Contingent Electric Skin Shock (CESS) Task Force
The ABAI Executive Council appointed this Task Force to assess the use of contingent electric skin shock (CESS) in the treatment of severe challenging behavior in consideration of the well-being of the individuals served, the effectiveness of CESS and alternative interventions, and the ethical considerations.
Task Force Members
CESS Task Force members’ conflicts of interest: The members of the task force conducted their work on a voluntary basis. They attest that they have no financial or professional relationship with any organization that uses CESS, and that the ABAI Executive Council has not attempted to influence the preparation of the task force’s position statement.
Task Force Charge
The Task Force was charged with addressing the following questions in its report to Council:
- How is CESS used in contemporary behavior analysis? What are best practices for implementing CESS and fading it out of a treatment plan or removing it altogether?
- What are best practices for ensuring the safety of clients treated with CESS?
- For the type of behavior that is treated with CESS, and the conditions under which the behavior occurs, what alternatives to CESS are available?
- How effective is CESS?
- How effective are the alternatives to CESS?
- What are the costs and benefits of CESS to the clients and others?
- What are the costs and benefits of the alternatives to the clients and others?
- What ethical issues are raised by CESS that distinguish it from the alternatives?
- How are the ethical issues raised by CESS addressed in contemporary behavior analysis?
Task Force Report
From February through September 2022, the CESS Task Force conducted an extensive, systematic, and detailed review of CESS as a behavioral intervention and the issues associated with its use. This review included the following: 1) considering the written and oral comments provided by ABAI members, nonmembers, affiliated organizations, and other interested stakeholders; 2) studying the published research on CESS; 3) interviewing staff, clients, and client family members affiliated with CESS interventions at the Judge Rotenberg Center, the only agency that includes CESS in its service programs; 4) interviewing the directors of major behavior-analytic treatment centers who have expertise in the treatment of severe challenging behavior; and 5) studying ethical standards as they pertain to the use of punishment in behavior-analytic practice. The CESS Task Force has completed a report of its review in response to the charge from the ABAI Council. The preliminary draft of recommendations for a statement on CESS was posted to all members for commentary on October 3, 2022. The period of commentary lasted until 11:59PM EDT, October 17, 2022. We thank all the members who provided input. Both the CESS Task Force and the ABAI Executive Council reviewed members’ commentary. The CESS Task Force examined all the members’ input carefully on an ongoing basis during the period of commentary. Based on the valuable input of the members’ commentary, the CESS Task Force reviewed its Draft Recommendations for a Statement on CESS and submitted their final version on October 18, 2022.
Please be aware that you must be an active ABAI member and log into the ABAI website portal to read the Task Force’s Report.
Positions on CESS Submitted to Full Members for a Vote
The ABAI Executive Council reviewed both the Final Recommendations of the CESS Task Force as well as the commentary from members. The Executive Council appreciates the thoughtful, honest, and detailed suggestions from the members, which included a wide range of perspectives. The discussion by the Council reflected a similar range of views. After extensive and collegial debate, it became clear that no single statement put forward by the Council could capture the diversity of opinion and that no single position could be endorsed unanimously by all members of the Council.
The ABAI Executive Council agreed to offer two position statements for a vote by the Full members, consistent with the ABAI bylaws. The positions were released on October 24, 2022. Both position statements are informed by the Task Force’s report and members’ commentary. The Council will support the vote of the membership.
Results of the vote: The ballots were opened on November 15 at 10 am EST. Present at the meeting were three ABAI Presidents, CEO, attorney, and two staff members. The ballots were opened for the first time using a system-generated password, scheduled to be released on this date; no one had prior access to the votes. Votes remain confidential at all times.
Of voting Full members, the majority voted for Position B. Therefore, Position B is now the official position of ABAI on the use of CESS. The Executive Council supports the vote of membership. We appreciate the input and participation of members both during the period of commentary and the final vote.
ABAI Council members’ conflicts of interest: The members of the ABAI Executive Council (voting and nonvoting) have no financial or professional relationship with any organization that uses CESS. The Judge Rotenberg Center has been an exhibitor at the ABAI annual convention. Consistent with ABAI’s exhibitor policy, exhibiting or promotion of services, products, or equipment at the ABAI exhibit does not constitute endorsement by ABAI. An exhibitor is not permitted to represent in any manner that its goods or services have been endorsed by ABAI.
November 2021: The Council initiated the procedure set forth in the bylaws to consider a position statement on the use of CESS in the treatment of severe challenging behaviors.
January 2022: The Council confirmed participation of the Task Force members. The Task Force began its work.
May 2022: The Task Force hosted a panel discussion to share its progress and obtained input from invited participants and members of the audience.
September 2022: The Task Force submitted a written report to the Council. The Council reviewed the report and recommendations of the Task Force.
October 3, 2022: The ABAI Executive Council invited member input on the CESS Task Force's Draft Recommendations for a Statement on CESS, based on the study of the Task Force Report.
October 17, 2022: The period for commentary on the Task Force's Draft Recommendations for a Statement on CESS closes at 11:59PM EDT.
October 18, 2022. The CESS Task Force sent the final recommendations of the for a statement of CESS to the ABAI Executive Council.
October 21 and 22, 2022. The ABAI Executive Council met and carefully reviewed and deliberated on the Final Recommendations of the CESS Task Force and members’ commentary. The Council decided that two position statements would be submitted to the Full members for a vote.
October 24, 2022. The ABAI Council presented two position statements on CESS for a vote of the Full members. Both positions have been informed by the CESS Task Force Report and recommendations and members’ commentary.
November 14, 2022. The period of voting ends at 11:59 p.m. EST.
November 15, 2022. The ballots of voting Full members were counted at 10:00 a.m. EST.
November 16, 2022. The results of the Full members’ vote are released. The majority vote determined ABAI’s position on CESS: Position B, we strongly oppose the use of contingent electric skin shock (CESS) under any condition.
This sequence of steps is required by ABAI bylaws, and a majority vote of ABAI Full members is required for adoption of an organizational position statement.
Three CESS-related events were presented at that 2022 ABAI Annual Convention in Boston. We regret that our limited space availability and the fire code restrictions did not permit all those interested to watch the presentations live. In response to attendee inquiries, we are offering access to the session recordings for all convention registrants and current ABAI members. To see details of the events and their videos, please click the link of the relevant event below.
You must be a current ABAI member or a 2022 convention registrant to view the session recordings.
The CESS Task Force and the ABAI Executive Council reviewed input from members received from February 17 to September 28, 2022. Members were invited to share information and suggestions with the Task Force via an input form. The Task Force thoroughly reviewed all input submitted and took it into consideration for their report and recommendations. The input from members was also reviewed by the ABAI Executive Council. That form for the preliminary input to the Task Force is now closed; a new period of commentary opened to respond to the CESS Task Force's Draft Recommendations for a Statement on CESS on October 3 and closed on October 17.