Digital Journal
June 23, 2008 Monday 4:13 PM EST
Jun. 23, 2008 (Digital Journal delivered by Newstex) -- Judge Rotenberg Educational Center in Massachusetts has 250 mentally handicapped children who are divided between 38 group homes. One of the forms of punishment is electroshock therapy. It goes under the guise of 'behavior modification'.Located in Canton, MA, the Judge Rotenberg Educational Center is special needs school for children with varying degrees of mental retardation. Its website states that for 38 years JRC has provided very effective education and treatment to both high-functioning students with conduct, behavior, emotional, and/or psychiatric problems and low-functioning students with autistic-like behaviors.
Each student has his or her own individualized plan of treatment, which is charted daily. If, after eleven months of positive programming and educational procedures it is clear that the students aren't responding to the treatment, then an intensive treatment procedure is introduced, called "adversives." Simply put, electroshock treatments.
Of all the students, sixty percent of the students do have court-authorized treatment plans, which include electroshock therapy. These are used only after obtaining prior parental, medical, psychiatric, human rights, peer review and individual approval from a Massachusetts Probate Court. Putting the icing on the proverbial cake, the State of Massachusetts just "renewed" Rotenberg's authority to use electric shocks on students.
This, even though Rotenberg had admitted to administering excessive and unfair shocks to two children after being told to do so by a prank caller and the state tried twice to have the school shut down due to this practice and failed both times!The prank caller, who is believed to have been a former student, called the center pretending to be one of the staff, and ordering shock treatments to be initiated on a then 16-and 19-year old students because of some things that were done hours prior. After the call, the students were awakened. One was shocked 22 times and the other student was shocked 77 times.
A spokesman for the school, Ernest Corrigan agreed that it was unusual for someone to receive 77 shocks, and that it was "excessive to what is normal protocol.
"As a result of this incident, the school fired seven people and that steps had been taken to be assured it would not happen again.
The conditions of this renewal are that there must be proof that the students being shocked are dangerous with self-destructive behaviors. As well, these bee sting-like shocks could not be used for minor infractions, like swearing or moving from a seat without being told to.
The final condition is that the school, who is the only remaining school in the US that still uses electroshock therapy, must be showing that they are phasing out the use of this form of treatment. Rotenberg has agreed to eliminate the practice of delayed punishment or waking students up to receive punishments.Of course, children's rights and mental health advocates have had their say about this practise.
Barry Pizant of the Brown University Center for the Study of Human Development said, "I see [shock therapy] as the last vestige of [an] old practice that was proven ineffective and we should have stopped doing it all together 20 or 30 years ago."
"It's inexplicable. There's no reason to [shock] another human being," said Rita Shreffler, executive director of the National Autism Association. Shreffler urges parents of special needs children to thoroughly research the people and the institutions that they are considering entrusting their children to. Newstex ID: DIJO-0001-26180108
Wednesday, July 16, 2008
School of Shock
Eight states are sending autistic, mentally retarded, and emotionally troubled kids to a facility that punishes them with painful electric shocks. How many times do you have to zap a child before it's torture?
Jennifer Gonnerman
June 13, 2008
Features
The Texas Observer
Rob Santana awoke terrified. He'd had that dream again, the one where silver wires ran under his shirt and into his pants, connecting to electrodes attached to his limbs and torso. Adults armed with surveillance cameras and remote-control activators watched his every move. One press of a button, and there was no telling where the shock would hit—his arm or leg or, worse, his stomach. All Rob knew was that the pain would be intense.
Every time he woke from this dream, it took him a few moments to remember that he was in his own bed, that there weren't electrodes locked to his skin, that he wasn't about to be shocked. It was no mystery where this recurring nightmare came from—not A Clockwork Orange or 1984, but the years he spent confined in America's most controversial "behavior modification" facility.
In 1999, when Rob was 13, his parents sent him to the Judge Rotenberg Educational Center, located in Canton, Massachusetts, 20 miles outside Boston. The facility, which calls itself a "special needs school," takes in all kinds of troubled kids—severely autistic, mentally retarded, schizophrenic, bipolar, emotionally disturbed—and attempts to change their behavior with a complex system of rewards and punishments, including painful electric shocks to the torso and limbs. Of the 234 current residents, about half are wired to receive shocks, including some as young as nine or ten. Nearly 60 percent come from New York, a quarter from Massachusetts, the rest from six other states and Washington, D.C. The Rotenberg Center, which has 900 employees and annual revenues exceeding $56 million, charges $220,000 a year for each student. States and school districts pick up the tab.
The Rotenberg Center is the only facility in the country that disciplines students by shocking them, a form of punishment not inflicted on serial killers or child molesters or any of the 2.2 million inmates now incarcerated in U.S. jails and prisons. Over its 36-year history, six children have died in its care, prompting numerous lawsuits and government investigations. Last year, New York state investigators filed a blistering report that made the place sound like a high school version of Abu Ghraib. Yet the program continues to thrive—in large part because no one except desperate parents, and a few state legislators, seems to care about what happens to the hundreds of kids who pass through its gates.
In Rob Santana's case, he freely admits he was an out-of-control kid with "serious behavioral problems." At birth he was abandoned at the hospital, traces of cocaine, heroin, and alcohol in his body. A middle-class couple adopted him out of foster care when he was 11 months old, but his troubles continued. He started fires; he got kicked out of preschool for opening the back door of a moving school bus; when he was six, he cut himself with a razor. His mother took him to specialists, who diagnosed him with a slew of psychiatric problems: attention-deficit/hyperactivity disorder, post-traumatic stress disorder, bipolar disorder, and obsessive-compulsive disorder.
Rob was at the Rotenberg Center for about three and a half years. From the start, he cursed, hollered, fought with employees. Eventually the staff obtained permission from his mother and a Massachusetts probate court to use electric shock. Rob was forced to wear a backpack containing five two-pound, battery-operated devices, each connected to an electrode attached to his skin. "I felt humiliated," he says. "You have a bunch of wires coming out of your shirt and pants." Rob remained hooked up to the apparatus 24 hours a day. He wore it while jogging on the treadmill and playing basketball, though it wasn't easy to sink a jump shot with a 10-pound backpack on. When he showered, a staff member would remove his electrodes, all except the one on his arm, which he had to hold outside the shower to keep it dry. At night, Rob slept with the backpack next to him, under the gaze of a surveillance camera.
Employees shocked him for aggressive behavior, he says, but also for minor misdeeds, like yelling or cursing. Each shock lasts two seconds. "It hurts like hell," Rob says. (The school's staff claim it is no more painful than a bee sting; when I tried the shock, it felt like a horde of wasps attacking me all at once. Two seconds never felt so long.) On several occasions, Rob was tied facedown to a four-point restraint board and shocked over and over again by a person he couldn't see. The constant threat of being zapped did persuade him to act less aggressively, but at a high cost. "I thought of killing myself a few times," he says.
Rob's mother Jo-Anne deLeon had sent him to the Rotenberg Center at the suggestion of the special-ed committee at his school district in upstate New York, which, she says, told her that the program had everything Rob needed. She believed he would receive regular psychiatric counseling—though the school does not provide this.
As the months passed, Rob's mother became increasingly unhappy. "My whole dispute with them was, 'When is he going to get psychiatric treatment?'" she says. "I think they had to get to the root of his problems—like why was he so angry? Why was he so destructive? I really think they needed to go in his head somehow and figure this out." She didn't think the shocks were helping, and in 2002 she sent a furious fax demanding that Rob's electrodes be removed before she came up for Parents' Day. She says she got a call the next day from the executive director, Matthew Israel, who told her, "You don't want to stick with our treatment plan? Pick him up." (Israel says he doesn't remember this conversation, but adds, "If a parent doesn't want the use of the skin shock and wants psychiatric treatment, this isn't the right program for them.")
Rob's mother is not the only parent angry at the Rotenberg Center. Last year, Evelyn Nicholson sued the facility after her 17-year-old son Antwone was shocked 79 times in 18 months. Nicholson says she decided to take action after Antwone called home and told her, "Mommy, you don't love me anymore because you let them hurt me so bad." Rob and Antwone don't know each other (Rob left the facility before Antwone arrived), but in some ways their stories are similar. Antwone's birth mother was a drug addict; he was burned on an electric hot plate as an infant. Evelyn took him in as a foster child and later adopted him. The lawsuit she filed against the Rotenberg Center set off a chain of events: investigations by multiple government agencies, emotional public hearings, scrutiny by the media. Legislation to restrict or ban the use of electric shocks in such facilities has been introduced in two state legislatures. Yet not much has changed.
Rob has paid little attention to the public debate over his alma mater, though he visits its website occasionally to see which of the kids he knew are still there. After he left the center he moved back in with his parents. At first glance, he seems like any other 21-year-old: baggy Rocawear jeans, black T-shirt, powder-blue Nikes. But when asked to recount his years at the Rotenberg Center, he speaks for nearly two hours in astonishing detail, recalling names and specific events from seven or eight years earlier. When he describes his recurring nightmares, he raises both arms and rubs his forehead with his palms.
Despite spending more than three years at this behavior-modification facility, Rob still has problems controlling his behavior. In 2005, he was arrested for attempted assault and sent to jail. (This year he was arrested again, for drugs and assault.) Being locked up has given him plenty of time to reflect on his childhood, and he has gained a new perspective on the Rotenberg Center. "It's worse than jail," he told me. "That place is the worst place on earth."
One Punishment Fits All
The story of the Rotenberg Center is in many ways a tale of two schools. Slightly more than half the residents are what the school calls "high functioning": kids like Rob and Antwone, who have diagnoses like attention-deficit disorder, bipolar disorder, post-traumatic stress disorder, and other emotional problems. The other group is even more troubled. Referred to as "low functioning," it includes kids with severe autism and mental retardation; most cannot speak or have very limited verbal abilities. Some have behaviors so extreme they can be life threatening: chomping on their hands and arms, running into walls, nearly blinding themselves by banging their heads on the floor again and again.
The Rotenberg Center has long been known as the school of last resort—a place that will take any kid, no matter how extreme his or her problems are. It doesn't matter if a child has been booted out of 2, 5, 10, or 20 other programs—he or she is still welcome here. For desperate parents, the Rotenberg Center can seem like a godsend. Just ask Louisa Goldberg, the mother of 25-year-old Andrew, who has severe mental retardation. Andrew's last residential school kicked him out after he kept assaulting staff members; the Rotenberg Center was the only place willing to accept him. According to Louisa, Andrew's quality of life has improved dramatically since 2000, when he was hooked up to the shock device, known as the Graduated Electronic Decelerator, or ged.
The Rotenberg Center has a policy of not giving psychiatric drugs to students—no Depakote, Paxil, Risperdal, Ritalin, or Seroquel. It's a policy that appeals to Louisa and many other parents. At Andrew's last school, she says, "he had so many medicines in him he'd take a two-hour nap in the morning, he'd take a two-hour nap in the afternoon. They'd have him in bed at eight o'clock at night. He was sleeping his life away." These days, Louisa says she is no longer afraid when her son comes home to visit. "[For him] to have an electrode on and to receive a ged is to me a much more favorable way of dealing with this," she says. "He's not sending people to the hospital."
Marguerite Famolare brought her son Michael to the Rotenberg Center six years ago, after he attacked her so aggressively she had to call 911 and, in a separate incident, flipped over a kitchen table onto a tutor. Michael, now 19, suffers from mental retardation and severe autism. These days, when he comes home for a visit, Marguerite carries his shock activator in her purse. All she has to do, she says, is show it to him. "He'll automatically comply to whatever my signal command may be, whether it is 'Put on your seatbelt,' or 'Hand me that apple,' or 'Sit appropriately and eat your food,'" she says. "It's made him a human being, a civilized human being."
Massachusetts officials have twice tried to shut the Rotenberg Center down—once in the 1980s and again in the 1990s. Both times parents rallied to its defense, and both times it prevailed in court. (See "Why Can't Massachusetts Shut Matthew Israel Down?" page 44.) The name of the center ensures nobody forgets these victories; it was Judge Ernest Rotenberg, now deceased, who in the mid-'80s ruled that the facility could continue using aversives—painful punishments designed to change behavior—so long as it obtained authorization from the Bristol County Probate and Family Court in each student's case. But even though the facility wasn't using electric shock when this ruling was handed down, the court rarely, if ever, bars the Rotenberg Center from adding shock to a student's treatment plan, according to lawyers and disability advocates who have tried to prevent it from doing so.
Since Evelyn Nicholson filed her lawsuit in 2006, the Rotenberg Center has faced a new wave of criticism and controversy. (See "Nagging? Zap. Swearing? Zap," page 41.) And again, the facility has relied heavily on the testimonials of parents like Louisa Goldberg and Marguerite Famolare to defend itself. Not surprisingly, the most vocal parent-supporters tend to be those with the sickest children, since they are the ones with the fewest options. But at the Rotenberg Center, the same methods of "behavior modification" are applied to all kids, no matter what is causing their behavior problems. And so, while Rob would seem to have little in common with mentally retarded students like Michael and Andrew, they all shared a similar fate once their parents placed them under the care of the same psychologist, a radical behaviorist known as Dr. Israel.
Dr. Israel's Radical Behavior
In 1950, matt israel was a Harvard freshman looking to fill his science requirement. He knew little about B.F. Skinner when he signed up for his course, Human Behavior. Soon, though, Israel became fascinated with Skinner's scientific approach to the study of behavior, and he picked up Walden Two, Skinner's controversial novel about an experimental community based on the principles of behaviorism. The book changed Israel's life. "I decided my mission was to start a utopian community," he says. Israel got a Ph.D. in psychology in 1960 from Harvard, and started two communal houses outside Boston.
One of the people Israel lived with was a three-year-old named Andrea, the daughter of a roommate. The two did not get along. "She was wild and screaming," Israel recalls. "I would retreat to my own room, and she'd be trying to pull away and get into my room, and I'd have to hold the door on one side to keep her from disturbing me." When company would come over, he says, "She would walk around with a toy broom and whack people over the head."
Through experiments with rats and pigeons, Skinner had demonstrated how animals learn from the consequences of their actions. With permission from Andrea's mother, Israel decided to try out Skinner's ideas on the three-year-old. When Andrea was well behaved, Israel took her out for walks. But when she misbehaved, he punished her by snapping his finger against her cheek. His mentor Skinner preached that positive reinforcement was vastly preferable to punishment, but Israel says his methods transformed the girl. "Instead of being an annoyance, she became a charming addition to the house."
Israel's success with Andrea convinced him to start a school. In 1971, he founded the Behavior Research Institute in Rhode Island, a facility that would later move to Massachusetts and become known as the Judge Rotenberg Center. Israel took in children nobody else wanted—severely autistic and mentally retarded kids who did dangerous things to themselves and others. To change their behavior, he developed a large repertoire of punishments: spraying kids in the face with water, shoving ammonia under their noses, pinching the soles of their feet, smacking them with a spatula, forcing them to wear a "white-noise helmet" that assaulted them with static.
In 1977, Israel opened a branch of his program in California's San Fernando Valley, along with Judy Weber, whose son Tobin is severely autistic. Two years later, the Los Angeles Times reported Israel had pinched the feet of Christopher Hirsch, an autistic 12-year-old, at least 24 times in 30 minutes, while the boy screamed and cried. This was a punishment for soiling his pants. ("It might have been true," Israel says. "It's true that pinches were being used as an aversive. The pinch, the spank, the muscle squeeze, water sprays, bad taste—all those procedures were being used.") Israel was in the news again in 1981, when another student, 14-year-old Danny Aswad, died while strapped facedown to his bed. In 1982, the California Department of Social Services compiled a 64-page complaint that read like a catalog of horrors, describing students with bruises, welts, and cuts. It also accused Israel of telling a staff member "to grow his fingernails longer so he could give an effective pinch."
In 1982, the facility settled with state officials and agreed to stop using physical punishments. Now called Tobinworld, and still run by Judy Weber, it is a $10-million-a-year organization operating day schools near Los Angeles and San Francisco. The Rotenberg Center considers itself a "sister school" to Tobinworld, and Israel makes frequent trips to California to visit Weber. The two were married last year.
Despite his setback in California, Israel continued to expand on the East Coast—and to generate controversy. In 1985, Vincent Milletich, an autistic 22-year-old, suffered a seizure and died after he was put in restraints and forced to wear a white-noise helmet. Five years later, 19-year-old Linda Cornelison, who had the mental capacity of a toddler, refused to eat. On the bus to school, she clutched her stomach; someone had to carry her inside, and she spent the day on a couch in a classroom. Linda could not speak, and the staff treated her actions as misbehaviors. Between 3:52 p.m. and 8 p.m., staffers punished her with 13 spatula spankings, 29 finger pinches, 14 muscle squeezes, and 5 forced inhalings of ammonia. It turned out that Linda had a perforated stomach. She died on the operating table at 1:45 a.m.
The local district attorney's office examined the circumstances of Vincent's death but declined to file any charges. In Linda's case, the Massachusetts Department of Mental Retardation investigated and found that while Linda's treatment had "violated the most basic codes and standards of decency and humane treatment," there was insufficient evidence to prove that the use of aversives had caused her death.
The local district attorney's office examined the circumstances of Vincent's death but declined to file any charges. In Linda's case, the Massachusetts Department of Mental Retardation investigated and found that while Linda's treatment had "violated the most basic codes and standards of decency and humane treatment," there was insufficient evidence to prove that the use of aversives had caused her death.
