Autism Vox

31 opinions for The JRC, a prank phone call, and 2 students get shocked

• Harold L Doherty
  Dec 19, 2007 at 7:03 am

  When I first read of the Rotenberg school tactics I responded much as you did in this comment. But I received testimonials from parents who tell of their children’s dangerously self injurious behavior being treated - successfully - with a 2 second skin shock administered once a week. One of those parents is a Medical Doctor.

  If a 2 second skin shock successfully prevents dangerous self injurious behavior which option would you choose? I know you like to “see things” through your child’s eyes etc but I am sure that the parents who resort to the Rotenberg have also hugged their children, tried to see their perspective etc.

  What choice would Autism Vox make between a 2 second skin shock once a week versus self injurious behavior resulting in some cases in brain injury and mutilation?

• Cliff
  Dec 19, 2007 at 7:29 am

  Rarely do situations in simple dichotomies such as “this or this”, and I think that this is the case with this. I think an individual can be trained or taught to handle such situations without such measures. Plus, I’m honestly not sure destroying someone mentally using submission tactics is ethically all that much better than letting someone kill themselves.

  Cliff

• Marla
  Dec 19, 2007 at 7:46 am

  My daughter used to do lots of self abuse behavior. I would never have considered shocking her to stop it. Even if a doctor okayed it. We all know doctors don’t always know what they are talking about. Our daughter stopped the behavior through compassion, reduction of stressful situations and medication. No shocks needed! This is all disgusting. Truly cruel.

• Linda
  Dec 19, 2007 at 9:17 am

  JRC (Judge Rotenberg Center) used to be BRI (Behavioral Research Center) and based in Rhode Island. The MA DMR Commissioner at the time unilaterally decided that no DMR consumer would be placed at BRI. BRI sued DMR and WON. BRI then moved to MA and became the Judge Rotenberg Center named after the judge who presided on the case.

  Electric shocks are barbaric and cruel under any circumstances. I would not judge parents who felt they had no other opeions, but I do fault JRC and the so-called professionals who perpetuate that aversive treatment is the only option.

• Kristina Chew, PhD
  Dec 19, 2007 at 9:24 am

  I have read all the testimonials from parents about the JRC and what is written therein is not easy to read. I am concerned about what seems to be some lapses in the administrative structure of the JRC. The delivery of such a treatment—electric shock—seems to be such as to require a carefully supervised and very well-documented protocol, lest abuses such as the Boston Globe article describes arise. It is also unfortunate that behavioral treatments (such as ABA) continue to be associated with the use of aversives, due, indeed, to the JRC’s noting that it uses behavior therapy and the electric shocks. The Lovaas Institute itself does not use aversives; while aversives were used by Lovaas in the past, they are no longer, and not, condoned.

• Club 166
  Dec 19, 2007 at 10:57 am

  This case presents an interesting conundrum, both for the prosecutors as well as the JRC.

  If the state prosecutes the case, is it admitting that shocking people is a form of torture? Will the JRC attempt to have a thousand angels dance on the head of a pin while they say from one side of their mouth that shocking is totally harmless, while from the other side give testimony against someone who caused them to give “harmless” shocks to patients?

  Joe

• Michelle Dawson
  Dec 19, 2007 at 11:21 am

  In response to Kristina’s 9:24 message…

  Ivar Lovaas and colleagues presented at this year’s ABA annual meeting in a session (chaired by Svein Eikeseth) called “Issues in Addressing Problem Behavior in Persons with Autism.” Here’s the absract:

  ———————————————

  Use of Aversive and Restrictive Interventions in Behavioral Treatment . SVEIN EIKESETH (Akershus University College, Norway), O. Ivar Lovaas (University Of California-Los Angeles), and Børge Holden (Habilitation Services Hedmark, Norway)

  Abstract: This presentation discusses the educational, therapeutic, ethical and scientific context within which aversive and restricted procedures should be used and evaluated if indeed they are employed. The guidelines we propose, build on previous behavior analytic attempts, and center on the importance of informing the clients’ parents as well as the community of the intent to use aversive or restrictive interventions. Further, they emphasize the importance of providing staff training in how to apply non-restrictive interventions, as in teaching appropriate communication and other social skills, the need for supervision by qualified colleagues as in peer-review, the need to take objective data to evaluate the positive and negative effects of aversive interventions. This includes long-term follow-ups to assess whether the treatment did benefit the clients’ social development rather than being restricted to short-term suppression which may invite repeated application of aversive or restrictive procedures and the likelihood of adaptation to pain or discomfort.

