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Self-Injurious Behavior Inhibiting System


The Self-Injurious Behavior Inhibiting System (SIBIS) is an apparatus designed to reduce self-injurious behavior (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 electric shock contingent on its occurrence.

It use is controversial and some areas in the United States have banned its use. In 2016 the FDA proposed banning the device.

The amount of evidence that looks at the usefulness of SIBIS is small. One study was undertaken in 1990 of five individuals with developmental disabilities exhibiting severe self-injurious behavior that was resistant to multiple other treatments, who showed rapid and large decreases in self-injury when a SIBIS device was used. Another study in 2004 reported positive effects of SIBIS on a single pre-school child. Its usefulness, however, varies between people.

The FDA states that psychological and physical harm may result from the devices us. This may include depression, anxiety, and worsened behavior. Physical issues may include burns and pain.

There are two models of SIBIS. The simpler model consists of an electrode and a radio transmitter wrapped around the arm or leg using Velcro. 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 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.

SIBIS is designed to reduce SIB by immediately delivering positive punishment when head-directed SIB occurs. Only 5 cm × 3 cm × 1 cm in size, 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. 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, allowing for the reduction of punishment over time and the eventual dismissal of the apparatus from the child's punishment schedule.


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