Scenario: Kevin continues to bang his head when attempting to seek attention from his parents and teachers. The following approaches have been implemented: sensory integration recommended by the occupational therapist; deep pressure, joint compression, and jumping on a trampoline. Kevin continues to bang his head. Sign language was recommended by the speech therapist: Kevin is unable to discriminate between the signs; therefore he continues to bang his head.The use of a helmet is recommended by the physical therapist: Kevin continues to bang his head with the helmet and he has now begun to bite his fingers.The behavior specialist has now recommended shock therapy and/or medication after reviewing all the interventions.

1. Is it ethical to use an aversive strategy at this point?
2. How long should interventions continue to be in place before medication and/or shock therapy are considered?
3. What has not been considered and what should be considered early on in the assessment process?