  ————————————————————-

  …Also, the recent peer-reviewed behaviour analytic literature contains multiple favourable reports of the use of aversive procedures, including electric shock. This includes a recent paper involving the JRC and the GED (Oursouw et al., in press), published in a journal edited by a major behaviour analyst. This includes two recent (2007) papers authored by Richard Foxx, one of the most important and respected behaviour analysts in the world.

  Dr Foxx has also written about the “myth of nonaversive treatment” (Foxx, 2005), in a book edited by major behaviour analysts. The renowned behaviour analyst James Mulick was recently in the authorship of a study reporting the use of electric shock on a preschool child (Salvy et al., 2004). The current edition of the major ABA textbook provides information about and recommends the use of a variety of aversive procedures, including electric shock (Cooper et al., 2007).

  Just to give a few examples.

• jonathan
  Dec 19, 2007 at 12:37 pm

  kristina: Lovaas’ work, according to his own research was completely dependent upon aversives and he would not have gotten the same results without them, even though aversives have been outlawed in california where i live. Yet, Lovaas’ work can be presented as evidence in special ed lawsuits in california? That is quite an inconsistency where science and law are completely incompatible. You are very much misleading people by claiming that lovaas’ aversives are only of historical interest.

• Kristina Chew, PhD
  Dec 19, 2007 at 12:46 pm

  The historical record is important for all to study and not “only” of interest.

  Thank you for all of this information. There have never been any aversives used in the ABA that my son has received from therapists from the Lovaas agency (as distinguished from Lovaas the person’s own research, though it is hard to separate these of course), but this is of course my personal experience. Please also note that I refer to the ABA he has received; I hope that more of the research and studies that Michelle Dawson notes can be widely disseminated.

  Other ABA providers that have overseen therapy for my son have used aversives and we no longer use these. One provider in particular was not someone we would have ourselves chosen, but a “behavior management consultant” that our then-school district had contracted out for.

• theasman
  Dec 19, 2007 at 1:04 pm

  Kristina,

  the autism diva on her blog has video about children being slapped. Even of them being in bare feet while the floor is charged so they get electrocuted and they do a lil jig until it is over.

  Also to be fair Aspies for freedom has had a campaign against JRC going since 2004

• Kristina Chew, PhD
  Dec 19, 2007 at 1:24 pm

  Yes, I have seen the videos. Thanks for mentioning the Aspies for Freedom campaign: What is going on with this now?

• theasman
  Dec 19, 2007 at 1:43 pm

  Also Kristina,
  ABA is all about aversives. ABA is reward/punishment. Punishment is the nice way to say aversive. It is all based on flawed theory. by BF skinner - behavioralism. “Men really do think”
  It works precisely for the reason it is wrong any thinking being will respond to rewards and punishments. ABA was invented to “cure” homosexuality.
  Would support the continues use of ABA so that homosexuals act more like straights? if Not why support it so autistics can act more like NTs?

• Leila
  Dec 19, 2007 at 1:45 pm

  Electric shocks are torture. End of the story. We cannot do this to prisoners, we cannot do this to any person in this country. The fact that people are willing to accept this to be done to mentally disabled, defenseless people, just goes to show how they are being treated as non-citizens, non-humans. Shame on Massachusetts.

  “The ends justify the means” is a fascist way of thinking. This is the 21st Century, USA, we should be beyond that.