Israel purchased a shock device then on the market known as sibis—Self-Injurious Behavior Inhibiting System—that had been invented by the parents of an autistic girl and delivered a mild shock that lasted .2 second. Between 1988 and 1990, Israel used sibis on 29 students, including one of his most challenging, Brandon, then 12, who would bite off chunks of his tongue, regurgitate entire meals, and pound himself on the head. At times Brandon was required to keep his hands on a paddle; if he removed them, he would get automatic shocks, one per second. One infamous day, Brandon received more than 5,000 shocks. "You have to realize," Israel says. "I thought his life was in the balance. I couldn't find any medical solution. He was vomiting, losing weight. He was down to 52 pounds. I knew it was risky to use the shock in large numbers, but if I persevered that day, I thought maybe it would eventually work. There was nothing else I could think of to do...but by the time it went into the 3,000 or 4,000 range, it became clear it wasn't working."
This day was a turning point in the history of Israel's operation—that's when he decided to ratchet up the pain. The problem, he decided, was that the shock sibis emitted was not strong enough. He says he asked sibis's manufacturer, Human Technologies, to create a more powerful device, but it refused. "So we had to redesign the device ourselves," he says. He envisioned a device that would start with a low current but that could increase the voltage if needed—hence its name, Graduated Electronic Decelerator or ged—but he abandoned this idea early on. "As it turns out, that's really not a wise approach," he says. "It's sort of like operating a car and wearing out the brakes because you never really apply them strongly enough. Instead, we set it at a certain level that was more or less going to be effective for most of our students."
Thirty years earlier, O. Ivar Lovaas, a psychology professor at ucla, had pioneered the use of slaps and screams and electric jolts to try to normalize the behavior of autistic kids. Life magazine featured his work in a nine-page photo essay in 1965 with the headline, "A surprising, shocking treatment helps far-gone mental cripples." Lovaas eventually abandoned these methods, telling cbs in 1993 that shock was "only a temporary suppression" because patients become inured to the pain. "These people are so used to pain that they can adapt to almost any kind of aversive you give them," he said.
Israel encountered this same sort of adaptation in his students, but his solution was markedly different: He decided to increase the pain once again. Today, there are two shock devices in use at the Rotenberg Center: the ged and the ged-4. The devices look similar and both administer a two-second shock, but the ged-4 is nearly three times more powerful—and the pain it inflicts is that much more severe.
The Mickey Mouse Club
Ten years ago, Israel hung up a Mickey Mouse poster in the main hall, and he noticed that it made people smile—so he bought every Mickey Mouse poster he could find. He hung them in the corridors and even papered the walls of what became known as the Mickey Mouse Conference Room. Entering the Rotenberg Center is a bit like stepping into a carnival fun house, I discovered during a two-day visit last autumn. Two brushed-aluminum dogs, each nearly 5 feet tall and sporting a purple neon collar, stand guard outside. Giant silver stars dangle from the lobby ceiling; the walls and chairs in the front offices are turquoise, lime green, and lavender.
Israel, 74, still holds the title of executive director, for which he pays himself nearly $400,000 in salary and benefits. He appears utterly unimposing: short and slender with soft hands, rounded shoulders, curly white hair, paisley tie. Then he sits down beside me and, unprompted, starts talking about shocking children. "The treatment is so powerful it's hard not to use if you have seen how effective it is," he says quietly. "It's brief. It's painful. But there are no side effects. It's two seconds of discomfort." His tone is neither defensive nor apologetic; rather, it's perfectly calm, almost soothing. It's the sort of demeanor a mother might find comforting if she were about to hand over her child.
Before we set off on our tour of the facility, there's something Israel wants me to see: Before & After, a homemade movie featuring six of his most severe cases. Israel has been using some of the same grainy footage for more than two decades, showing it to parents of prospective students as well as visiting reporters. They've already mailed me a copy, but Israel wants to make sure I watch it. An assistant slips the tape into the vcr, Israel presses the remote, and we all stare at the screen:
1977: An 11-year-old girl named Caroline arrives at the school strapped down onto a stretcher, her head encased in a helmet. In the next shot, free from restraints, she crouches down and tries to smash her helmeted head against the floor.
1981: Janine, also 11 years old, shrieks and slams her head against the ground, a table, the door. Bald spots testify to the severity of her troubles; she's yanked out so much hair it's half gone.
Both girls exhibit autistic behaviors, and compared with these scenes, the "After" footage looks almost unbelievable: Janine splashes in a plastic pool, while Caroline grins as she sits in a chair at a beauty salon. "Most people haven't seen these pictures," Israel says, setting down the remote. "They haven't seen children like this, so they cannot imagine. These are children for whom positive-only procedures did not work, drugs did not work. And if it wasn't for this treatment, some of these people would not be alive." The video is extremely persuasive: The girls' self-abuse is so violent and so frightening that it almost makes me want to grab a ged remote and push the button myself. Of course, this is precisely the point.
Considering how compelling the "After" footage is, I am surprised to learn that five of the six children featured in it are still here. "This is Caroline," one of my escorts says an hour or two later as we walk down a corridor. Without an introduction, I would not have known. Caroline, 39, slumps forward in a wheelchair, her fists balled up, head covered by a red helmet. "Blow me a kiss, Caroline," Israel says. She doesn't respond.
A few minutes later, I meet 36-year-old Janine, who appears in much better shape. She's not wearing a helmet and has a full head of black hair. She's also got a backpack on her shoulders and canvas straps hanging from her legs, the telltale sign that electrodes are attached to both calves. For 16 years—nearly half her life—Janine has been hooked up to Israel's shock device. A couple years ago, when the shocks began to lose their effect, the staff switched the devices inside her backpack to the much more painful ged-4.
Rogue Science
In 1994, matthew israel had just 64 students. Today he has 234. This astonishing rate of growth is largely the result of a dramatic change in the types of students he takes in. Until recently, nearly all were "low functioning," autistic and mentally retarded people. But today slightly more than 50 percent are "high functioning," with diagnoses like add, adhd, and bipolar disorder. New York state supplies the majority of these students, many of whom grew up in the poorest parts of New York City. Yet despite this change in his population, Israel's methods have remained essentially the same.
Israel has long faced criticism that he has not published research about his use of electric shocks in peer-reviewed journals, where experts could scrutinize it. To defend his methods, he points to a bibliography of 110 research articles that he's posted on the Rotenberg Center website. This catalog seems impressive at first. Studied more closely, however, it is not nearly so convincing. Three-quarters of the articles were published more than 20 years ago. Eight were written or cowritten by Lovaas, the ucla-affiliated behaviorist. One of America's leading autism experts, Lovaas long ago stopped endorsing painful aversives. And Lovaas' old studies focus primarily on children with autism who engage in extreme self-injury—not on troubled teens who have been diagnosed with adhd or add.
But then, it would be hard for Israel to find contemporary research supporting his program, because the practice of treating self-abusive kids with pain has been largely abandoned. According to Dr. Saul Axelrod, a professor at Temple University and an expert on behavior modification, "the field has moved away from painful stimuli because of public outcry and because we've devised better techniques," including determining the cause of an individual's self-abuse.
Another expert Israel cites several times is Dr. Brian A. Iwata, a consultant on the development of sibis, the device Israel modified to create his ged. Now a professor of psychology and psychiatry at the University of Florida, he's a nationally recognized authority on treating severe self-abuse among children with developmental disabilities. Iwata has visited the Rotenberg Center and describes its approach as dangerously simplistic: "There appears to be a mission of that program to use shock for problem behaviors. It doesn't matter what that behavior is." Iwata has consulted for 25 states and says there is little relationship between what goes on at Israel's program and what goes on at other facilities. "He may have gotten his Ph.D. at Harvard, but he didn't learn what he's doing at Harvard. Whatever he's doing, he decided to do on his own."
Paul Touchette, who also studied with B.F. Skinner, has known Israel since the 1960s when they were both in Cambridge. Like Israel, Touchette went on to treat children with autism who exhibit extreme self-abuse, but he isn't a fan of Israel's approach either. "Punishment doesn't get at the cause," says Touchette, who is on the faculty of the University of California-Irvine School of Medicine. "It just scares the hell out of patients."
Over the decades, Touchette has followed Israel's career and bumped into him at professional conferences. "He's a very smart man, but he's an embarrassment to his profession," Touchette says. "I've never been able to figure out if Matt is a little off-kilter and actually believes all this stuff, or whether he's just a clever businessman."
Big Reward Store
At the rotenberg center, an elaborate system of rewards and punishments governs all interactions. Well-behaved kids can watch TV, go for pizza, play basketball. Students who've earned points for good behavior visit a store stocked with dvd players, cds, cologne, PlayStation 2, Essence magazine, knockoff Prada purses—anything the staff thinks students might want. But even more prized is a visit to the "Big Reward Store," an arcade full of pinball machines, video games, a pool table, and the most popular feature, a row of 42-inch flat-screen TVs hooked up to Xbox 360s.
Students like the "brs" for another reason—it's the only place many can socialize freely. At the Rotenberg Center, students have to earn the right to talk to each other. "We had to wait until we were in brs to communicate with others," says Isabel Cedeño, a 16-year-old who ran away from Rotenberg in 2006 after her boyfriend, a former student, came and got her. "That was the only time you really laughed, had fun, hung around with your friends. Because usually, you can't talk to them. It was basically like we had to have enemies. They didn't want us to be friendly with nobody."
Students live grouped together in homes and apartments scattered in nearby towns and are bused to the facility's headquarters every morning. They spend their days in classrooms, staring at a computer screen, their backs to the teacher. They are supposed to teach themselves, using self-instruction programs that include lessons in math, reading, and typing. Even with breaks for gym and lunch, the days can be incredibly dull. "On paper, it does look like they're being educated, because we have lesson plans," says former teacher Jessica Croteau, who oversaw a classroom of high-functioning teens for six months before leaving in 2006. But "to self-teach is not exciting. Why would the kids want to sit there and read a chapter on their own without any discussion?"
Croteau says teachers have to spend so much time monitoring misbehaviors there's often little time left for teaching. Whenever a student disobeys a rule, a staff member must point it out, using the student's name and just one or two rote phrases like, "Mark, there's no stopping work. Work on your task, please." Each time a student curses or yells, a staffer marks it on the student's recording sheet. Teachers and aides then use the sheet to calculate what level of punishment is required—when to just say "No!" and when to shock.
Employees carry students' shock activators inside plastic cases, which they hook onto their belt loops. These cases are known as "sleds," and each sled has a photo on it to ensure employees don't zap the wrong kid.
Behaviorism would seem to dictate that staff shock students immediately after they break the rules. But if employees learn about a misbehavior after it has occurred—by, say, reviewing surveillance footage—they may still administer punishment. Rob Santana recalls that Mondays were always the most stressful day of the week. He would sit at his desk all day, trying to remember if he had broken any rules over the weekend, waiting to see if he'd be shocked.
Employees are encouraged to use the element of surprise. "Attempt to be as discreet as possible and hold the transmitter out of view of the student," states the employee manual. This way, students cannot do anything to minimize the pain, like flipping over their electrodes or tensing their muscles. "We hear the sound of [a staffer] picking up a sled," says Isabel, the former student. "Then we turn around and see the person jump out of their seat."
Employees shock students for a wide range of behaviors, from violent actions to less serious offenses, like getting out of their seats without permission. In 2006, the New York State Education Department sent a team of investigators, including three psychologists, to the Rotenberg Center, then issued a scathing report. Among its many criticisms was that the staff shocked kids for "nagging, swearing, and failing to maintain a neat appearance." Israel only disputes the latter. As for nagging and swearing? "Sometimes a behavior looks innocuous," he says, "but if it's an antecedent for aggression, it may have to be treated with an aversive."
New York officials disagreed, and in January 2007 issued regulations that would prohibit shocking New York students for minor infractions. But a group of New York parents filed a federal lawsuit to stop the state from enforcing these regulations. They prevailed, winning a temporary restraining order against the state, one that permits the Rotenberg Center staffers to continue using shock. The parents' case is expected to go to trial in 2008.
When they talk about why they use the shock device, Israel and his employees like to use the word "treatment," but it might be more accurate to use words like "convenience" or "control." "The ged—it's two seconds and it's done," says Patricia Rivera, a psychologist who serves as assistant director of clinical services. "Then it's right back to work." By contrast, it can take 8 or 10 employees half an hour or longer to restrain a strong male student: to pin him to the floor, wait for him to stop struggling, then move his body onto a restraint board and tie down each limb. Restraining five or eight kids in a single day—or the same student again and again—can be incredibly time-consuming and sometimes dangerous.
When they talk about why they use the shock device, Israel and his employees like to use the word "treatment," but it might be more accurate to use words like "convenience" or "control." "The ged—it's two seconds and it's done," says Patricia Rivera, a psychologist who serves as assistant director of clinical services. "Then it's right back to work." By contrast, it can take 8 or 10 employees half an hour or longer to restrain a strong male student: to pin him to the floor, wait for him to stop struggling, then move his body onto a restraint board and tie down each limb. Restraining five or eight kids in a single day—or the same student again and again—can be incredibly time-consuming and sometimes dangerous.
"Our Students Have a Tendency to Lie"
Rotenberg staff place the more troubled (or troublesome) residents on 1:1 status, meaning that an aide monitors them everywhere they go. For extremely violent students, the ratio is 2:1. Soon after I arrived, right before I set off on my tour, a small crowd gathered—it seemed that almost the entire hierarchy of the Rotenberg Center was going to follow me around. That's when I realized I'd been put on 5:1. As I began to roam around the school with my escorts, my every move monitored by surveillance cameras, I realized it would be impossible to have a private conversation with any student. The best I could hope for would be a few unscripted moments.
Ten years ago, a reporter visiting Israel's center would have been unable to talk to most students; back then few of them could speak. These days, there are more than 100 high-functioning kids fully capable of voicing their views, and Israel has enlisted a few in his campaign to promote the ged. "If we had only [severely] autistic students, they couldn't talk to you and say, 'Gee, this is really helping me,'" Israel says. "Now for the first time we have students like Katie who can tell you it helped them."
In the world of the Rotenberg Center, Katie Spartichino is a star. She left the facility in the spring of 2006 and now attends community college in Boston. Around noon, a staff member brings her back to the facility to talk to me. We sit at an outdoor picnic table away from the surveillance cameras but there's no privacy: Israel and Karen LaChance, the assistant to the executive director for admissions, sit with us.
Katie, 19, tells me she overdosed on pills at 9, spent her early adolescence in and out of psych wards, was hooked up to the ged at 16, and stayed on the device for two years. "This is a great place," she says. "It took me off all my medicine. I was close to 200 pounds and I'm 160 now." She admits her outlook was less rosy when she first had to wear the electrodes. "I cried," she says. "I kind of felt like I was walking on eggshells; I had to watch everything I said. Sometimes a curse word would just come out of my mouth automatically. So being on the geds and knowing that swearing was a targeted behavior where I would receive a [GED] application, it really got me to think twice before I said something disrespectful or something just plain-out rude."
As Katie speaks, LaChance runs her fingers through Katie's hair again and again. The gesture is so deliberate it draws my attention. I wonder if it's just an expression of affection—or something more, like a reward.
"Do you swear anymore?" I ask.
"Oh, God, all the time," Katie says. She pauses. "Well, I have learned to control it, but I'm not going to lie. When I'm on the phone, curse words come out."
The hair stroking stops. LaChance turns to Katie. "I hope you're not going to tell me you're aggressive."
"Oh, no, that's gone," Katie says. "No, no, no. The worst thing I do sometimes is me and my mom get into little arguments."
For Israel, of course, one drawback of having so many high-functioning students is that he cannot control everything they say. One afternoon, when I walk into a classroom of teenagers, a 15-year-old girl catches my eye, smiles, and holds up a sheet of paper with a message written in pink marker: HELP US. She puts it back down and shuffles it into her stack of papers before anyone else sees. When I move closer, she tells me her name is Raquel, she is from the Bronx, and she wants to go home.
My escorts allow me to interview Raquel while two of them sit nearby. Raquel is not hooked up to the ged, but she has many complaints, including that she has just witnessed one of her housemates get shocked. "She was screaming," Raquel says. "They told her to step up to be searched; she didn't want to step up to be searched, so they gave her one." After 20 minutes, my escorts cut us off. "Raquel, you did a great job—thank you for taking the time," says Patricia Rivera, the psychologist.
Once Raquel is out of earshot, Rivera adds, "Some of the things she said are not true, some of them are. Our students obviously have a tendency to lie about things." She explains that a staff member searches Raquel's housemate every hour because she's the one who recently stabbed an employee with a pencil.
The Rotenberg Center does not have a rule about how old a child must be before he or she can be hooked up to the ged. One of the program's youngest students is a nine-year-old named Rodrigo. When I see him, he is seated outside at a picnic table with his aide. Rodrigo's backpack looks enormous on his tiny frame; canvas straps dangle from both legs.
"He was horrible when he first came in," Rivera says. "It would take five staff to restrain him because he's so wiry." What was he like? "A lot of aggression. A lot of disruptive behavior. Whenever he was asked to do a task that he didn't feel like doing, he would scream, yell, swear. The stuff that would come out of his mouth you wouldn't believe—very sexually inappropriate."
