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Adults with Autism, Self-injury, Hospitalizations and Aversives

According to a recent study, "Adults with ASD were twice as likely as adults without ASD to have a hospitalization related to self-injurious behavior and ideation. Among adults with such a hospitalization, those with ASD had longer stays and, even after the analysis accounted for length of stay, higher costs." The study involved "5,341 discharge records for adults with ASD and 16,023 records for adults without ASD," (Morgan C. Shields, Ilhom Akobirshoev, Robert S. Dembo, and Monika Mitra, "Self-Injurious Behavior Among Adults With ASD: Hospitalizations, Length of Stay, and Costs of Resources to Deliver Care," Psychiatric Services; published Online:7 Mar 2019,

Here are some highlights of a literature analysis, discussed in a previous post, how skin shock is much more effective for some individuals than second generation antipsychotics (SGAs) in reducing and even eliminating self-injury. Skin shock certainly for some individuals improves functioning, quality of life and decreases costs.

With SGAs, 23 of 136 problem behaviors were eliminated in 88 subjects With skin shock treatment, 83 of 117 problem behaviors were eliminated in 114 subjects The mean daily rate of baseline problem behaviors were 5,300.23 in skin shock studies compared to 282.31 with SGAs, nearly 19 times as high as in the studies on SGAs, Blenkush N (2017) A Risk-Benefit Analysis of Antipsychotic Medication and Contingent Skin Shock for the Treatment of Destructive Behaviors. Into J Psychol Behav Anal 3: 121.

Making an effective evidence based treatment which cuts costs by preventing hospitalizations and medication side effects inaccessible for political reasons is unethical.