Oregon Association for Behavior Analysis Position Statement on the Use of Electric Shock in Treatment of Individuals with Disabilities

Contingent electric skin shock (CESS) is an unnecessary tactic with possible long term harmful physical and emotional effects (Zarcone, et al. 2020). The use of contingent electric skin shock is inconsistent with the ethics rules of Applied Behavior Analysis and is outside of the scope of the practice of behavior analysis (BACB, 2020). 

We believe that the treatment of individuals with developmental disabilities should be guided by the following principles:

  • All individuals deserve access to respect, dignity, and safety

  • Positive supportive procedures that focus development of adaptive capacities should be the focus on ABA treatment

  • Procedures to reduce behaviors must be done in a manner that is consistent with our ethical standards and includes oversight and compliance with all local, state, national, and industry guidelines for treatment

CESS does not align with the Behavior Analysts Code of Ethics (BACB, 2022). Our ethics standards require behavior analysts to engage in the following professional ethical behaviors:

  • Treat all individuals with respect (Core Principle #2)

  • Provide treatment within our scope of competence (1.05)

  • Minimize risk of behavior change interventions (2.15)

  • Recommend treatments based on behavioral function (2.14)

  • Obtain consent and assent for treatment (2.11)

Further, we recognize that CESS has been banned by the Food and Drug Administration (FDA) (Federal Register, 2020) and is not a regular part of the training of behavior analysts (BACB, 2017). We recognize the use of CESS to be outside of the scope of behavior analysis and only to be administered under the supervision of a medical professional in a medical setting. There is evidence that these treatments have the potential for long term harmful physical and emotional effects as cited in research (Zarcone, et al. 2020) and through the collected stories and testimonials from individuals and families who have undergone such treatment (Brown, 2021).

We do not support the dissemination of information about CESS within the behavior analytic professional community. 

As an affiliate chapter of ABAI, we request the following actions to be taken by ABAI. 

  1. We request that ABAI immediately publish a written position statement against the use of CESS as a treatment strategy. 

  2. We request that ABAI place a moratorium on acceptance of any future presentations or workshops related to the use of CESS immediately, in advance of the call for papers for next year’s conferences which will open in October 2022. 

  3. We request that ABAI refrain from accepting sponsorship or exhibitors from organizations known to implement CESS.

  4. We request increased transparency between the CESS task force and ABAI members in order to promote the advancement of ethical and humane behavioral science including (a) making task force meetings public or making meeting recordings available, (b) sharing resources with membership, (c ) disclosing conflicts of interest between ABAI and organizations known to implement CESS, (d) disclosing relationships between ABAI board members and organizations known to implement CESS. 

State associations such as ours look to ABAI for moral and ethical leadership. However, we believe that ABAI has gotten this one wrong. Many organizations are taking a clear stand against contingent electric skin shock. We are hopeful that ABAI will join us in our efforts to protect humanity and encourage ethical advancement of behavior science. 

References:

Brown, Lydia. Living Archive & Repository on the Judge Rotenberg Center’s Abuses, last updated Feb 2021, https://autistichoya.net/judge-rotenberg-center/

Behavior Analyst Certification Board. (2017). BCBA/BCaBA task list (5th ed.). Littleton, CO: Author 

Behavior Analyst Certification Board. (2020). Ethics code for behavior analysts. Littleton, CO: Author. 

Federal Register (2020). 21 CFR Parts 882 and 895: 85 FR 13312: Banned Devices; Electrical Stimulation Devices for Self-Injurious or Aggressive Behavior (2020): A Rule by the Food and Drug Administration, Docket No. FDA-2016-N-1111, 2020-04328, 85 (45), 13312-13354. 

Zarcone, J. R., Mullane, M. P., Langdon, P. E., & Brown, I. (2020). Contingent Electric Shock as a Treatment for Challenging Behavior for People with Intellectual and Developmental Disabilities: Support for the IASSIDD Policy Statement Opposing Its Use [https://doi.org/10.1111/jppi.12342]. Journal of Policy and Practice in Intellectual Disabilities,17(4), 291-296. https://doi.org/https://doi.org/10.1111/jppi.12342