"Rodrigo, come here," one of my escorts says.
Rodrigo walks over, his straps slapping the ground. He wears a white dress shirt and tie—the standard uniform for male students—but because he is so small, maybe 4 feet tall, his tie nearly reaches his thighs. "What's that?" he asks.
"That's a tape recorder," I say. "Do you want to say something?"
"Yeah."
"That's a tape recorder," I say. "Do you want to say something?"
"Yeah."
The Employee-Modification System
To understand how the Rotenberg Center works, it helps to know that it runs not just one behavior-modification program, but two—one for the residents, and one for the staff. Employees have no autonomy. If a staffer believes it's okay to shock a kid who is smashing his head against a wall, but it's not okay to shock someone for getting out of his chair without permission, that could spell trouble. "There's pressure on you to do it," a former teacher told me. "They punish you if you don't."
I met this former teacher at a restaurant, and our meeting stretched on for six hours. At times it felt less like an interview than a confession. "The first time you give someone a ged is the worst one," the teacher said. "You don't want to hurt somebody; you want to help. You're thinking, 'This has got to be okay. This has got to be legal, or they wouldn't be doing this.'" At the Rotenberg Center, it's virtually impossible to discuss such concerns with coworkers because there are cameras everywhere, even in the staff break room. Staff members who want to talk to each other without being overheard may meet up in the parking lot or scribble notes to each other. But it's hard to know whom to trust, since Israel encourages employees to file anonymous reports about their coworkers' lapses.
In addition, staff members are prohibited from having casual conversations with each other. They cannot, for example, say to a coworker, "Hey, did you see the Red Sox game last night?" "We don't want them discussing their social life or the ball games in front of the students or while they're on duty," Israel says. "So we'll sometimes actually have one staffer deliberately start a social conversation with another and we'll see whether the other—as he or she should—will say, 'I don't want to discuss that now.'" Monitors watch these setups on the surveillance cameras and punish staffers who take the bait.
Former employees describe a workplace permeated with fear—fear of being attacked by students and fear of losing their job. There are so many rules—and so many cameras—it's not easy to stay out of trouble. Employees quit or are fired so often that two-thirds of the direct-care employees remain on the job for less than a year.
New employees must sign a confidentiality agreement promising not to talk about the Rotenberg Center—even after they no longer work there. Of the eight ex-employees I interviewed, most did not want to be identified by name for fear of Israel suing them; all were critical of how the ged is used. Maybe, says one, the use of shocks was justified in a few extreme self-injurious cases, but that's all. "Say you had a hospital that was the only hospital in the nation that had chemotherapy, and they were treating people who had the common cold with it," she says. "I think the extreme to which they abuse their power has outweighed what good they do."
The Hard Lessons of Connie Chung
Matthew Israel has been fielding questions from journalists since the 1970s, but few have examined his operation as thoroughly—and critically—as the producers at Eye to Eye with Connie Chung did. In 1993, they spent six months investigating the facility. They even found an employee willing to go inside with a hidden camera. But Israel ended up getting the last laugh. As he recounts the story for me, he can barely contain his glee. "We refused to meet with her unless the parents could be in the same room," he says, grinning. "She talked to the parents, and they really gave it to her." This is no exaggeration: When Chung tried to ask him tough questions, his parent-supporters shouted her down.
Throughout this raucous meeting, Israel had his own camera rolling, too, which turned out to be a brilliant move. Before cbs got its 40-minute story on the air, Israel launched a national campaign to discredit both Chung and her report. He accused her of being "biased" and "hostile," and to prove it, he distributed edited videotapes of her interview to media critics and cbs affiliates. It worked. A New York Times television critic savaged cbs, accusing it of using "shabby tricks of the trade." Suddenly the story was not about whether the school had abused students—but whether cbs had abused the school.
"I don't think it was a positive thing for her career," says Israel, still smiling. It's late in the day, right near the end of my visit, and I'm starting to wonder why he's brought up this topic.
By now I've spent 22 hours with Israel and his staff—wandering around the facility, meeting parents they've brought in for me to interview. But before I depart, there's one more place I want to see, the room where they repair the geds. Israel and Glenda Crookes, an assistant executive director, agree to take me there. It is just past 7 p.m. and drizzling as we climb into Israel's Lexus for a short drive to the maintenance building.
There, Crookes and Israel lead me down a hall, past storerooms filled with red helmets, ged sleds, batteries and their chargers. The room at the end of the hall looks like it could be a repair shop for any sort of electronics equipment: scissors, screwdrivers, industrial-grade glue, a Black & Decker Pivot Driver. On one desk, I spot a form called a ged Trouble Report. The report explains that someone dropped off Duane's shock device because it was "making rattling noises." Crookes explains, "Anytime a screw is loose or anything is wrong with the device, it's automatically sent back here."
A Trouble Report on another desk suggests a more serious problem: "Jamie Z was getting his battery changed, Luigi received a shock." "What does this mean?" I ask. Crookes picks up the paper, reads it, then hands it to Israel and walks away. Her gesture seems to say, I cannot believe we just spent two days with this reporter and now this is the last thing she sees.
Israel stares at the report, then reaches into his pocket and pulls out a pair of reading glasses. Nobody says anything. Outside, one car after another races by, the tail end of the evening commute.
After a minute or two, Israel says, "Well, I don't understand the whole of it." He is still staring at the paper in his hand. "But there was apparently a spontaneous activation." The ged, in other words, delivered a shock without anyone pressing its remote.
This moment reminds me of something Israel told me earlier about the premise of Skinner's Walden Two, that by changing people's behaviors you can help them have a better life. But, Israel was careful to add, "The notion was that you needed to have the whole environment under control. With a school like this, we have an awful lot. Not the whole environment, but an awful lot."
He was right; he controls nearly every aspect of his facility. But all of his surveillance cameras and microphones and paperwork and protocols had failed to protect Luigi, a mentally retarded resident who had done nothing wrong.
Jennifer Gonnerman
June 13, 2008
Features
The Texas Observer
Rob Santana awoke terrified. He'd had that dream again, the one where silver wires ran under his shirt and into his pants, connecting to electrodes attached to his limbs and torso. Adults armed with surveillance cameras and remote-control activators watched his every move. One press of a button, and there was no telling where the shock would hit—his arm or leg or, worse, his stomach. All Rob knew was that the pain would be intense.
Every time he woke from this dream, it took him a few moments to remember that he was in his own bed, that there weren't electrodes locked to his skin, that he wasn't about to be shocked. It was no mystery where this recurring nightmare came from—not A Clockwork Orange or 1984, but the years he spent confined in America's most controversial "behavior modification" facility.
In 1999, when Rob was 13, his parents sent him to the Judge Rotenberg Educational Center, located in Canton, Massachusetts, 20 miles outside Boston. The facility, which calls itself a "special needs school," takes in all kinds of troubled kids—severely autistic, mentally retarded, schizophrenic, bipolar, emotionally disturbed—and attempts to change their behavior with a complex system of rewards and punishments, including painful electric shocks to the torso and limbs. Of the 234 current residents, about half are wired to receive shocks, including some as young as nine or ten. Nearly 60 percent come from New York, a quarter from Massachusetts, the rest from six other states and Washington, D.C. The Rotenberg Center, which has 900 employees and annual revenues exceeding $56 million, charges $220,000 a year for each student. States and school districts pick up the tab.
The Rotenberg Center is the only facility in the country that disciplines students by shocking them, a form of punishment not inflicted on serial killers or child molesters or any of the 2.2 million inmates now incarcerated in U.S. jails and prisons. Over its 36-year history, six children have died in its care, prompting numerous lawsuits and government investigations. Last year, New York state investigators filed a blistering report that made the place sound like a high school version of Abu Ghraib. Yet the program continues to thrive—in large part because no one except desperate parents, and a few state legislators, seems to care about what happens to the hundreds of kids who pass through its gates.
In Rob Santana's case, he freely admits he was an out-of-control kid with "serious behavioral problems." At birth he was abandoned at the hospital, traces of cocaine, heroin, and alcohol in his body. A middle-class couple adopted him out of foster care when he was 11 months old, but his troubles continued. He started fires; he got kicked out of preschool for opening the back door of a moving school bus; when he was six, he cut himself with a razor. His mother took him to specialists, who diagnosed him with a slew of psychiatric problems: attention-deficit/hyperactivity disorder, post-traumatic stress disorder, bipolar disorder, and obsessive-compulsive disorder.
Rob was at the Rotenberg Center for about three and a half years. From the start, he cursed, hollered, fought with employees. Eventually the staff obtained permission from his mother and a Massachusetts probate court to use electric shock. Rob was forced to wear a backpack containing five two-pound, battery-operated devices, each connected to an electrode attached to his skin. "I felt humiliated," he says. "You have a bunch of wires coming out of your shirt and pants." Rob remained hooked up to the apparatus 24 hours a day. He wore it while jogging on the treadmill and playing basketball, though it wasn't easy to sink a jump shot with a 10-pound backpack on. When he showered, a staff member would remove his electrodes, all except the one on his arm, which he had to hold outside the shower to keep it dry. At night, Rob slept with the backpack next to him, under the gaze of a surveillance camera.
Employees shocked him for aggressive behavior, he says, but also for minor misdeeds, like yelling or cursing. Each shock lasts two seconds. "It hurts like hell," Rob says. (The school's staff claim it is no more painful than a bee sting; when I tried the shock, it felt like a horde of wasps attacking me all at once. Two seconds never felt so long.) On several occasions, Rob was tied facedown to a four-point restraint board and shocked over and over again by a person he couldn't see. The constant threat of being zapped did persuade him to act less aggressively, but at a high cost. "I thought of killing myself a few times," he says.
Rob's mother Jo-Anne deLeon had sent him to the Rotenberg Center at the suggestion of the special-ed committee at his school district in upstate New York, which, she says, told her that the program had everything Rob needed. She believed he would receive regular psychiatric counseling—though the school does not provide this.
As the months passed, Rob's mother became increasingly unhappy. "My whole dispute with them was, 'When is he going to get psychiatric treatment?'" she says. "I think they had to get to the root of his problems—like why was he so angry? Why was he so destructive? I really think they needed to go in his head somehow and figure this out." She didn't think the shocks were helping, and in 2002 she sent a furious fax demanding that Rob's electrodes be removed before she came up for Parents' Day. She says she got a call the next day from the executive director, Matthew Israel, who told her, "You don't want to stick with our treatment plan? Pick him up." (Israel says he doesn't remember this conversation, but adds, "If a parent doesn't want the use of the skin shock and wants psychiatric treatment, this isn't the right program for them.")
Rob's mother is not the only parent angry at the Rotenberg Center. Last year, Evelyn Nicholson sued the facility after her 17-year-old son Antwone was shocked 79 times in 18 months. Nicholson says she decided to take action after Antwone called home and told her, "Mommy, you don't love me anymore because you let them hurt me so bad." Rob and Antwone don't know each other (Rob left the facility before Antwone arrived), but in some ways their stories are similar. Antwone's birth mother was a drug addict; he was burned on an electric hot plate as an infant. Evelyn took him in as a foster child and later adopted him. The lawsuit she filed against the Rotenberg Center set off a chain of events: investigations by multiple government agencies, emotional public hearings, scrutiny by the media. Legislation to restrict or ban the use of electric shocks in such facilities has been introduced in two state legislatures. Yet not much has changed.
Rob has paid little attention to the public debate over his alma mater, though he visits its website occasionally to see which of the kids he knew are still there. After he left the center he moved back in with his parents. At first glance, he seems like any other 21-year-old: baggy Rocawear jeans, black T-shirt, powder-blue Nikes. But when asked to recount his years at the Rotenberg Center, he speaks for nearly two hours in astonishing detail, recalling names and specific events from seven or eight years earlier. When he describes his recurring nightmares, he raises both arms and rubs his forehead with his palms.
Despite spending more than three years at this behavior-modification facility, Rob still has problems controlling his behavior. In 2005, he was arrested for attempted assault and sent to jail. (This year he was arrested again, for drugs and assault.) Being locked up has given him plenty of time to reflect on his childhood, and he has gained a new perspective on the Rotenberg Center. "It's worse than jail," he told me. "That place is the worst place on earth."
One Punishment Fits All
The story of the Rotenberg Center is in many ways a tale of two schools. Slightly more than half the residents are what the school calls "high functioning": kids like Rob and Antwone, who have diagnoses like attention-deficit disorder, bipolar disorder, post-traumatic stress disorder, and other emotional problems. The other group is even more troubled. Referred to as "low functioning," it includes kids with severe autism and mental retardation; most cannot speak or have very limited verbal abilities. Some have behaviors so extreme they can be life threatening: chomping on their hands and arms, running into walls, nearly blinding themselves by banging their heads on the floor again and again.
The Rotenberg Center has long been known as the school of last resort—a place that will take any kid, no matter how extreme his or her problems are. It doesn't matter if a child has been booted out of 2, 5, 10, or 20 other programs—he or she is still welcome here. For desperate parents, the Rotenberg Center can seem like a godsend. Just ask Louisa Goldberg, the mother of 25-year-old Andrew, who has severe mental retardation. Andrew's last residential school kicked him out after he kept assaulting staff members; the Rotenberg Center was the only place willing to accept him. According to Louisa, Andrew's quality of life has improved dramatically since 2000, when he was hooked up to the shock device, known as the Graduated Electronic Decelerator, or ged.
The Rotenberg Center has a policy of not giving psychiatric drugs to students—no Depakote, Paxil, Risperdal, Ritalin, or Seroquel. It's a policy that appeals to Louisa and many other parents. At Andrew's last school, she says, "he had so many medicines in him he'd take a two-hour nap in the morning, he'd take a two-hour nap in the afternoon. They'd have him in bed at eight o'clock at night. He was sleeping his life away." These days, Louisa says she is no longer afraid when her son comes home to visit. "[For him] to have an electrode on and to receive a ged is to me a much more favorable way of dealing with this," she says. "He's not sending people to the hospital."
Marguerite Famolare brought her son Michael to the Rotenberg Center six years ago, after he attacked her so aggressively she had to call 911 and, in a separate incident, flipped over a kitchen table onto a tutor. Michael, now 19, suffers from mental retardation and severe autism. These days, when he comes home for a visit, Marguerite carries his shock activator in her purse. All she has to do, she says, is show it to him. "He'll automatically comply to whatever my signal command may be, whether it is 'Put on your seatbelt,' or 'Hand me that apple,' or 'Sit appropriately and eat your food,'" she says. "It's made him a human being, a civilized human being."
Massachusetts officials have twice tried to shut the Rotenberg Center down—once in the 1980s and again in the 1990s. Both times parents rallied to its defense, and both times it prevailed in court. (See "Why Can't Massachusetts Shut Matthew Israel Down?" page 44.) The name of the center ensures nobody forgets these victories; it was Judge Ernest Rotenberg, now deceased, who in the mid-'80s ruled that the facility could continue using aversives—painful punishments designed to change behavior—so long as it obtained authorization from the Bristol County Probate and Family Court in each student's case. But even though the facility wasn't using electric shock when this ruling was handed down, the court rarely, if ever, bars the Rotenberg Center from adding shock to a student's treatment plan, according to lawyers and disability advocates who have tried to prevent it from doing so.
Since Evelyn Nicholson filed her lawsuit in 2006, the Rotenberg Center has faced a new wave of criticism and controversy. (See "Nagging? Zap. Swearing? Zap," page 41.) And again, the facility has relied heavily on the testimonials of parents like Louisa Goldberg and Marguerite Famolare to defend itself. Not surprisingly, the most vocal parent-supporters tend to be those with the sickest children, since they are the ones with the fewest options. But at the Rotenberg Center, the same methods of "behavior modification" are applied to all kids, no matter what is causing their behavior problems. And so, while Rob would seem to have little in common with mentally retarded students like Michael and Andrew, they all shared a similar fate once their parents placed them under the care of the same psychologist, a radical behaviorist known as Dr. Israel.
Dr. Israel's Radical Behavior
In 1950, matt israel was a Harvard freshman looking to fill his science requirement. He knew little about B.F. Skinner when he signed up for his course, Human Behavior. Soon, though, Israel became fascinated with Skinner's scientific approach to the study of behavior, and he picked up Walden Two, Skinner's controversial novel about an experimental community based on the principles of behaviorism. The book changed Israel's life. "I decided my mission was to start a utopian community," he says. Israel got a Ph.D. in psychology in 1960 from Harvard, and started two communal houses outside Boston.
One of the people Israel lived with was a three-year-old named Andrea, the daughter of a roommate. The two did not get along. "She was wild and screaming," Israel recalls. "I would retreat to my own room, and she'd be trying to pull away and get into my room, and I'd have to hold the door on one side to keep her from disturbing me." When company would come over, he says, "She would walk around with a toy broom and whack people over the head."
Through experiments with rats and pigeons, Skinner had demonstrated how animals learn from the consequences of their actions. With permission from Andrea's mother, Israel decided to try out Skinner's ideas on the three-year-old. When Andrea was well behaved, Israel took her out for walks. But when she misbehaved, he punished her by snapping his finger against her cheek. His mentor Skinner preached that positive reinforcement was vastly preferable to punishment, but Israel says his methods transformed the girl. "Instead of being an annoyance, she became a charming addition to the house."
