|The Case for Contingent Skin Shock
|Monday, May 26, 2008
|9:00 AM–9:50 AM
|Area: CSE; Domain: Applied Research
|Chair: Nathan Blenkush (Judge Rotenberg Center)
|Discussant: F. J. Barrera (Private Consultant Practice)
|CE Instructor: Nathan Blenkush, Ph.D.
Contingent Skin Shock (CSS), within a comprehensive behavior program, is a useful (often life-saving) procedure for a small group of individuals who engage in various topographies of severe problem behaviors that are refractory to typical behavioral interventions. Opponents of CSS are often unwilling to weigh the associated risks and benefits, state that all problem behaviors can be effectively treated without CSS, and opine that skin shock is not appropriate for people who are cognitively typical. Here, we present a risk benefit analysis amongst CSS, psychotropic medications, and restraint. In addition, we describe problem behaviors that, at this time, cannot be successfully treated without CSS. Finally, we describe the usefulness of CSS with cognitively typical individuals.
|A Risk Benefit Analysis of Medication, Restraint, and Contingent Skin Shock.
|NATHAN BLENKUSH (Judge Rotenberg Center)
|Abstract: Every surgical, dental, or medical treatment involves discomfort, risks, or costs on the one hand and expected benefits on the other. A reasonable approach is to weigh the former against the latter in deciding whether to undergo or approve the treatment. Here, we present a risk benefit analysis of psychotropic medications, restraint, and contingent skin shock within the context of severe behavior disorders. The analysis suggests that CSS, combined with reinforcement procedures, is more effective, has less side effects, and allows the consumer to access more reinforcing stimuli when compared to the alternatives.
|Can All Problem Behaviors Be Treated without Contingent Skin Shock?
|GREGORY J TODISCO (The Judge Rotenberg Center)
|Abstract: There are some who assert that all problem behaviors can be effectively treated without contingent skin shock (CSS). There is no doubt, that in general, the problem behaviors of most consumers can be effectively treated without the need for a supplementary aversive such as CSS. However, there exists a group of people whose problem behaviors cannot be treated effectively with typical behavioral interventions. These people can be found in psychiatric hospitals and highly restrictive settings around the country. Here, the notion that all problem behaviors can be effectively treated without CSS is critically evaluated.
|The Value of Contingent Skin Shock with Cognitively Typical Students.
|PATRICIA RIVERA (Judge Rotenberg Center)
|Abstract: Most, if not all of the current literature on the use of contingent skin shock (CSS) focuses on the behavior problems of individuals with a diagnoses of Mental Retardation and/or Autism. There is a large population of individuals who are considered cognitively typical and have been diagnosed with Conduct Disorder, Depression, Bipolar Disorder, Intermittent Explosive Disorder, Obsessive Compulsive Disorder, etc. who also exhibit very dangerous behaviors that present a constant risk to themselves or others. This presentation will focus on the benefits of using a supplemental contingent skin shock along with a positive behavior program with cognitively typical individuals. Focus will be given to particular symptoms of specific diagnoses, behaviors associated with these symptoms and how the CSS can be used to help target these specific behaviors. Case studies and behavioral charts will also be presented.