PT  - JOURNAL ARTICLE
AU  - Golnaz Yadollahikhales
AU  - Nathan Blenkush
AU  - Miles Cunningham
TI  - Response patterns for individuals receiving contingent skin shock aversion intervention to treat violent self-injurious and assaultive behaviours
AID  - 10.1136/bcr-2020-241204
DP  - 2021 May 01
TA  - BMJ Case Reports
PG  - e241204
VI  - 14
IP  - 5
4099  - http://casereports.bmj.com/content/14/5/e241204.short
4100  - http://casereports.bmj.com/content/14/5/e241204.full
SO  - BMJ Case Reports2021 May 01; 14
AB  - A small proportion of patients with intellectual disabilities (IDs) and/or autism spectrum disorder (ASD) exhibit extraordinarily dangerous self-injurious and assaultive behaviours that persist despite long-term multidisciplinary interventions. These uncontrolled behaviours result in physical and emotional trauma to the patients, care providers and family members. A graduated electronic decelerator (GED) is an aversive therapy device that has been shown to reduce the frequency of severe problem behaviours by 97%. Within a cohort of 173 patients, we have identified the four most common patterns of response: (1) on removal of GED, behaviours immediately return, and GED is reinstated; (2) GED is removed for periods of time (faded) and reinstated if and when behaviours return; (3) a low frequency of GED applications maintains very low rates of problem behaviours; and (4) GED is removed permanently after cessation of problem behaviours. GED is intended as a therapeutic option only for violent, treatment-resistant patients with ID and ASD.