Israel's success with Andrea convinced him to start a school. In 1971, he founded the Behavior Research Institute in Rhode Island, a facility that would later move to Massachusetts and become known as the Judge Rotenberg Center. Israel took in children nobody else wanted—severely autistic and mentally retarded kids who did dangerous things to themselves and others. To change their behavior, he developed a large repertoire of punishments: spraying kids in the face with water, shoving ammonia under their noses, pinching the soles of their feet, smacking them with a spatula, forcing them to wear a "white-noise helmet" that assaulted them with static.
In 1977, Israel opened a branch of his program in California's San Fernando Valley, along with Judy Weber, whose son Tobin is severely autistic. Two years later, the Los Angeles Times reported Israel had pinched the feet of Christopher Hirsch, an autistic 12-year-old, at least 24 times in 30 minutes, while the boy screamed and cried. This was a punishment for soiling his pants. ("It might have been true," Israel says. "It's true that pinches were being used as an aversive. The pinch, the spank, the muscle squeeze, water sprays, bad taste—all those procedures were being used.") Israel was in the news again in 1981, when another student, 14-year-old Danny Aswad, died while strapped facedown to his bed. In 1982, the California Department of Social Services compiled a 64-page complaint that read like a catalog of horrors, describing students with bruises, welts, and cuts. It also accused Israel of telling a staff member "to grow his fingernails longer so he could give an effective pinch."
In 1982, the facility settled with state officials and agreed to stop using physical punishments. Now called Tobinworld, and still run by Judy Weber, it is a $10-million-a-year organization operating day schools near Los Angeles and San Francisco. The Rotenberg Center considers itself a "sister school" to Tobinworld, and Israel makes frequent trips to California to visit Weber. The two were married last year.
Despite his setback in California, Israel continued to expand on the East Coast—and to generate controversy. In 1985, Vincent Milletich, an autistic 22-year-old, suffered a seizure and died after he was put in restraints and forced to wear a white-noise helmet. Five years later, 19-year-old Linda Cornelison, who had the mental capacity of a toddler, refused to eat. On the bus to school, she clutched her stomach; someone had to carry her inside, and she spent the day on a couch in a classroom. Linda could not speak, and the staff treated her actions as misbehaviors. Between 3:52 p.m. and 8 p.m., staffers punished her with 13 spatula spankings, 29 finger pinches, 14 muscle squeezes, and 5 forced inhalings of ammonia. It turned out that Linda had a perforated stomach. She died on the operating table at 1:45 a.m.
The local district attorney's office examined the circumstances of Vincent's death but declined to file any charges. In Linda's case, the Massachusetts Department of Mental Retardation investigated and found that while Linda's treatment had "violated the most basic codes and standards of decency and humane treatment," there was insufficient evidence to prove that the use of aversives had caused her death.
The local district attorney's office examined the circumstances of Vincent's death but declined to file any charges. In Linda's case, the Massachusetts Department of Mental Retardation investigated and found that while Linda's treatment had "violated the most basic codes and standards of decency and humane treatment," there was insufficient evidence to prove that the use of aversives had caused her death.
Israel purchased a shock device then on the market known as sibis—Self-Injurious Behavior Inhibiting System—that had been invented by the parents of an autistic girl and delivered a mild shock that lasted .2 second. Between 1988 and 1990, Israel used sibis on 29 students, including one of his most challenging, Brandon, then 12, who would bite off chunks of his tongue, regurgitate entire meals, and pound himself on the head. At times Brandon was required to keep his hands on a paddle; if he removed them, he would get automatic shocks, one per second. One infamous day, Brandon received more than 5,000 shocks. "You have to realize," Israel says. "I thought his life was in the balance. I couldn't find any medical solution. He was vomiting, losing weight. He was down to 52 pounds. I knew it was risky to use the shock in large numbers, but if I persevered that day, I thought maybe it would eventually work. There was nothing else I could think of to do...but by the time it went into the 3,000 or 4,000 range, it became clear it wasn't working."
This day was a turning point in the history of Israel's operation—that's when he decided to ratchet up the pain. The problem, he decided, was that the shock sibis emitted was not strong enough. He says he asked sibis's manufacturer, Human Technologies, to create a more powerful device, but it refused. "So we had to redesign the device ourselves," he says. He envisioned a device that would start with a low current but that could increase the voltage if needed—hence its name, Graduated Electronic Decelerator or ged—but he abandoned this idea early on. "As it turns out, that's really not a wise approach," he says. "It's sort of like operating a car and wearing out the brakes because you never really apply them strongly enough. Instead, we set it at a certain level that was more or less going to be effective for most of our students."
Thirty years earlier, O. Ivar Lovaas, a psychology professor at ucla, had pioneered the use of slaps and screams and electric jolts to try to normalize the behavior of autistic kids. Life magazine featured his work in a nine-page photo essay in 1965 with the headline, "A surprising, shocking treatment helps far-gone mental cripples." Lovaas eventually abandoned these methods, telling cbs in 1993 that shock was "only a temporary suppression" because patients become inured to the pain. "These people are so used to pain that they can adapt to almost any kind of aversive you give them," he said.
Israel encountered this same sort of adaptation in his students, but his solution was markedly different: He decided to increase the pain once again. Today, there are two shock devices in use at the Rotenberg Center: the ged and the ged-4. The devices look similar and both administer a two-second shock, but the ged-4 is nearly three times more powerful—and the pain it inflicts is that much more severe.
The Mickey Mouse Club
Ten years ago, Israel hung up a Mickey Mouse poster in the main hall, and he noticed that it made people smile—so he bought every Mickey Mouse poster he could find. He hung them in the corridors and even papered the walls of what became known as the Mickey Mouse Conference Room. Entering the Rotenberg Center is a bit like stepping into a carnival fun house, I discovered during a two-day visit last autumn. Two brushed-aluminum dogs, each nearly 5 feet tall and sporting a purple neon collar, stand guard outside. Giant silver stars dangle from the lobby ceiling; the walls and chairs in the front offices are turquoise, lime green, and lavender.
Israel, 74, still holds the title of executive director, for which he pays himself nearly $400,000 in salary and benefits. He appears utterly unimposing: short and slender with soft hands, rounded shoulders, curly white hair, paisley tie. Then he sits down beside me and, unprompted, starts talking about shocking children. "The treatment is so powerful it's hard not to use if you have seen how effective it is," he says quietly. "It's brief. It's painful. But there are no side effects. It's two seconds of discomfort." His tone is neither defensive nor apologetic; rather, it's perfectly calm, almost soothing. It's the sort of demeanor a mother might find comforting if she were about to hand over her child.
Before we set off on our tour of the facility, there's something Israel wants me to see: Before & After, a homemade movie featuring six of his most severe cases. Israel has been using some of the same grainy footage for more than two decades, showing it to parents of prospective students as well as visiting reporters. They've already mailed me a copy, but Israel wants to make sure I watch it. An assistant slips the tape into the vcr, Israel presses the remote, and we all stare at the screen:
1977: An 11-year-old girl named Caroline arrives at the school strapped down onto a stretcher, her head encased in a helmet. In the next shot, free from restraints, she crouches down and tries to smash her helmeted head against the floor.
1981: Janine, also 11 years old, shrieks and slams her head against the ground, a table, the door. Bald spots testify to the severity of her troubles; she's yanked out so much hair it's half gone.
Both girls exhibit autistic behaviors, and compared with these scenes, the "After" footage looks almost unbelievable: Janine splashes in a plastic pool, while Caroline grins as she sits in a chair at a beauty salon. "Most people haven't seen these pictures," Israel says, setting down the remote. "They haven't seen children like this, so they cannot imagine. These are children for whom positive-only procedures did not work, drugs did not work. And if it wasn't for this treatment, some of these people would not be alive." The video is extremely persuasive: The girls' self-abuse is so violent and so frightening that it almost makes me want to grab a ged remote and push the button myself. Of course, this is precisely the point.
Considering how compelling the "After" footage is, I am surprised to learn that five of the six children featured in it are still here. "This is Caroline," one of my escorts says an hour or two later as we walk down a corridor. Without an introduction, I would not have known. Caroline, 39, slumps forward in a wheelchair, her fists balled up, head covered by a red helmet. "Blow me a kiss, Caroline," Israel says. She doesn't respond.
A few minutes later, I meet 36-year-old Janine, who appears in much better shape. She's not wearing a helmet and has a full head of black hair. She's also got a backpack on her shoulders and canvas straps hanging from her legs, the telltale sign that electrodes are attached to both calves. For 16 years—nearly half her life—Janine has been hooked up to Israel's shock device. A couple years ago, when the shocks began to lose their effect, the staff switched the devices inside her backpack to the much more painful ged-4.
Rogue Science
In 1994, matthew israel had just 64 students. Today he has 234. This astonishing rate of growth is largely the result of a dramatic change in the types of students he takes in. Until recently, nearly all were "low functioning," autistic and mentally retarded people. But today slightly more than 50 percent are "high functioning," with diagnoses like add, adhd, and bipolar disorder. New York state supplies the majority of these students, many of whom grew up in the poorest parts of New York City. Yet despite this change in his population, Israel's methods have remained essentially the same.
Israel has long faced criticism that he has not published research about his use of electric shocks in peer-reviewed journals, where experts could scrutinize it. To defend his methods, he points to a bibliography of 110 research articles that he's posted on the Rotenberg Center website. This catalog seems impressive at first. Studied more closely, however, it is not nearly so convincing. Three-quarters of the articles were published more than 20 years ago. Eight were written or cowritten by Lovaas, the ucla-affiliated behaviorist. One of America's leading autism experts, Lovaas long ago stopped endorsing painful aversives. And Lovaas' old studies focus primarily on children with autism who engage in extreme self-injury—not on troubled teens who have been diagnosed with adhd or add.
But then, it would be hard for Israel to find contemporary research supporting his program, because the practice of treating self-abusive kids with pain has been largely abandoned. According to Dr. Saul Axelrod, a professor at Temple University and an expert on behavior modification, "the field has moved away from painful stimuli because of public outcry and because we've devised better techniques," including determining the cause of an individual's self-abuse.
Another expert Israel cites several times is Dr. Brian A. Iwata, a consultant on the development of sibis, the device Israel modified to create his ged. Now a professor of psychology and psychiatry at the University of Florida, he's a nationally recognized authority on treating severe self-abuse among children with developmental disabilities. Iwata has visited the Rotenberg Center and describes its approach as dangerously simplistic: "There appears to be a mission of that program to use shock for problem behaviors. It doesn't matter what that behavior is." Iwata has consulted for 25 states and says there is little relationship between what goes on at Israel's program and what goes on at other facilities. "He may have gotten his Ph.D. at Harvard, but he didn't learn what he's doing at Harvard. Whatever he's doing, he decided to do on his own."
Paul Touchette, who also studied with B.F. Skinner, has known Israel since the 1960s when they were both in Cambridge. Like Israel, Touchette went on to treat children with autism who exhibit extreme self-abuse, but he isn't a fan of Israel's approach either. "Punishment doesn't get at the cause," says Touchette, who is on the faculty of the University of California-Irvine School of Medicine. "It just scares the hell out of patients."
Over the decades, Touchette has followed Israel's career and bumped into him at professional conferences. "He's a very smart man, but he's an embarrassment to his profession," Touchette says. "I've never been able to figure out if Matt is a little off-kilter and actually believes all this stuff, or whether he's just a clever businessman."
Big Reward Store
At the rotenberg center, an elaborate system of rewards and punishments governs all interactions. Well-behaved kids can watch TV, go for pizza, play basketball. Students who've earned points for good behavior visit a store stocked with dvd players, cds, cologne, PlayStation 2, Essence magazine, knockoff Prada purses—anything the staff thinks students might want. But even more prized is a visit to the "Big Reward Store," an arcade full of pinball machines, video games, a pool table, and the most popular feature, a row of 42-inch flat-screen TVs hooked up to Xbox 360s.
Students like the "brs" for another reason—it's the only place many can socialize freely. At the Rotenberg Center, students have to earn the right to talk to each other. "We had to wait until we were in brs to communicate with others," says Isabel Cedeño, a 16-year-old who ran away from Rotenberg in 2006 after her boyfriend, a former student, came and got her. "That was the only time you really laughed, had fun, hung around with your friends. Because usually, you can't talk to them. It was basically like we had to have enemies. They didn't want us to be friendly with nobody."
Students live grouped together in homes and apartments scattered in nearby towns and are bused to the facility's headquarters every morning. They spend their days in classrooms, staring at a computer screen, their backs to the teacher. They are supposed to teach themselves, using self-instruction programs that include lessons in math, reading, and typing. Even with breaks for gym and lunch, the days can be incredibly dull. "On paper, it does look like they're being educated, because we have lesson plans," says former teacher Jessica Croteau, who oversaw a classroom of high-functioning teens for six months before leaving in 2006. But "to self-teach is not exciting. Why would the kids want to sit there and read a chapter on their own without any discussion?"
Croteau says teachers have to spend so much time monitoring misbehaviors there's often little time left for teaching. Whenever a student disobeys a rule, a staff member must point it out, using the student's name and just one or two rote phrases like, "Mark, there's no stopping work. Work on your task, please." Each time a student curses or yells, a staffer marks it on the student's recording sheet. Teachers and aides then use the sheet to calculate what level of punishment is required—when to just say "No!" and when to shock.
Employees carry students' shock activators inside plastic cases, which they hook onto their belt loops. These cases are known as "sleds," and each sled has a photo on it to ensure employees don't zap the wrong kid.
Behaviorism would seem to dictate that staff shock students immediately after they break the rules. But if employees learn about a misbehavior after it has occurred—by, say, reviewing surveillance footage—they may still administer punishment. Rob Santana recalls that Mondays were always the most stressful day of the week. He would sit at his desk all day, trying to remember if he had broken any rules over the weekend, waiting to see if he'd be shocked.
Employees are encouraged to use the element of surprise. "Attempt to be as discreet as possible and hold the transmitter out of view of the student," states the employee manual. This way, students cannot do anything to minimize the pain, like flipping over their electrodes or tensing their muscles. "We hear the sound of [a staffer] picking up a sled," says Isabel, the former student. "Then we turn around and see the person jump out of their seat."
Employees shock students for a wide range of behaviors, from violent actions to less serious offenses, like getting out of their seats without permission. In 2006, the New York State Education Department sent a team of investigators, including three psychologists, to the Rotenberg Center, then issued a scathing report. Among its many criticisms was that the staff shocked kids for "nagging, swearing, and failing to maintain a neat appearance." Israel only disputes the latter. As for nagging and swearing? "Sometimes a behavior looks innocuous," he says, "but if it's an antecedent for aggression, it may have to be treated with an aversive."
New York officials disagreed, and in January 2007 issued regulations that would prohibit shocking New York students for minor infractions. But a group of New York parents filed a federal lawsuit to stop the state from enforcing these regulations. They prevailed, winning a temporary restraining order against the state, one that permits the Rotenberg Center staffers to continue using shock. The parents' case is expected to go to trial in 2008.
When they talk about why they use the shock device, Israel and his employees like to use the word "treatment," but it might be more accurate to use words like "convenience" or "control." "The ged—it's two seconds and it's done," says Patricia Rivera, a psychologist who serves as assistant director of clinical services. "Then it's right back to work." By contrast, it can take 8 or 10 employees half an hour or longer to restrain a strong male student: to pin him to the floor, wait for him to stop struggling, then move his body onto a restraint board and tie down each limb. Restraining five or eight kids in a single day—or the same student again and again—can be incredibly time-consuming and sometimes dangerous.
When they talk about why they use the shock device, Israel and his employees like to use the word "treatment," but it might be more accurate to use words like "convenience" or "control." "The ged—it's two seconds and it's done," says Patricia Rivera, a psychologist who serves as assistant director of clinical services. "Then it's right back to work." By contrast, it can take 8 or 10 employees half an hour or longer to restrain a strong male student: to pin him to the floor, wait for him to stop struggling, then move his body onto a restraint board and tie down each limb. Restraining five or eight kids in a single day—or the same student again and again—can be incredibly time-consuming and sometimes dangerous.
"Our Students Have a Tendency to Lie"
Rotenberg staff place the more troubled (or troublesome) residents on 1:1 status, meaning that an aide monitors them everywhere they go. For extremely violent students, the ratio is 2:1. Soon after I arrived, right before I set off on my tour, a small crowd gathered—it seemed that almost the entire hierarchy of the Rotenberg Center was going to follow me around. That's when I realized I'd been put on 5:1. As I began to roam around the school with my escorts, my every move monitored by surveillance cameras, I realized it would be impossible to have a private conversation with any student. The best I could hope for would be a few unscripted moments.
Ten years ago, a reporter visiting Israel's center would have been unable to talk to most students; back then few of them could speak. These days, there are more than 100 high-functioning kids fully capable of voicing their views, and Israel has enlisted a few in his campaign to promote the ged. "If we had only [severely] autistic students, they couldn't talk to you and say, 'Gee, this is really helping me,'" Israel says. "Now for the first time we have students like Katie who can tell you it helped them."
In the world of the Rotenberg Center, Katie Spartichino is a star. She left the facility in the spring of 2006 and now attends community college in Boston. Around noon, a staff member brings her back to the facility to talk to me. We sit at an outdoor picnic table away from the surveillance cameras but there's no privacy: Israel and Karen LaChance, the assistant to the executive director for admissions, sit with us.