  Also, the fact that a former student elaborated this prank is very telling. He knew very well it would be easy to get the center employees to administer an awful lot of shock and restraint treatments on other patients, because it’s probably routine and it wouldn’t be considered strange for an employee to receive that order from a supervisor.

• Kristina Chew, PhD
  Dec 19, 2007 at 1:56 pm

  Good questions, AS man. We don’t teach my son using the “reward/punishment” conceptualization that you mention and, again, am glad you bring this up. I’ve had this on my mind as I’m grading finals and certainly a 49% (translates into a non-passing grade) is not rewarding to see!

• theasman
  Dec 19, 2007 at 1:56 pm

  As for the AFF campaign. Me and aff had a falling out in 2005. So… you would have to ask them. Kev was part of the problem but he left on his own. he was too good for us. All those angry aspies who were mistreated had a lot nerve to vent with him around. He put us in our place.

• Kristina Chew, PhD
  Dec 19, 2007 at 2:11 pm

  Thank you and I really mean it for this discussion. Questions of “reward” and “discipline” and punishment” get to the core (for me) of my son’s education. Too often people think that he is “misbehaving” and the next thought is how to discipline him—-and that’s not the case at all.

• Sarah
  Dec 19, 2007 at 3:01 pm

  according to the center’s website, they also use food deprivation as “aversive therapy”:

  “The Specialized Food Program- the student will not receive any make-up food at the end of the day unless the student has received less than 20% of his daily targeted calories. It is instituted with the approval of a consulting physician (and a neurologist if the student is seizure prone or a cardiologist if there are any cardiac problems) and the JRC medical and nursing staff. The student continues to be able to earn his other food through various task completions, the exhibition of “supergoodie” behaviors, and the passage of contracts, among other means…”

• Patrick
  Dec 19, 2007 at 4:35 pm

  “…we cannot do this to any person in this country.”

  Slightly untrue, Tasers are (supposed to be) used when perpetrators are not complying. Though they seem to have been used in many situations where the level of miscompliance did not justify the end outcome.

  I live in Spokane Washington, where in this past year a slightly unruly mentally challenged person Died from Taser use.

  I disagree with the use of GED for JRC ‘inmates’, and I will not condone the use of the word students at a facility that appears to lack the ethical code required of most public school districts.

• Another Voice
  Dec 19, 2007 at 8:08 pm

  The first comment to this post subverts the situation very severely. Nothing in the article mentions a two second shock once a week. Everyone is entitled to an opinion but not to their own set of facts.

  A student was zapped 77 times before anyone figured out they were the subject of a prank caller. How dumb are they?

  This place needs to be closed because they can not be trusted to consider the welfare of their of their students. If an inmate at any prison in this country were zapped 77 times the ACLU would be jumping all over the warden; where are they now?

• Regan
  Dec 19, 2007 at 8:59 pm

  The model, on a simple-cut basis, is reinforcement/punishment/extinction=cessation of reinforcement of a behavior previously reinforced in the past) of behavior, not a person or organism, which is a functional definition based on the effect of a consequating stimuli on a future probability of a behavior or behavioral response class, and the function is defined by future events. Not all are socially mediated by someone delivering or taking something. Many are direct (turning on a light switch, determining which tap to turn on when I want hot water, being more careful with the hammer after the first time that I accidentally hit my thumb with it), some are inadvertant (accidental reinforcemnent or punishment of other than what would be the normally controlling stimuli, because of coincidence, which shapes superstitious behavior), and if one is guessing based on typical topography of reinforc(ers), punish(ers), the effect may be paradoxical, because topography does not define functional relationships.

  I absolutely agree that there are important ethical questions around the whole question of definition of person centered vs. system centered, self-determinism, social validity, candor about what is really known about the understanding of processes underlying procedure and the effectiveness rate of procedure, personal liberty, understanding function vs. applying topography. I appreciate the perspective on the question of ethical treatment and options from Herb Lovett, (”Learning To Listen: Positive Approaches and People With Difficult Behavior”.)

