The Self-Injurious Behavior Inhibiting System (SIBIS) is an apparatus designed to reduce

self-injurious behavior Self-harm is intentional behavior that is considered harmful to oneself. This is most commonly regarded as direct injury of one's own skin tissues usually without a suicidal intention. Other terms such as cutting, self-injury and self-mutilatio ...

(SIB) directed at the head, such as banging the head against walls and other objects or hitting oneself in the head. Invented by Dr. Robert E. Fischell, Glen H. Fountain, and Charles M. Blackburn in 1984, the device is able to detect instances of head-directed SIB, and delivers an

aversive In psychology, aversives are unpleasant stimuli that induce changes in behavior via negative reinforcement or positive punishment. By applying an aversive immediately before or after a behavior the likelihood of the target behavior occurring in t ...

electric shock Electrical injury is a physiological reaction caused by electric current passing through the body. The injury depends on the density of the current, tissue resistance and duration of contact. Very small currents may be imperceptible or produce a ...

contingent on its occurrence. The

United States Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a federal agency of the Department of Health and Human Services. The FDA is responsible for protecting and promoting public health through the control and supervision of food s ...

banned the device in 2020 as part of a larger blanket ban on devices that use electric shocks to modify behavior without the consent of the user. Other devices covered by this ban include the

Graduated Electronic Decelerator The graduated electronic decelerator (GED) is an aversive conditioning device that delivers a powerful electric skin shock to punish behaviors considered undesirable. The GED was created by Matthew Israel for use on students at the Judge Roten ...

Effectiveness and Safety

The

(FDA) has concluded that

conditioning devices like the SIBIS pose an "unreasonable risk of harm" and are less effective than

positive behavior support Positive behavior support (PBS) uses a combination of tools from Applied behaviour Analysis and combines it with the values from the 'normalisation and social role valorisation theory' to focus on improving Quality of life. PBS uses functional an ...

alone. While some studies appear to support their efficacy, these studies do no meet modern standards of evidence. Newer and better designed studies find more risks and fewer benefits. The FDA states that such devices may cause both physical and psychological harm, including: depression, anxiety, worsening of self-injurious behavior,

PTSD Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that can develop because of exposure to a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on a ...

, burns, and pain.

Design

There are two models of SIBIS. The simpler model consists of an

electrode An electrode is an electrical conductor used to make contact with a nonmetallic part of a circuit (e.g. a semiconductor, an electrolyte, a vacuum or air). Electrodes are essential parts of batteries that can consist of a variety of materials ...

and a radio transmitter wrapped around the arm or leg using

Velcro Velcro, officially known as Velcro IP Holdings LLC and trading as Velcro Companies, is a British privately held company, founded by Swiss electrical engineer George de Mestral in the 1950s. It is the original manufacturer of hook-and-loop fast ...

. When a child administers a blow to the head, the SIBIS device is used to recognize the self-injurious behavior. This is possible because the SIBIS device is composed of two wirelessly connected parts: the "sensor module" and the "stimulus module". The

impact monitor A shock detector, shock indicator, or impact monitor is a device which indicates whether a physical shock or impact has occurred. These usually have a binary output (go/no-go) and are sometimes called ''shock overload devices''. Shock detect ...

serves to both detect an impact to the head and to protect the head from the damage that the impact could potentially incur. The sensor module is placed on either the body part receiving the impact (such as the head) or on the body part delivering the impact (such as the arm or knee). Wherever it is placed, the sensor module senses the impact of the blow and sends out an electrical signal. This electrical signal triggers the stimulus module, allowing for the aversive stimulation, the shock, to be delivered.

Specifications

SIBIS is designed to reduce SIB by immediately delivering

positive punishment In operant conditioning, punishment is any change in a human or animal's surroundings which, occurring after a given behavior or response, reduces the likelihood of that behavior occurring again in the future. As with reinforcement, it is the ''be ...

when head-directed SIB occurs. Only 5 cm × 3 cm × 1 cm in size,Linscheid, T.R., Iwata, B.A., Ricketts, R.W., Williams, D.E., & Griffin, J.C. (1990). Clinical evaluation of the self-injurious behavior inhibiting system (SIBIS). Journal of Applied Behavior Analysis, 23, 53–78. the stimulus module delivers an 85 V electrical shock at 3.5 mA of current to the subject each time the patient strikes his or her head sufficiently hard enough to register on the velocity impact detector.Salvy, S., Mulick, J., Butter, E., Bartlett, R.K., & Linscheid, T.R. (2004). Contingent electric shock (SIBIS) and a conditioned punisher eliminate severe head banging in a preschool child. Behavioral Interventions, 19, 59–72. The delivered shock is designed not to be very painful, but rather an uncomfortable response to the SIB. The impact detector of the apparatus can be adjusted.

Judge Rotenberg Center

The SIBIS was used at the

Judge Rotenberg Center The Judge Rotenberg Center (founded in 1971 as the Behavior Research Institute) is an institution in Canton, Massachusetts, United States, for people with developmental disabilities, emotional disorders, and autistic-like behaviors. The center ...

between 1988 and 1990 as part of the school's behavior modification program. Behaviorists at the center used the SIBIS not only for the purpose of reducing self-harming behavior, but to deter any behavior that they considered undesirable. The school's behaviorists were not satisfied with the SIBIS because its shock was not powerful enough to produce compliance some cases: The school's founder,

Matthew Israel Matthew Israel is an American behavioral psychologist who is known for founding the Judge Rotenberg Center and inventing the Graduated Electronic Decelerator. As a freshman in college, Israel read B. F. Skinner's novel, ''Walden Two'', in which t ...

, reported that one student was shocked by the SIBIS over 5000 times in a day without the desired change in behavior. Israel asked the manufacturer of the SIBIS, Human Technologies, to build a device that delivered stronger shocks, but they refused. Israel then designed the

(GED), which delivered much more powerful shocks than the SIBIS that lasted ten times as long. The SIBIS was soon phased out at the Judge Rotenberg Center in favor of the GED.

References

External links