Katie, 19, tells me she overdosed on pills at 9, spent her early adolescence in and out of psych wards, was hooked up to the ged at 16, and stayed on the device for two years. "This is a great place," she says. "It took me off all my medicine. I was close to 200 pounds and I'm 160 now." She admits her outlook was less rosy when she first had to wear the electrodes. "I cried," she says. "I kind of felt like I was walking on eggshells; I had to watch everything I said. Sometimes a curse word would just come out of my mouth automatically. So being on the geds and knowing that swearing was a targeted behavior where I would receive a [GED] application, it really got me to think twice before I said something disrespectful or something just plain-out rude."
As Katie speaks, LaChance runs her fingers through Katie's hair again and again. The gesture is so deliberate it draws my attention. I wonder if it's just an expression of affection—or something more, like a reward.
"Do you swear anymore?" I ask.
"Oh, God, all the time," Katie says. She pauses. "Well, I have learned to control it, but I'm not going to lie. When I'm on the phone, curse words come out."
The hair stroking stops. LaChance turns to Katie. "I hope you're not going to tell me you're aggressive."
"Oh, no, that's gone," Katie says. "No, no, no. The worst thing I do sometimes is me and my mom get into little arguments."
For Israel, of course, one drawback of having so many high-functioning students is that he cannot control everything they say. One afternoon, when I walk into a classroom of teenagers, a 15-year-old girl catches my eye, smiles, and holds up a sheet of paper with a message written in pink marker: HELP US. She puts it back down and shuffles it into her stack of papers before anyone else sees. When I move closer, she tells me her name is Raquel, she is from the Bronx, and she wants to go home.
My escorts allow me to interview Raquel while two of them sit nearby. Raquel is not hooked up to the ged, but she has many complaints, including that she has just witnessed one of her housemates get shocked. "She was screaming," Raquel says. "They told her to step up to be searched; she didn't want to step up to be searched, so they gave her one." After 20 minutes, my escorts cut us off. "Raquel, you did a great job—thank you for taking the time," says Patricia Rivera, the psychologist.
Once Raquel is out of earshot, Rivera adds, "Some of the things she said are not true, some of them are. Our students obviously have a tendency to lie about things." She explains that a staff member searches Raquel's housemate every hour because she's the one who recently stabbed an employee with a pencil.
The Rotenberg Center does not have a rule about how old a child must be before he or she can be hooked up to the ged. One of the program's youngest students is a nine-year-old named Rodrigo. When I see him, he is seated outside at a picnic table with his aide. Rodrigo's backpack looks enormous on his tiny frame; canvas straps dangle from both legs.
"He was horrible when he first came in," Rivera says. "It would take five staff to restrain him because he's so wiry." What was he like? "A lot of aggression. A lot of disruptive behavior. Whenever he was asked to do a task that he didn't feel like doing, he would scream, yell, swear. The stuff that would come out of his mouth you wouldn't believe—very sexually inappropriate."
"Rodrigo, come here," one of my escorts says.
Rodrigo walks over, his straps slapping the ground. He wears a white dress shirt and tie—the standard uniform for male students—but because he is so small, maybe 4 feet tall, his tie nearly reaches his thighs. "What's that?" he asks.
"That's a tape recorder," I say. "Do you want to say something?"
"Yeah."
"That's a tape recorder," I say. "Do you want to say something?"
"Yeah."
The Employee-Modification System
To understand how the Rotenberg Center works, it helps to know that it runs not just one behavior-modification program, but two—one for the residents, and one for the staff. Employees have no autonomy. If a staffer believes it's okay to shock a kid who is smashing his head against a wall, but it's not okay to shock someone for getting out of his chair without permission, that could spell trouble. "There's pressure on you to do it," a former teacher told me. "They punish you if you don't."
I met this former teacher at a restaurant, and our meeting stretched on for six hours. At times it felt less like an interview than a confession. "The first time you give someone a ged is the worst one," the teacher said. "You don't want to hurt somebody; you want to help. You're thinking, 'This has got to be okay. This has got to be legal, or they wouldn't be doing this.'" At the Rotenberg Center, it's virtually impossible to discuss such concerns with coworkers because there are cameras everywhere, even in the staff break room. Staff members who want to talk to each other without being overheard may meet up in the parking lot or scribble notes to each other. But it's hard to know whom to trust, since Israel encourages employees to file anonymous reports about their coworkers' lapses.
In addition, staff members are prohibited from having casual conversations with each other. They cannot, for example, say to a coworker, "Hey, did you see the Red Sox game last night?" "We don't want them discussing their social life or the ball games in front of the students or while they're on duty," Israel says. "So we'll sometimes actually have one staffer deliberately start a social conversation with another and we'll see whether the other—as he or she should—will say, 'I don't want to discuss that now.'" Monitors watch these setups on the surveillance cameras and punish staffers who take the bait.
Former employees describe a workplace permeated with fear—fear of being attacked by students and fear of losing their job. There are so many rules—and so many cameras—it's not easy to stay out of trouble. Employees quit or are fired so often that two-thirds of the direct-care employees remain on the job for less than a year.
New employees must sign a confidentiality agreement promising not to talk about the Rotenberg Center—even after they no longer work there. Of the eight ex-employees I interviewed, most did not want to be identified by name for fear of Israel suing them; all were critical of how the ged is used. Maybe, says one, the use of shocks was justified in a few extreme self-injurious cases, but that's all. "Say you had a hospital that was the only hospital in the nation that had chemotherapy, and they were treating people who had the common cold with it," she says. "I think the extreme to which they abuse their power has outweighed what good they do."
The Hard Lessons of Connie Chung
Matthew Israel has been fielding questions from journalists since the 1970s, but few have examined his operation as thoroughly—and critically—as the producers at Eye to Eye with Connie Chung did. In 1993, they spent six months investigating the facility. They even found an employee willing to go inside with a hidden camera. But Israel ended up getting the last laugh. As he recounts the story for me, he can barely contain his glee. "We refused to meet with her unless the parents could be in the same room," he says, grinning. "She talked to the parents, and they really gave it to her." This is no exaggeration: When Chung tried to ask him tough questions, his parent-supporters shouted her down.
Throughout this raucous meeting, Israel had his own camera rolling, too, which turned out to be a brilliant move. Before cbs got its 40-minute story on the air, Israel launched a national campaign to discredit both Chung and her report. He accused her of being "biased" and "hostile," and to prove it, he distributed edited videotapes of her interview to media critics and cbs affiliates. It worked. A New York Times television critic savaged cbs, accusing it of using "shabby tricks of the trade." Suddenly the story was not about whether the school had abused students—but whether cbs had abused the school.
"I don't think it was a positive thing for her career," says Israel, still smiling. It's late in the day, right near the end of my visit, and I'm starting to wonder why he's brought up this topic.
By now I've spent 22 hours with Israel and his staff—wandering around the facility, meeting parents they've brought in for me to interview. But before I depart, there's one more place I want to see, the room where they repair the geds. Israel and Glenda Crookes, an assistant executive director, agree to take me there. It is just past 7 p.m. and drizzling as we climb into Israel's Lexus for a short drive to the maintenance building.
There, Crookes and Israel lead me down a hall, past storerooms filled with red helmets, ged sleds, batteries and their chargers. The room at the end of the hall looks like it could be a repair shop for any sort of electronics equipment: scissors, screwdrivers, industrial-grade glue, a Black & Decker Pivot Driver. On one desk, I spot a form called a ged Trouble Report. The report explains that someone dropped off Duane's shock device because it was "making rattling noises." Crookes explains, "Anytime a screw is loose or anything is wrong with the device, it's automatically sent back here."
A Trouble Report on another desk suggests a more serious problem: "Jamie Z was getting his battery changed, Luigi received a shock." "What does this mean?" I ask. Crookes picks up the paper, reads it, then hands it to Israel and walks away. Her gesture seems to say, I cannot believe we just spent two days with this reporter and now this is the last thing she sees.
Israel stares at the report, then reaches into his pocket and pulls out a pair of reading glasses. Nobody says anything. Outside, one car after another races by, the tail end of the evening commute.
After a minute or two, Israel says, "Well, I don't understand the whole of it." He is still staring at the paper in his hand. "But there was apparently a spontaneous activation." The ged, in other words, delivered a shock without anyone pressing its remote.
This moment reminds me of something Israel told me earlier about the premise of Skinner's Walden Two, that by changing people's behaviors you can help them have a better life. But, Israel was careful to add, "The notion was that you needed to have the whole environment under control. With a school like this, we have an awful lot. Not the whole environment, but an awful lot."
He was right; he controls nearly every aspect of his facility. But all of his surveillance cameras and microphones and paperwork and protocols had failed to protect Luigi, a mentally retarded resident who had done nothing wrong.
A shocking error in treatment
The Boston Globe
December 21, 2007
Friday THIRD EDITION
THE JUDGE ROTENBERG Educational Center is the only school in the nation that routinely uses skin shocks to control self-destructive and violent behavior by autistic, retarded, and emotionally disabled patients. But the Canton-based center is too error-prone to be allowed to keep using aversive therapy without intensive and ongoing oversight by state health officials. The state Executive Office of Health and Human Services must decide soon if the controversial program warrants continued support and student placements.
There is a role for aversive therapy if it is practiced with great restraint and respect. But such was not the case in August, when two emotionally disturbed teens in a Stoughton group home run by the Rotenberg center were given dozens of electrical shocks at the direction of a telephone caller posing as a medical supervisor. That caller was later identified as a former student. The fact that the staff was so easily duped speaks to both poor screening of new hires and a dangerous lack of training. On that night, at least, the center resembled not a therapeutic environment but the infamous Milgram experiment, which measured the willingness of ordinary people to hurt a test subject based on nothing more than the verbal order of a phony scientist.
Critics of the center are many, and include a majority of the Massachusetts Senate, which has tried to ban Rotenberg's controversial treatment. But the testimonials from Rotenberg families speak with greater authority. The skin-shock techniques often stop or reduce the eye gouging, head banging, self-mutilation, and assaults that defy the practitioners of positive reinforcement, drugs, and other traditional therapies. Rotenberg's roughly 200 students typically arrive on the doorstep having attended four prior programs, according to school founder Matthew Israel.
Several state agencies monitor the Rotenberg Center. But the buck stops with the certifying agency - the state Department of Mental Retardation. This week, DMR recertified the Rotenberg Center for one year. But the agency should be prepared to withdraw that certification if a pending study by the state Disabled Persons Protection Commission uncovers additional problems at the center. Wisely, the state has sent no new clients to the center for aversive treatment since January.
Israel says the center has implemented a slew of new supervisory and monitoring practices for its 38 group homes. But the overnight shift still lacks direct supervision by a registered nurse or other licensed medical professional. That doesn't inspire confidence.
The decision to apply aversive techniques rests in the hands of parents and a probate court judge who vets each case with medical experts. The question isn't so much whether skin shocks are an acceptable form of treatment, but whether the Rotenberg Center is the right place to do it.
December 21, 2007
Friday THIRD EDITION
THE JUDGE ROTENBERG Educational Center is the only school in the nation that routinely uses skin shocks to control self-destructive and violent behavior by autistic, retarded, and emotionally disabled patients. But the Canton-based center is too error-prone to be allowed to keep using aversive therapy without intensive and ongoing oversight by state health officials. The state Executive Office of Health and Human Services must decide soon if the controversial program warrants continued support and student placements.
There is a role for aversive therapy if it is practiced with great restraint and respect. But such was not the case in August, when two emotionally disturbed teens in a Stoughton group home run by the Rotenberg center were given dozens of electrical shocks at the direction of a telephone caller posing as a medical supervisor. That caller was later identified as a former student. The fact that the staff was so easily duped speaks to both poor screening of new hires and a dangerous lack of training. On that night, at least, the center resembled not a therapeutic environment but the infamous Milgram experiment, which measured the willingness of ordinary people to hurt a test subject based on nothing more than the verbal order of a phony scientist.
Critics of the center are many, and include a majority of the Massachusetts Senate, which has tried to ban Rotenberg's controversial treatment. But the testimonials from Rotenberg families speak with greater authority. The skin-shock techniques often stop or reduce the eye gouging, head banging, self-mutilation, and assaults that defy the practitioners of positive reinforcement, drugs, and other traditional therapies. Rotenberg's roughly 200 students typically arrive on the doorstep having attended four prior programs, according to school founder Matthew Israel.
Several state agencies monitor the Rotenberg Center. But the buck stops with the certifying agency - the state Department of Mental Retardation. This week, DMR recertified the Rotenberg Center for one year. But the agency should be prepared to withdraw that certification if a pending study by the state Disabled Persons Protection Commission uncovers additional problems at the center. Wisely, the state has sent no new clients to the center for aversive treatment since January.
Israel says the center has implemented a slew of new supervisory and monitoring practices for its 38 group homes. But the overnight shift still lacks direct supervision by a registered nurse or other licensed medical professional. That doesn't inspire confidence.
The decision to apply aversive techniques rests in the hands of parents and a probate court judge who vets each case with medical experts. The question isn't so much whether skin shocks are an acceptable form of treatment, but whether the Rotenberg Center is the right place to do it.
JRC Records Seized by State Police
May 17, 2008 Saturday 1:34 AM EST
BYLINE: Kristina Chew, PhD
May 17, 2008 (b5media delivered by Newstex) -- This past Thursday in Virginia, a 24 year old autistic man was tazered by James City County police after he was to "become unruly with employees at Wilsons Leather at the Prime Outlets-Williamsburg shopping mall," according to the Daily Press. It was only after the man was placed under arrest and charged with trespassing and resisting arrest that police learned that he had Asperger's Syndrome. Needless to say, incidents like these make training about autism for police and other first responders more than essential. The Daily Press quotes a James City Police spokesman, Mike Spearsman, as saying that the 24-year-old man was "'rather large'"---these are words that strike home with me more and more. Almost every day someone comments to me that Charlie is "so big" or says "he's taller than you!". The words are meant kindly but, in practical terms, Charlie's height and size (he's the biggest in his class but the youngest in age), combined with his limited speech and communication skills (especially to strangers, especially when he's under duress), can make people who don't know him uneasy, even when he's simply sitting on the subway and does not respond quickly enough when someone asks him to move over. It's been some time since Charlie got very, very upset in public; it helps that we work a lot on teaching him to manage his anxiety and how he responds to it. In the past, when Charlie got very upset and aggressed--not out of wanting, I have to emphasize, to hurt anyone, but because that was the response of his body under extreme stress, a kind of "fight or flight" response--personnel at a previous school placement had been instructed to use physical restraints to stop the behavior. What usually happened was that Charlie struggled more (especially when a basket hold was used) and things escalated. And, Charlie started to make it clear that he did not want to go to school: There were many occurrences of those types of physical struggles, phone calls from nurses and principals, bruises and tears. (At one point, Charlie threw his shoes out of the car window as I drove him to school---a pretty clear message.) That was a few schools and households ago and Charlie's had his best school year ever. His teachers and therapists are trained in crisis management procedures and it always seems that the tallest aide (a guy) is assigned to Charlie, but it's very, very rare that any sort of physical force has to be applied. Careful and highly structured teaching and carefully training, highly motivated staff have made all the difference for Charlie. So it troubles me all the more to read about how often physical violence and force are used to "treat" or "discipline" autistic and disabled individuals. One of the most egregious examples is the use of "aversive therapy"--electric skin shock transmitted by a device called the Graduated Electronic Decelerator. A school in Canton, Massachusetts, the Judge Rotenburg Center (JRC), uses this highly controversial "therapy." Some parents swear that it has made all the difference in their children's lives and theirs. Derrick Jeffries, who has Asperger Syndrome, and University of Delaware professor Nancy Weiss have started an online petition to call on the American Psychological Association to condemn the JRC's shock therapy and other "aversive" treatments. In December of 2007, more questionable practices at the JRC were noted in an article by the Boston Globe. Back in January, a key legislative committee in Massachusetts considered a bill to decrease the use of shock treatment. A state investigation into the JRC was called after an August 2007 incident, in which a former JRC student made a prank phone call to administer shocks to two students. The May 15th Boston Globe reports that State Police were ordered to seize documents from the offices of the JRC related to that prank phone call: The collection of evidence has to do with a yearlong grand jury investigation led by the office of Attorney General Martha Coakley, said Kenneth Mollins, a New York lawyer who has filed several lawsuits against the school and who said he spoke to a representative of Coakley's office about the Rotenberg investigation. Mollins said he was told the grand jury is also examining possible financial improprieties by the school. JRC officials say that they have issued "numerous safeguards" to prevent the August prank call from happening again: The incident was caught on 24-hour surveillance tapes, which were shown to investigators last summer. The tapes were subsequently destroyed by school officials, even though investigators had instructed them to preserve the tapes. After hearing about the destruction of the tapes, Senator Brian A. Joyce, a Democrat from Milton who has sought to ban shock therapy at the school, said he intended to ask the attorney general's office to look into the matter. More analysis at Club 166. Charlie was able to tell me that he wanted out of his former school by throwing his shoes out the car window. But would a JRC student do, if they had minimal or no language or communication skills do?
