycle. Followup observations of nearly 3 yr duration indicated total suppression generalized over all settings in which the subject functioned. The findings were related to the contrasting limits prevailing in most reports of punishment-based SIB suppression.