BYLINE: Kristina Chew, PhD
May 17, 2008 (b5media delivered by Newstex) -- This past Thursday in Virginia, a 24 year old autistic man was tazered by James City County police after he was to "become unruly with employees at Wilsons Leather at the Prime Outlets-Williamsburg shopping mall," according to the Daily Press. It was only after the man was placed under arrest and charged with trespassing and resisting arrest that police learned that he had Asperger's Syndrome. Needless to say, incidents like these make training about autism for police and other first responders more than essential. The Daily Press quotes a James City Police spokesman, Mike Spearsman, as saying that the 24-year-old man was "'rather large'"---these are words that strike home with me more and more. Almost every day someone comments to me that Charlie is "so big" or says "he's taller than you!". The words are meant kindly but, in practical terms, Charlie's height and size (he's the biggest in his class but the youngest in age), combined with his limited speech and communication skills (especially to strangers, especially when he's under duress), can make people who don't know him uneasy, even when he's simply sitting on the subway and does not respond quickly enough when someone asks him to move over. It's been some time since Charlie got very, very upset in public; it helps that we work a lot on teaching him to manage his anxiety and how he responds to it. In the past, when Charlie got very upset and aggressed--not out of wanting, I have to emphasize, to hurt anyone, but because that was the response of his body under extreme stress, a kind of "fight or flight" response--personnel at a previous school placement had been instructed to use physical restraints to stop the behavior. What usually happened was that Charlie struggled more (especially when a basket hold was used) and things escalated. And, Charlie started to make it clear that he did not want to go to school: There were many occurrences of those types of physical struggles, phone calls from nurses and principals, bruises and tears. (At one point, Charlie threw his shoes out of the car window as I drove him to school---a pretty clear message.) That was a few schools and households ago and Charlie's had his best school year ever. His teachers and therapists are trained in crisis management procedures and it always seems that the tallest aide (a guy) is assigned to Charlie, but it's very, very rare that any sort of physical force has to be applied. Careful and highly structured teaching and carefully training, highly motivated staff have made all the difference for Charlie. So it troubles me all the more to read about how often physical violence and force are used to "treat" or "discipline" autistic and disabled individuals. One of the most egregious examples is the use of "aversive therapy"--electric skin shock transmitted by a device called the Graduated Electronic Decelerator. A school in Canton, Massachusetts, the Judge Rotenburg Center (JRC), uses this highly controversial "therapy." Some parents swear that it has made all the difference in their children's lives and theirs. Derrick Jeffries, who has Asperger Syndrome, and University of Delaware professor Nancy Weiss have started an online petition to call on the American Psychological Association to condemn the JRC's shock therapy and other "aversive" treatments. In December of 2007, more questionable practices at the JRC were noted in an article by the Boston Globe. Back in January, a key legislative committee in Massachusetts considered a bill to decrease the use of shock treatment. A state investigation into the JRC was called after an August 2007 incident, in which a former JRC student made a prank phone call to administer shocks to two students. The May 15th Boston Globe reports that State Police were ordered to seize documents from the offices of the JRC related to that prank phone call: The collection of evidence has to do with a yearlong grand jury investigation led by the office of Attorney General Martha Coakley, said Kenneth Mollins, a New York lawyer who has filed several lawsuits against the school and who said he spoke to a representative of Coakley's office about the Rotenberg investigation. Mollins said he was told the grand jury is also examining possible financial improprieties by the school. JRC officials say that they have issued "numerous safeguards" to prevent the August prank call from happening again: The incident was caught on 24-hour surveillance tapes, which were shown to investigators last summer. The tapes were subsequently destroyed by school officials, even though investigators had instructed them to preserve the tapes. After hearing about the destruction of the tapes, Senator Brian A. Joyce, a Democrat from Milton who has sought to ban shock therapy at the school, said he intended to ask the attorney general's office to look into the matter. More analysis at Club 166. Charlie was able to tell me that he wanted out of his former school by throwing his shoes out the car window. But would a JRC student do, if they had minimal or no language or communication skills do?
Parents Defend School's Use of Shock Therapy
The New York Times
December 25, 2007 Tuesday Correction Appended Late Edition - Final
Nearly a year ago, New York made plans to ban the use of electric shocks as a punishment for bad behavior, a therapy used at a Massachusetts school where New York State had long sent some of its most challenging special education students.
But state officials trying to limit New York's association with the school, the Judge Rotenberg Educational Center in Canton, southwest of Boston, and its ''aversive therapy'' practices have found a large obstacle in their paths: parents of students who are given shocks.
''I understand people who don't know about it think it is cruel,'' said Susan Handon of Jamaica, Queens, whose 20-year-old daughter, Crystal, has been at Rotenberg for four years. ''But she is not permanently scarred and she has really learned that certain behaviors, like running up and hitting people in the face, are not acceptable.''
Indeed, Rotenberg is full of children who will run up and hit strangers in the face, or worse. Many have severe types of dysfunction, including self-mutilation, head banging, eye gouging and biting, that can result from autism or mental retardation. Parents tend to be referred there by desperate education officials, after other institutions have decided they cannot keep the child.
While at Rotenberg, students must wear backpacks containing a device that allows a staff member to deliver a moderate shock to electrodes attached to the limbs, or in some cases palms, feet or torso, when the students engage in a prohibited behavior. Both the children's parents and a court must consent to the shocks.
Michael P. Flammia, the lawyer for Rotenberg, defended the practice in an interview.
''People want to believe positive interventions work even in the most extreme cases,'' he said. ''If they did, that is all we would use. Many of these kids come in on massive dosages of antipsychotic drugs, so doped up that they are almost comatose. We get them off drugs and give their parents something very important: hope.''
But for state officials, many behavior experts and even some former Rotenberg parents, the shock therapy at the school represents a dangerous, outdated approach to severe behavioral problems, reminiscent of the electric shock helmets used on some autistic patients into the 1980s and now discredited.
They say Rotenberg does not use shock punishments only for dangerous self-mutilation, but rather for a wide variety of actions, including shouting profanities and spitting, which are known to be effectively treated with less extreme punishments. And critics of the school say that unlike the more widely known electroconvulsive therapy, which has been used successfully in cases of severe depression and is being used experimentally on severely autistic people, applying shock as a punishment is not widely supported by the scientific community.
''People don't use it anymore because they don't need to. It is not the standard of care. There are alternative procedures that do not involve aversives like electronic shock,'' said William Pelham, a behavioral specialist and director of the Center for Children and Families at the State University of New York at Buffalo. ''And I am not talking about drugs as an alternative. I am talking about other behavioral treatments.''
Still, the parents say the shocks are making a difference in their children's lives as nothing else has. In 2006, after New York issued an immediate ban on electric shock for behavior modification, Ms. Handon was among the parents of more than 40 children who sued and won a court injunction to keep treatments going.
In January, the state, which pays for treatment of all New York students at Rotenberg to age 21, enacted a new ban on the treatment for those students, to take effect in 2009; it also set new restrictions on who can begin the therapy in the interim. But the parents amended their suit, and a trial beginning in 2008 will decide the issue.
''The point is that at Rotenberg, they still manage Crystal to control what she needs to do,'' Ms. Handon said. ''Her behaviors were not acceptable for society. Now I think I can bring her home.''
The Rotenberg Center, which says it is the only school in the nation using electric shock, has been the subject of many critical reports by the news media and state investigators.
Just last week, Massachusetts investigators issued a report saying a child at the school was shocked 77 times in three hours last summer as a result of a prank.
The report, by the Department of Early Education and Care, found that a former student pretending to be a school official demanded the punishment of two students, and that counselors administered shocks without double-checking. One of the children suffered first-degree burns.
''Our kids should not be sent there, and we will act immediately,'' Gov. Eliot Spitzer of New York said in response to the report.
But unlike many special education schools, Rotenberg, as a matter of policy, never rejects or expels a child, except an adjudicated sex offender. As a result, it continues to get referrals from around the nation.
Currently, nearly 100 of the more than 200 children at Rotenberg are from New York State, down from roughly 140 in 2006. The school says that it also has children from 10 other states, including California and Illinois, and that it has had students as young as 10. At a cost of about $228,000 per child per year, the students receive a range of therapies, including, in the case of more than 40 of the New Yorkers, the use of electric shocks.
Just how painful those shocks are has been an area of particular debate. Technically, the lowest shock given by Rotenberg is roughly twice what pain researchers have said is tolerable for most humans, said James Eason, a professor of biomedical engineering at Washington and Lee University. The highest shock given by Rotenberg is three times the lowest amount.
The lawyer for Rotenberg, Mr. Flammia, said the current has to hurt to work. He described the highest shock as ''a hard pinch.''
But a former teacher from the school, who asked not to be named because he signed a confidentiality agreement as a condition of employment and fears he could be sued for speaking to a reporter, said he had seen children scream and writhe on the floor from the shock.
Mr. Flammia called the accusation false. If a teacher saw such things, he should have reported it, the lawyer said. No teacher ever has made that sort of report, he added.
Ms. Handon said she does not care what the critics say, not even those perturbed by the report of the prank shocking. She said her fierce loyalty to her daughter's school was not hard to understand. Crystal developed slowly as a baby. She was eventually found to be mentally retarded and placed in special education. But by the time she was 13, the local schools could no longer hold her and Ms. Handon, a divorced mother of five, was having troubles as well.
She described her daughter as ''the sweetest person,'' a child obsessed with Michael Jackson who loves to dance to ''Billie Jean.'' But Crystal's condition led to peculiar antisocial behavior, her mother said. Even after her adolescence, she would strip off her clothes and park herself naked in the living room. She would bite herself on her arms and legs until she bled, and then would peel off the scabs until she left deep black scars.
Then there were her rages. Denied something, she would throw furniture and shatter windows. Once, she ripped the door frames out of the plaster walls of her family's apartment. ''I was always afraid the landlord was going to evict us,'' Ms. Handon remembered -- not an inconsequential fear for a woman like her whohad once been homeless.
As a young teenager, Crystal was moved to residential placements, but even those special education schools could barely handle her. They would use restraints and psychotropic drugs. Crystal grew to 180 pounds and was ''so doped up,'' her mother said, ''that she could barely walk straight.''
When she was 16, education officials recommended Rotenberg. At first Ms. Handon wouldn't consider a place that used shock as therapy, but over time she began to see advantages. Rotenberg would take her child off the medicines. They would punish her only for behavior in her control, like spitting, not for bedwetting. And while the shock hurt, Ms. Handon said she believed it caused no permanent damage or health risk
In their lawsuit, the parents contend that none of the other options have been satisfactory and that other schools have simply drugged their children to remove the bad behavior, without teaching them how to behave differently. The state's perspective, however, is that Rotenberg uses shocks too capriciously, that shocks are used to curb trivial behaviors, like cursing, and that positive reinforcement would often provide similar results.
''The use of electronic skin shock conditioning devices as used at J.R.C. raises health and safety concerns,'' state evaluators wrote in 2006 after a surprise inspection. They also ''compromised'' the ''privacy and dignity'' of the students, the evaluators wrote.
Ms. Handon, however, does not share these qualms. She said she likes the fact that the school will let her visit any time, unannounced. From her computer, she can monitor Crystal's progress.
One green bar chart keeps track of the number of times her daughter has engaged in prohibited behavior; another, the number of times she was given a shock. In the past month, it appears that her daughter has been given shocks only four times, down from the 200 a month she received at first.
To Ms. Handon, this is a sign that her daughter is learning to control herself. When Crystal is too old for special education, her mother plans to keep her at home for good. In the meantime, however, she says her daughter is having too much fun.
''She loves that place,'' Ms. Handon said. ''If she knows she is returning from vacation on a Monday, on Saturday she will pack her bags and start begging to go.''
December 25, 2007 Tuesday Correction Appended Late Edition - Final
Nearly a year ago, New York made plans to ban the use of electric shocks as a punishment for bad behavior, a therapy used at a Massachusetts school where New York State had long sent some of its most challenging special education students.
But state officials trying to limit New York's association with the school, the Judge Rotenberg Educational Center in Canton, southwest of Boston, and its ''aversive therapy'' practices have found a large obstacle in their paths: parents of students who are given shocks.
''I understand people who don't know about it think it is cruel,'' said Susan Handon of Jamaica, Queens, whose 20-year-old daughter, Crystal, has been at Rotenberg for four years. ''But she is not permanently scarred and she has really learned that certain behaviors, like running up and hitting people in the face, are not acceptable.''
Indeed, Rotenberg is full of children who will run up and hit strangers in the face, or worse. Many have severe types of dysfunction, including self-mutilation, head banging, eye gouging and biting, that can result from autism or mental retardation. Parents tend to be referred there by desperate education officials, after other institutions have decided they cannot keep the child.
While at Rotenberg, students must wear backpacks containing a device that allows a staff member to deliver a moderate shock to electrodes attached to the limbs, or in some cases palms, feet or torso, when the students engage in a prohibited behavior. Both the children's parents and a court must consent to the shocks.
Michael P. Flammia, the lawyer for Rotenberg, defended the practice in an interview.
''People want to believe positive interventions work even in the most extreme cases,'' he said. ''If they did, that is all we would use. Many of these kids come in on massive dosages of antipsychotic drugs, so doped up that they are almost comatose. We get them off drugs and give their parents something very important: hope.''
But for state officials, many behavior experts and even some former Rotenberg parents, the shock therapy at the school represents a dangerous, outdated approach to severe behavioral problems, reminiscent of the electric shock helmets used on some autistic patients into the 1980s and now discredited.
They say Rotenberg does not use shock punishments only for dangerous self-mutilation, but rather for a wide variety of actions, including shouting profanities and spitting, which are known to be effectively treated with less extreme punishments. And critics of the school say that unlike the more widely known electroconvulsive therapy, which has been used successfully in cases of severe depression and is being used experimentally on severely autistic people, applying shock as a punishment is not widely supported by the scientific community.
''People don't use it anymore because they don't need to. It is not the standard of care. There are alternative procedures that do not involve aversives like electronic shock,'' said William Pelham, a behavioral specialist and director of the Center for Children and Families at the State University of New York at Buffalo. ''And I am not talking about drugs as an alternative. I am talking about other behavioral treatments.''
Still, the parents say the shocks are making a difference in their children's lives as nothing else has. In 2006, after New York issued an immediate ban on electric shock for behavior modification, Ms. Handon was among the parents of more than 40 children who sued and won a court injunction to keep treatments going.
In January, the state, which pays for treatment of all New York students at Rotenberg to age 21, enacted a new ban on the treatment for those students, to take effect in 2009; it also set new restrictions on who can begin the therapy in the interim. But the parents amended their suit, and a trial beginning in 2008 will decide the issue.
''The point is that at Rotenberg, they still manage Crystal to control what she needs to do,'' Ms. Handon said. ''Her behaviors were not acceptable for society. Now I think I can bring her home.''
The Rotenberg Center, which says it is the only school in the nation using electric shock, has been the subject of many critical reports by the news media and state investigators.
Just last week, Massachusetts investigators issued a report saying a child at the school was shocked 77 times in three hours last summer as a result of a prank.
The report, by the Department of Early Education and Care, found that a former student pretending to be a school official demanded the punishment of two students, and that counselors administered shocks without double-checking. One of the children suffered first-degree burns.
''Our kids should not be sent there, and we will act immediately,'' Gov. Eliot Spitzer of New York said in response to the report.
But unlike many special education schools, Rotenberg, as a matter of policy, never rejects or expels a child, except an adjudicated sex offender. As a result, it continues to get referrals from around the nation.
Currently, nearly 100 of the more than 200 children at Rotenberg are from New York State, down from roughly 140 in 2006. The school says that it also has children from 10 other states, including California and Illinois, and that it has had students as young as 10. At a cost of about $228,000 per child per year, the students receive a range of therapies, including, in the case of more than 40 of the New Yorkers, the use of electric shocks.
Just how painful those shocks are has been an area of particular debate. Technically, the lowest shock given by Rotenberg is roughly twice what pain researchers have said is tolerable for most humans, said James Eason, a professor of biomedical engineering at Washington and Lee University. The highest shock given by Rotenberg is three times the lowest amount.
The lawyer for Rotenberg, Mr. Flammia, said the current has to hurt to work. He described the highest shock as ''a hard pinch.''
But a former teacher from the school, who asked not to be named because he signed a confidentiality agreement as a condition of employment and fears he could be sued for speaking to a reporter, said he had seen children scream and writhe on the floor from the shock.
Mr. Flammia called the accusation false. If a teacher saw such things, he should have reported it, the lawyer said. No teacher ever has made that sort of report, he added.
Ms. Handon said she does not care what the critics say, not even those perturbed by the report of the prank shocking. She said her fierce loyalty to her daughter's school was not hard to understand. Crystal developed slowly as a baby. She was eventually found to be mentally retarded and placed in special education. But by the time she was 13, the local schools could no longer hold her and Ms. Handon, a divorced mother of five, was having troubles as well.
She described her daughter as ''the sweetest person,'' a child obsessed with Michael Jackson who loves to dance to ''Billie Jean.'' But Crystal's condition led to peculiar antisocial behavior, her mother said. Even after her adolescence, she would strip off her clothes and park herself naked in the living room. She would bite herself on her arms and legs until she bled, and then would peel off the scabs until she left deep black scars.
Then there were her rages. Denied something, she would throw furniture and shatter windows. Once, she ripped the door frames out of the plaster walls of her family's apartment. ''I was always afraid the landlord was going to evict us,'' Ms. Handon remembered -- not an inconsequential fear for a woman like her whohad once been homeless.
As a young teenager, Crystal was moved to residential placements, but even those special education schools could barely handle her. They would use restraints and psychotropic drugs. Crystal grew to 180 pounds and was ''so doped up,'' her mother said, ''that she could barely walk straight.''
When she was 16, education officials recommended Rotenberg. At first Ms. Handon wouldn't consider a place that used shock as therapy, but over time she began to see advantages. Rotenberg would take her child off the medicines. They would punish her only for behavior in her control, like spitting, not for bedwetting. And while the shock hurt, Ms. Handon said she believed it caused no permanent damage or health risk
In their lawsuit, the parents contend that none of the other options have been satisfactory and that other schools have simply drugged their children to remove the bad behavior, without teaching them how to behave differently. The state's perspective, however, is that Rotenberg uses shocks too capriciously, that shocks are used to curb trivial behaviors, like cursing, and that positive reinforcement would often provide similar results.
''The use of electronic skin shock conditioning devices as used at J.R.C. raises health and safety concerns,'' state evaluators wrote in 2006 after a surprise inspection. They also ''compromised'' the ''privacy and dignity'' of the students, the evaluators wrote.
Ms. Handon, however, does not share these qualms. She said she likes the fact that the school will let her visit any time, unannounced. From her computer, she can monitor Crystal's progress.
One green bar chart keeps track of the number of times her daughter has engaged in prohibited behavior; another, the number of times she was given a shock. In the past month, it appears that her daughter has been given shocks only four times, down from the 200 a month she received at first.
To Ms. Handon, this is a sign that her daughter is learning to control herself. When Crystal is too old for special education, her mother plans to keep her at home for good. In the meantime, however, she says her daughter is having too much fun.
''She loves that place,'' Ms. Handon said. ''If she knows she is returning from vacation on a Monday, on Saturday she will pack her bags and start begging to go.''
School of Shock NPR Radio Transcript
National Public Radio (NPR)
September 4, 2007 Tuesday
SHOW: News & Notes 9:00 AM EST
ANCHORS: FARAI CHIDEYA
It's been called the school of shock. The Boston-based Judge Rotenberg Center uses electroshock therapy to modify the behavior of its students. Kids from eight different states attend the center: many are autistic or mentally retarded, others suffer from acute emotional problems or disorders like attention deficit.
Jennifer Gonnerman is a freelance reporter whose piece on the center appears in this month's Mother Jones magazine. And Greg Miller is a former teacher's assistant at the school.
Welcome to you both.
Ms. JENNIFER GONNERMAN (Freelance Reporter): Thank you.
Mr. GREG MILLER (Former Teacher's Assistant, Judge Rotenberg Center): Thank you.
CHIDEYA: So Jennifer, Rob Santana is one of the kids you profiled in your piece. He spent three years at the center and why was he there? What happened with him?
Ms. GONNERMAN: Rob Santana went to this facility in 1999 when he was 13. His parents sent him there. He had been referred - his mother had been given the name of the place from a special education committee in Upstate New York. And he was a pretty troubled kid - always pretty aggressive and had been troubled since he was a baby actually when he was born, addicted to drugs, went into foster care and was adopted. His mother sent him there in the hopes that it would improve his behavior.
CHIDEYA: So what exactly has happened there? I know that there have been children who have died in the center's care. Can you tell me about that?
Ms. GONNERMAN: Over the years, that center has been around since the '70s. It's been around for 36 years. And six children who were in the care of the center have died, though none of those have been linked explicitly to the center's use of aversives or of shock.
CHIDEYA: You yourself got shocked. Describe what it felt like.
Ms. GONNERMAN: Sure. The shocks are two seconds long. I had a shock device, sort of, an electrode strapped on to my arm and in my other hand, I had a remote control. The kids wear backpacks with the shock devices and wires run down their pants and up their shirts. And then they have these electrodes locked on or attached to their arms, their legs, their torso. I pressed the button and the staff had told me that it's no more painful than a bee sting. And I have to say, two seconds never felt so long. To me, it felt less like a bee sting than being stung by a horde of wasps.
CHIDEYA: Greg, how did you come to this work?
Mr. MILLER: Well, I am (unintelligible) teacher certified in Massachusetts. And I wanted to try something different so I wanted to enter into the, you know, special ed and so I enrolled there as a teacher. I actually started off as a teacher's assistant and remained as a teacher's assistant. That's how I started.
CHIDEYA: What exactly constitutes a reason to be shocked? And how involved were you in these treatments in addition to the other aspects of educating the kids?
Mr. MILLER: I was working with mostly with the students with autism and I was - gave many electric shocks to students during my time there. The types of things, which I saw a student shocked there for are types of things such as tearing a - corner of a paper cup while they're sitting on the sofa. There's no differentiation between tearing a paper cup or tearing posters off the wall. A tear is a tear. Students, you know, blowing bubbles with their saliva or pulling arms or shirt sleeves, a lot of things that's aggression but still categorized things under aggression or other strange behaviors that aren't so severe and treat them like they are severe.
CHIDEYA: Now, Jennifer, as I understand it, a good number of the high- functioning children there are black and Latino. There are students who are very difficult to teach, who are very antisocial and other ones that are higher functioning. So why do you think that is in terms of the racial demographics?
Ms. GONNERMAN: You know, many of the kids who are considered so-called high functioning are actually from New York. And when I was there, I would ask them, you know, where are you from exactly in New York and they would name neighborhoods often in New York City that were among the poorest in the city, you know, places like south Bronx or northern Harlem. And I don't have a statistics on the racial breakdown or the class backgrounds of the students, but it did seem to me that they were so disproportionately poor. And I don't know if that had so much to do with this treatment facility or if it's more something that reflects on the sort of special education system in New York City that's sending a lot of kids to this place.
CHIDEYA: There is certainly - there's a lot of people who will say electric shock that's barbaric, but we reached out to the Judge Rotenberg Center. They sent us a response posted to the Mother Jones blog by Matthew Israel, director of the center. And he wrote - this is quite a bit of a copy but very important to get their perspective in here.
Other so-called effective treatments for severe behavior disorders that JRC has seen in the histories of newly admitted students include lobotomy, removal of teeth for severe biters, constant seclusion, constant medical restraint, and many others that experts refer to as, quote, "more humane and effective," end quote, alternatives to JRC's aversive procedures. The lack of an effective alternative and the sheer cruelty of drugging a child into a near coma is why parents turn to a non-public special needs school such as the center that is especially equipped to manage and educate the student and has a proven track record of saving students from the ravages of constant heavy sedation.
What do you say in response to that?
Ms. GONNERMAN: You know, the history of the Judge Rotenberg Center - originally, the students who were there - nearly all of them exhibited very, very extreme types of self-abusive, self-injurious behavior, things like banging their heads or tearing their hair out or chewing on their fingers, and that was the original justification for an approach that involved pain or for eventually for the use of these two-second electric shocks.
Today, the school has about 220 or 230 students and, as we mentioned earlier, a little bit more than half are what are called high functioning. These are not students who are severely autistic or mentally retarded. These are students who have things like bipolar - have been diagnosed with bipolar or attention deficit disorder. So the trouble rises when a device like the shock device, which was developed for very extreme cases of self-injurious behavior, then becomes instead a kind of routine disciplinary tool used on all different types of students.
CHIDEYA: Greg, what turned you away? What made you leave? You stayed there for years.
Mr. MILLER: I came to realize - just over time, I kept seeing things I disagreed with, you know, student being attacked in front of 40 other students by a staff with a knife as part of his treatment and shocked while he's in restraints and trying to keep the knife out of his face. And I saw that happen three times a week and I just - every time it happened, I just got sick and I said, hey, somebody's got to be wrong here.
But, you know, I stayed there even after that was taking place because, you know, the psychologists said it was okay. The judges said it was okay. The state, of course, approved it as far as its laws and the parents approved of it, so who was I to question attacking the student, you know, staff attacking the student in front of 40 other students who are also - they were so traumatized by watching it we'd have to shock them, too. Standing up out of their seat, you know, and the reaction - we'd have to shock them for that. And it just - or throwing a tantrum(ph), or screaming just in reaction of watching their classmate get shocked and attacked, you know, with a knife by a staff yelling at him.
So these scenes weighed on me and bothered me. And the last thing that kind of in helping make my final decision to leave was when I had to - a student stood up, raised his hand and asked politely to go to the bathroom, and he's a student with autism and they shocked him and I was part of that.
CHIDEYA: I'm going to have - sorry to interrupt. We're going to have to leave it there. Greg Miller, former employee of the center. Jennifer Gonnerman, the reporter who wrote the article on the center for this month's Mother Jones magazine.
Ms. GONNERMAN: Thanks, Farai.
Mr. MILLER: Thank you.
September 4, 2007 Tuesday
SHOW: News & Notes 9:00 AM EST
ANCHORS: FARAI CHIDEYA
It's been called the school of shock. The Boston-based Judge Rotenberg Center uses electroshock therapy to modify the behavior of its students. Kids from eight different states attend the center: many are autistic or mentally retarded, others suffer from acute emotional problems or disorders like attention deficit.
Jennifer Gonnerman is a freelance reporter whose piece on the center appears in this month's Mother Jones magazine. And Greg Miller is a former teacher's assistant at the school.
Welcome to you both.
Ms. JENNIFER GONNERMAN (Freelance Reporter): Thank you.
Mr. GREG MILLER (Former Teacher's Assistant, Judge Rotenberg Center): Thank you.
CHIDEYA: So Jennifer, Rob Santana is one of the kids you profiled in your piece. He spent three years at the center and why was he there? What happened with him?
Ms. GONNERMAN: Rob Santana went to this facility in 1999 when he was 13. His parents sent him there. He had been referred - his mother had been given the name of the place from a special education committee in Upstate New York. And he was a pretty troubled kid - always pretty aggressive and had been troubled since he was a baby actually when he was born, addicted to drugs, went into foster care and was adopted. His mother sent him there in the hopes that it would improve his behavior.
CHIDEYA: So what exactly has happened there? I know that there have been children who have died in the center's care. Can you tell me about that?
Ms. GONNERMAN: Over the years, that center has been around since the '70s. It's been around for 36 years. And six children who were in the care of the center have died, though none of those have been linked explicitly to the center's use of aversives or of shock.
CHIDEYA: You yourself got shocked. Describe what it felt like.
Ms. GONNERMAN: Sure. The shocks are two seconds long. I had a shock device, sort of, an electrode strapped on to my arm and in my other hand, I had a remote control. The kids wear backpacks with the shock devices and wires run down their pants and up their shirts. And then they have these electrodes locked on or attached to their arms, their legs, their torso. I pressed the button and the staff had told me that it's no more painful than a bee sting. And I have to say, two seconds never felt so long. To me, it felt less like a bee sting than being stung by a horde of wasps.
CHIDEYA: Greg, how did you come to this work?
Mr. MILLER: Well, I am (unintelligible) teacher certified in Massachusetts. And I wanted to try something different so I wanted to enter into the, you know, special ed and so I enrolled there as a teacher. I actually started off as a teacher's assistant and remained as a teacher's assistant. That's how I started.
CHIDEYA: What exactly constitutes a reason to be shocked? And how involved were you in these treatments in addition to the other aspects of educating the kids?
Mr. MILLER: I was working with mostly with the students with autism and I was - gave many electric shocks to students during my time there. The types of things, which I saw a student shocked there for are types of things such as tearing a - corner of a paper cup while they're sitting on the sofa. There's no differentiation between tearing a paper cup or tearing posters off the wall. A tear is a tear. Students, you know, blowing bubbles with their saliva or pulling arms or shirt sleeves, a lot of things that's aggression but still categorized things under aggression or other strange behaviors that aren't so severe and treat them like they are severe.
CHIDEYA: Now, Jennifer, as I understand it, a good number of the high- functioning children there are black and Latino. There are students who are very difficult to teach, who are very antisocial and other ones that are higher functioning. So why do you think that is in terms of the racial demographics?
Ms. GONNERMAN: You know, many of the kids who are considered so-called high functioning are actually from New York. And when I was there, I would ask them, you know, where are you from exactly in New York and they would name neighborhoods often in New York City that were among the poorest in the city, you know, places like south Bronx or northern Harlem. And I don't have a statistics on the racial breakdown or the class backgrounds of the students, but it did seem to me that they were so disproportionately poor. And I don't know if that had so much to do with this treatment facility or if it's more something that reflects on the sort of special education system in New York City that's sending a lot of kids to this place.
CHIDEYA: There is certainly - there's a lot of people who will say electric shock that's barbaric, but we reached out to the Judge Rotenberg Center. They sent us a response posted to the Mother Jones blog by Matthew Israel, director of the center. And he wrote - this is quite a bit of a copy but very important to get their perspective in here.
Other so-called effective treatments for severe behavior disorders that JRC has seen in the histories of newly admitted students include lobotomy, removal of teeth for severe biters, constant seclusion, constant medical restraint, and many others that experts refer to as, quote, "more humane and effective," end quote, alternatives to JRC's aversive procedures. The lack of an effective alternative and the sheer cruelty of drugging a child into a near coma is why parents turn to a non-public special needs school such as the center that is especially equipped to manage and educate the student and has a proven track record of saving students from the ravages of constant heavy sedation.
What do you say in response to that?
Ms. GONNERMAN: You know, the history of the Judge Rotenberg Center - originally, the students who were there - nearly all of them exhibited very, very extreme types of self-abusive, self-injurious behavior, things like banging their heads or tearing their hair out or chewing on their fingers, and that was the original justification for an approach that involved pain or for eventually for the use of these two-second electric shocks.
Today, the school has about 220 or 230 students and, as we mentioned earlier, a little bit more than half are what are called high functioning. These are not students who are severely autistic or mentally retarded. These are students who have things like bipolar - have been diagnosed with bipolar or attention deficit disorder. So the trouble rises when a device like the shock device, which was developed for very extreme cases of self-injurious behavior, then becomes instead a kind of routine disciplinary tool used on all different types of students.
CHIDEYA: Greg, what turned you away? What made you leave? You stayed there for years.
Mr. MILLER: I came to realize - just over time, I kept seeing things I disagreed with, you know, student being attacked in front of 40 other students by a staff with a knife as part of his treatment and shocked while he's in restraints and trying to keep the knife out of his face. And I saw that happen three times a week and I just - every time it happened, I just got sick and I said, hey, somebody's got to be wrong here.
But, you know, I stayed there even after that was taking place because, you know, the psychologists said it was okay. The judges said it was okay. The state, of course, approved it as far as its laws and the parents approved of it, so who was I to question attacking the student, you know, staff attacking the student in front of 40 other students who are also - they were so traumatized by watching it we'd have to shock them, too. Standing up out of their seat, you know, and the reaction - we'd have to shock them for that. And it just - or throwing a tantrum(ph), or screaming just in reaction of watching their classmate get shocked and attacked, you know, with a knife by a staff yelling at him.
So these scenes weighed on me and bothered me. And the last thing that kind of in helping make my final decision to leave was when I had to - a student stood up, raised his hand and asked politely to go to the bathroom, and he's a student with autism and they shocked him and I was part of that.
CHIDEYA: I'm going to have - sorry to interrupt. We're going to have to leave it there. Greg Miller, former employee of the center. Jennifer Gonnerman, the reporter who wrote the article on the center for this month's Mother Jones magazine.
Ms. GONNERMAN: Thanks, Farai.
Mr. MILLER: Thank you.
A Call for Ethical and Unprejudiced Leadership and Practice in the Field
Friday, October 12, 2007
A Call for Ethical and Unprejudiced Leadership and Practice in the Field of Psychology
An Autism & Mental Health Community Letter
October 10, 2007
This letter is to the American Psychological Association (hereafter referred to as APA), and to all professionals in the field of psychology. This letter calls upon APA and professionals who adhere to the APA Code of Ethics to act in a manner that is ethical and consistent with that Code of Ethics. Two recent APA documents are relevant to this call to action. They are, the 2006 "Resolution Against Torture and Other Cruel, Inhuman, and Degrading Treatment or punishment" (hereafter referred to as 2006 Resolution), and the 2007 "Reaffirmation of the American Psychological Association Position Against Torture and Other Cruel, Inhuman, or Degrading Treatment or Punishment and Its Application to Individuals Defined in the United States Code as "Enemy Combatants"" (hereafter referred to as 2007 Resolution). With fervor, we are advocating for people with autism, developmental differences, and mental health challenges; urgently entreating that they may be given the same respect with regard to human rights as alleged "Enemy Combatants," or any other human beings. As professionals who adhere to the APA Code of Ethics, nothing less than an unprejudiced stance in this matter should be considered acceptable.
Currently, children and young adults with autism, developmental differences, and mental health challenges are being treated in a manner that clearly meets the definition of Torture and Other Cruel, Inhuman, and Degrading Treatment or Punishment, as defined by the two previously mentioned APA documents. The Judge Rotenberg Educational Center (hereafter referred to as JRC) in Massachusetts has a long history of using electric shock, food deprivation and prolonged mechanical restraint, as well as other painful and dehumanizing aversive techniques.
The use of the phrase "effective treatment," does not make such techniques humane or acceptable. Furthermore, attempting to justify them as "treatments" of "last resort" may not be completely accurate. It has been clearly demonstrated that positive behavioral approaches, based on a careful analysis of the functions dangerous or disruptive behaviors may be serving are as effective and more enduring than behavior change techniques based on pain and fear. JRC uses a device that they call the Graduated Electronic Decelerator (GED), to deliver painful electric shocks. Reporters, legislators and others who have experienced the 2-second shock from this device describe it as incredibly painful. A report from the New York State Educational Department noted that JRC was not only using electric shock for dangerous and self-injurious behaviors but also for behaviors that are benign or idiosyncratic such as "nagging, swearing and failure to maintain a neat appearance," or "slouching in a chair." The director of the Judge Rotenberg Center testified at a legislative hearing that one student received 5,300 electric shocks in one day. In his testimony, he stated that over a 24-hour period, this student, a teenager who weighed only 52 pounds, was subjected to an average of one shock every 16 seconds. During some periods, the student was automatically shocked every second if he lifted his hand off a paddle. A copy of the New York State Report can be found here: http://boston.com/news/daily/15/school_report.pdf and a myriad of additional information on the school and its practices can be found by googling the Judge Rotenberg Center.
Proponents of behaviorism have voiced their opposition to these practices. Although the Director of the Judge Rotenberg Center often defends his practices by stating that he was trained by B. F. Skinner, Dr. Skinner made it very clear that he did not condone such practices. At the age of 83, he was interviewed by Daniel Goleman of the New York Times. In an article published August 25th, 1987, titled, "Embattled Giant Of Psychology Speaks His Mind," his view is stated.
“The use of punishment is another issue Dr. Skinner still feels impassioned about. He is an ardent opponent of the use of punishment, such as spanking, or using ''aversives'' -such as pinches and shocks - with autistic children. ''What's wrong with punishments is that they work immediately, but give no long-term results,'' Dr. Skinner said. ''The responses to punishment are either the urge to escape, to counterattack or a stubborn apathy. These are the bad effects you get in prisons or schools, or wherever punishments are used.''
The complete article can be viewed here:
http://query.nytimes.com/gst/fullpage.html?res=9B0DE3D6143CF936A1575BC0A961948260&sec=health&spon=&pagewanted=print
The 1965 experimental research of O. Ivar Lovaas, Benson Schaeffer, and James Q. Simmons, conducted at the University of California, Los Angeles, concluded that electric shock applications did not have enduring effectiveness. In conclusion, they questioned the need for shocking children with Autism by stating, “A basic question, then, is whether it is necessary to employ shock in accomplishing such an end or whether less drastic methods might suffice.” (Journal Of Experimental Research in Personality 1, 99-109 (1965))
A recent Mother Jones article about this institution began like this, “Rob Santana awoke terrified. He'd had that dream again, the one where silver wires ran under his shirt and into his pants, connecting to electrodes attached to his limbs and torso. Adults armed with surveillance cameras and remote-control activators watched his every move. One press of a button, and there was no telling where the shock would hit—his arm or leg or, worse, his stomach. All Rob knew was that the pain would be intense.”(Mother Jones, August 20, 2007).
A horror from the Abu Ghraib prison scandal? No, torture carried out in the name of treatment, right here in the State of Massachusetts, against the most vulnerable of our young people -- and designed and implemented by Psychologists.
It is additionally noted that programs that are built around scientific knowledge and principles will generally welcome peer review and a continual improvement process. Currently and historically, JRC practices are remarkably deficient in these areas. As leaders in the field of psychology, and as professionals who are intolerant of torture, APA has an opportunity, if not an obligation, to demonstrate leadership in this matter. Please consider the following facts and arguments.
Section 1 of the American Psychological Association Code of Ethics, creates a standard of excellence in regards to the personal accountability of psychologists to their Code of Ethics. It also establishes a means for resolving professional ethical issues between psychologists and with organizations with which Psychologists may be affiliated.
Sub-Section 1.05 of the Code of Ethics covers the topic of Reporting Ethical Violations. This sub-section related to reporting, places a grave responsibility upon APA members to report apparent ethical violations that have "substantially harmed or are likely to substantially harm a person or organization." This reporting "may include referral to state or national committees on professional ethics, to state licensing boards, or to the appropriate institutional authorities."
Within the 2007 Reaffirmation, reference is made to the 2006 Resolution, stating emphatically that it is "a comprehensive and foundational position applicable to all individuals, in all settings and in all contexts without exception." We are in agreement with this position.
We are pleading with APA psychologists, and all psychologists who independently and voluntarily follow the APA Code of Ethics, to consider that the 2006 Resolution is inclusive of all human beings. We ask that it be applied toward those who are receiving treatment/services related to symptoms associated with autism, developmental differences, and mental health challenges, including such that may cause or contribute to self-injurious behavior. This letter is an earnest appeal to APA leadership and all professionals in the field of psychology to demonstrate ethical practices and adhere to the principles of the 2006 Resolution and the 2007 Reaffirmation in opposing the use of skin-shock and food deprivation that are currently being administered as "treatment" for self-injurious behavior, aggressive behavior, and other behaviors that are being considered as precursors. Skin-shock or food deprivation under any other context, or being administered to any other population segment would be considered an inhumane form of punishment that in reality is truly torture. According to the 2006 Resolution, there can be no exception for this type of degrading treatment.
Although there are some within this mental health population segment who are able to communicate how they have been "substantially harmed by a person or organization," there are many others who are unable to do so. Even those young people with the ability to communicate how they are being harmed are virtually unheard. Regardless of the individual’s ability to communicate and describe torture and its physical, mental and emotional effect upon them, this type of "treatment," is still inherently wrong. Is it not the responsibility of a professional or any human being to take action when they personally are aware of acts that are inhumane and degrading forms of torture?
At the JRC this "treatment" is being authorized under court order. While Judges may have extensive expertise within the framework of law, they are reliant upon the testimony of experts (in these cases, Psychologists) to assist them in making decisions. Experts within the field of psychology need to see an example of leadership from organizations such as APA. Good leadership provides guidance and constraints in all areas that are conducive to professionalism and best practices.
In conclusion, we are respectfully appealing to APA members and leadership on the basis of professionalism and unprejudiced application of your own code of ethics, and consistent with your 2006 Resolution and 2007 Reaffirmation, to formally and specifically declare your position regarding the use of skin-shock "treatments," food deprivation, and any other aversives that inflict pain or deprive basic human rights at JRC or elsewhere. We are calling upon APA members to apply the Code which condemns the treatment that is currently taking place at JRC.
We respectfully request that the APA send this letter to its members, post it on their website and/or publish it in a newsletter or other publication that reaches its full membership. We request that the APA as a professional organization, and as professional individuals actively and vociferously advocate for best practices while opposing that which is torture. We furthermore request that the APA, as an organization, make a formal and specific declaration of its stance in this matter and exercise appropriate discipline, thereby demonstrating that the Code of Ethics will be applied without prejudice. Your example in this will be a voice of hope for those who have been locked away, subjected to daily torture and unseen and unheard for too long.
Written and Presented by:
Derrick Jeffries
Person with Asperger’s Syndrome
Nancy Weiss
Co-Director, The National Leadership Consortium on Developmental Disabilities, Center for
Disabilities Studies, University of Delaware
The following individuals and organizations endorse this message:
To be added to this list, please submit your name and/or the name of your organization to Derrick_Jeffries@Bestmail.us . Individual submittals should include an identifying title, such as parent, person with autism, Ph.D., concerned citizen, etc. For organizations, information must be submitted by an officer of the organization. Posting this letter on websites is encouraged; however, we do ask that you send us an e-mail address where updated copies can be received. It is our intent to update this section of the letter on a monthly basis for a reasonable length of time. Updated copies will also be sent to the APA.
For those interested in contacting APA directly, please consider sending mail or e-mail to:
Lynn F. Bufka, Ph.D.Assistant Executive Director, Practice Research and PolicyAmerican Psychological Association750 First St., NEWashington, DC 20002E-mail: http:/Local+Settings%5CTemporary+Internet+Files%5CContent.IE5%5C00PHZKYH%5CLBufka@apa.org
A Call for Ethical and Unprejudiced Leadership and Practice in the Field of Psychology
An Autism & Mental Health Community Letter
October 10, 2007
This letter is to the American Psychological Association (hereafter referred to as APA), and to all professionals in the field of psychology. This letter calls upon APA and professionals who adhere to the APA Code of Ethics to act in a manner that is ethical and consistent with that Code of Ethics. Two recent APA documents are relevant to this call to action. They are, the 2006 "Resolution Against Torture and Other Cruel, Inhuman, and Degrading Treatment or punishment" (hereafter referred to as 2006 Resolution), and the 2007 "Reaffirmation of the American Psychological Association Position Against Torture and Other Cruel, Inhuman, or Degrading Treatment or Punishment and Its Application to Individuals Defined in the United States Code as "Enemy Combatants"" (hereafter referred to as 2007 Resolution). With fervor, we are advocating for people with autism, developmental differences, and mental health challenges; urgently entreating that they may be given the same respect with regard to human rights as alleged "Enemy Combatants," or any other human beings. As professionals who adhere to the APA Code of Ethics, nothing less than an unprejudiced stance in this matter should be considered acceptable.
Currently, children and young adults with autism, developmental differences, and mental health challenges are being treated in a manner that clearly meets the definition of Torture and Other Cruel, Inhuman, and Degrading Treatment or Punishment, as defined by the two previously mentioned APA documents. The Judge Rotenberg Educational Center (hereafter referred to as JRC) in Massachusetts has a long history of using electric shock, food deprivation and prolonged mechanical restraint, as well as other painful and dehumanizing aversive techniques.
The use of the phrase "effective treatment," does not make such techniques humane or acceptable. Furthermore, attempting to justify them as "treatments" of "last resort" may not be completely accurate. It has been clearly demonstrated that positive behavioral approaches, based on a careful analysis of the functions dangerous or disruptive behaviors may be serving are as effective and more enduring than behavior change techniques based on pain and fear. JRC uses a device that they call the Graduated Electronic Decelerator (GED), to deliver painful electric shocks. Reporters, legislators and others who have experienced the 2-second shock from this device describe it as incredibly painful. A report from the New York State Educational Department noted that JRC was not only using electric shock for dangerous and self-injurious behaviors but also for behaviors that are benign or idiosyncratic such as "nagging, swearing and failure to maintain a neat appearance," or "slouching in a chair." The director of the Judge Rotenberg Center testified at a legislative hearing that one student received 5,300 electric shocks in one day. In his testimony, he stated that over a 24-hour period, this student, a teenager who weighed only 52 pounds, was subjected to an average of one shock every 16 seconds. During some periods, the student was automatically shocked every second if he lifted his hand off a paddle. A copy of the New York State Report can be found here: http://boston.com/news/daily/15/school_report.pdf and a myriad of additional information on the school and its practices can be found by googling the Judge Rotenberg Center.
Proponents of behaviorism have voiced their opposition to these practices. Although the Director of the Judge Rotenberg Center often defends his practices by stating that he was trained by B. F. Skinner, Dr. Skinner made it very clear that he did not condone such practices. At the age of 83, he was interviewed by Daniel Goleman of the New York Times. In an article published August 25th, 1987, titled, "Embattled Giant Of Psychology Speaks His Mind," his view is stated.
“The use of punishment is another issue Dr. Skinner still feels impassioned about. He is an ardent opponent of the use of punishment, such as spanking, or using ''aversives'' -such as pinches and shocks - with autistic children. ''What's wrong with punishments is that they work immediately, but give no long-term results,'' Dr. Skinner said. ''The responses to punishment are either the urge to escape, to counterattack or a stubborn apathy. These are the bad effects you get in prisons or schools, or wherever punishments are used.''
The complete article can be viewed here:
http://query.nytimes.com/gst/fullpage.html?res=9B0DE3D6143CF936A1575BC0A961948260&sec=health&spon=&pagewanted=print
The 1965 experimental research of O. Ivar Lovaas, Benson Schaeffer, and James Q. Simmons, conducted at the University of California, Los Angeles, concluded that electric shock applications did not have enduring effectiveness. In conclusion, they questioned the need for shocking children with Autism by stating, “A basic question, then, is whether it is necessary to employ shock in accomplishing such an end or whether less drastic methods might suffice.” (Journal Of Experimental Research in Personality 1, 99-109 (1965))
A recent Mother Jones article about this institution began like this, “Rob Santana awoke terrified. He'd had that dream again, the one where silver wires ran under his shirt and into his pants, connecting to electrodes attached to his limbs and torso. Adults armed with surveillance cameras and remote-control activators watched his every move. One press of a button, and there was no telling where the shock would hit—his arm or leg or, worse, his stomach. All Rob knew was that the pain would be intense.”(Mother Jones, August 20, 2007).
A horror from the Abu Ghraib prison scandal? No, torture carried out in the name of treatment, right here in the State of Massachusetts, against the most vulnerable of our young people -- and designed and implemented by Psychologists.
It is additionally noted that programs that are built around scientific knowledge and principles will generally welcome peer review and a continual improvement process. Currently and historically, JRC practices are remarkably deficient in these areas. As leaders in the field of psychology, and as professionals who are intolerant of torture, APA has an opportunity, if not an obligation, to demonstrate leadership in this matter. Please consider the following facts and arguments.
Section 1 of the American Psychological Association Code of Ethics, creates a standard of excellence in regards to the personal accountability of psychologists to their Code of Ethics. It also establishes a means for resolving professional ethical issues between psychologists and with organizations with which Psychologists may be affiliated.
Sub-Section 1.05 of the Code of Ethics covers the topic of Reporting Ethical Violations. This sub-section related to reporting, places a grave responsibility upon APA members to report apparent ethical violations that have "substantially harmed or are likely to substantially harm a person or organization." This reporting "may include referral to state or national committees on professional ethics, to state licensing boards, or to the appropriate institutional authorities."
Within the 2007 Reaffirmation, reference is made to the 2006 Resolution, stating emphatically that it is "a comprehensive and foundational position applicable to all individuals, in all settings and in all contexts without exception." We are in agreement with this position.
We are pleading with APA psychologists, and all psychologists who independently and voluntarily follow the APA Code of Ethics, to consider that the 2006 Resolution is inclusive of all human beings. We ask that it be applied toward those who are receiving treatment/services related to symptoms associated with autism, developmental differences, and mental health challenges, including such that may cause or contribute to self-injurious behavior. This letter is an earnest appeal to APA leadership and all professionals in the field of psychology to demonstrate ethical practices and adhere to the principles of the 2006 Resolution and the 2007 Reaffirmation in opposing the use of skin-shock and food deprivation that are currently being administered as "treatment" for self-injurious behavior, aggressive behavior, and other behaviors that are being considered as precursors. Skin-shock or food deprivation under any other context, or being administered to any other population segment would be considered an inhumane form of punishment that in reality is truly torture. According to the 2006 Resolution, there can be no exception for this type of degrading treatment.
Although there are some within this mental health population segment who are able to communicate how they have been "substantially harmed by a person or organization," there are many others who are unable to do so. Even those young people with the ability to communicate how they are being harmed are virtually unheard. Regardless of the individual’s ability to communicate and describe torture and its physical, mental and emotional effect upon them, this type of "treatment," is still inherently wrong. Is it not the responsibility of a professional or any human being to take action when they personally are aware of acts that are inhumane and degrading forms of torture?
At the JRC this "treatment" is being authorized under court order. While Judges may have extensive expertise within the framework of law, they are reliant upon the testimony of experts (in these cases, Psychologists) to assist them in making decisions. Experts within the field of psychology need to see an example of leadership from organizations such as APA. Good leadership provides guidance and constraints in all areas that are conducive to professionalism and best practices.
In conclusion, we are respectfully appealing to APA members and leadership on the basis of professionalism and unprejudiced application of your own code of ethics, and consistent with your 2006 Resolution and 2007 Reaffirmation, to formally and specifically declare your position regarding the use of skin-shock "treatments," food deprivation, and any other aversives that inflict pain or deprive basic human rights at JRC or elsewhere. We are calling upon APA members to apply the Code which condemns the treatment that is currently taking place at JRC.
We respectfully request that the APA send this letter to its members, post it on their website and/or publish it in a newsletter or other publication that reaches its full membership. We request that the APA as a professional organization, and as professional individuals actively and vociferously advocate for best practices while opposing that which is torture. We furthermore request that the APA, as an organization, make a formal and specific declaration of its stance in this matter and exercise appropriate discipline, thereby demonstrating that the Code of Ethics will be applied without prejudice. Your example in this will be a voice of hope for those who have been locked away, subjected to daily torture and unseen and unheard for too long.
Written and Presented by:
Derrick Jeffries
Person with Asperger’s Syndrome
Nancy Weiss
Co-Director, The National Leadership Consortium on Developmental Disabilities, Center for
Disabilities Studies, University of Delaware
The following individuals and organizations endorse this message:
To be added to this list, please submit your name and/or the name of your organization to Derrick_Jeffries@Bestmail.us . Individual submittals should include an identifying title, such as parent, person with autism, Ph.D., concerned citizen, etc. For organizations, information must be submitted by an officer of the organization. Posting this letter on websites is encouraged; however, we do ask that you send us an e-mail address where updated copies can be received. It is our intent to update this section of the letter on a monthly basis for a reasonable length of time. Updated copies will also be sent to the APA.
For those interested in contacting APA directly, please consider sending mail or e-mail to:
Lynn F. Bufka, Ph.D.Assistant Executive Director, Practice Research and PolicyAmerican Psychological Association750 First St., NEWashington, DC 20002E-mail: http:/Local+Settings%5CTemporary+Internet+Files%5CContent.IE5%5C00PHZKYH%5CLBufka@apa.org
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