  Although R. Foxx, J. Mulick are well-known behavior analysts, I would not say, and I doubt if every behavior analyst would say that they speak for the entire field. Murray Sidman, Rob Horner, V. Mark Durand and many others are also prominent behavior analysts and they have a very different point of view on the question of ethical treatment. Brian Iwata has made an entire career in the consideration of the function of behavior and the ability to discern what difficult to understand behavior functionally represents, which in turn has led to the technology of functional assessment and analysis.

  In regards to JRC and the peer reviewed paper in JADD, they state that they see no long term effects. On the other hand, there are questions about effectiveness because of the continued use of the GED over long periods and the methods of use. The justification is cessation of life-threatening behaviors which often have been intractible across many different placements, with alternatives of protracted 4 point restraint and multiple antipsychotic drugs and possible abuse as impromptu “intervention”. That is important, because I don’t have the history of how these folks ended up where they are, and what programs were they in before, was this failure of treatment, or were these in fact the result of treatment? What greatly concerns me is the trivial and capricious possibilities for infractions such as talking out, or sloppy shirt tails or other examples of typical student behavior, as well as the unethical use of restraining a person AND applying the GED. I also think that the restrictive diet is non-normative and control of personal right to choose beyond the pale. I would consider that JRC may be practicing behavior modification vs. behavior analysis, since they themselves seem to state that they do not rely on functional analysis to determine the function of the behavior, but seek to stop it or suppress it under the direct mean of the GED. I would ask questions about whether they use “fair pair” practices and seek to increase options to the students which are meaningful to the student him/herself, in addition to those chosen by the Center as meaningful, since absolute control must tread infrequently and assume a tremendous ethical responsibility.
  I would like to ask (respectfully), that assume the question–JRC shuts down tomorrow (and it might well should) ; what would be the next stop for the current enrollees, what treatment would they need, what program or therapy would be equipped and has a documented track record of doing so effectively and ethically? I think that would be the next part of the question.

• Another Voice
  Dec 20, 2007 at 12:30 am

  What if the JRC were to be shut down tomorrow? I don’t believe any facility should be closed in a day.

  I do believe that the management can be replaced and that people who would deliver 77 shocks to another human being can be fired in a day. Programs can be changed, different methods can be used to replace these practices. However, change will only occur if the people at the top determine that they must find a better way. We have been reading about the JRC and it’s predecessor for years, there seems to be no intention to replace the current tactics, so start replacing the staff.

• Regan
  Dec 20, 2007 at 1:02 am

  I agree that the system screwed up badly and that the prank exposed a major hole in self-monitoring and accountability. I might also suggest that the prankster has some responsibility in the unnecessary delivery of shock to these persons.

  The “day” could be hypothesized as rhetorical and expanded or changed as practical. The questions still remains what programs are being specified and what methods? Positive behavioral support, contingency management, a cognitive therapy, medication…?

  Is anyone familiar with the court cases and why they continue to prevail in that format, under the same directorship and continue to exist despite 20+ years of litigation and legislation in MA?
  (I believe that MA has 3 current bills in progress to increase oversight and professional competency, however I do not recall that any of them addressed the question of the GED and JRC specifically).

• Michelle Dawson
  Dec 20, 2007 at 1:52 am

  In response to Regan, Ooursowu et al. (in press) is not epublished in JADD, which in turn is not (nor has ever been) edited by a behaviour analyst.

  Re Bruce Iwata, see 1993 paper, “A comparison of shock intensity in the treatment of longstanding and severe self-injurious behavior,” of which he is senior author. This study was published more than a decade after the availability of functional analyses of behaviour.

  See also Lerman et al. (1997), Thomson et al. (1999)–Dr Iwata is in the authorship of both these papers (he is also, along with Drs Lovaas and Foxx, in the authorship of Van Houten et al., 1988). Also see the use of Dr Iwata’s work to justify the necessity of aversive procedures, including electric shock, in Cooper et al. (2007; as I wrote above, this is the most recent edition of the major ABA textbook).

• Regan
  Dec 20, 2007 at 2:45 am

  My apologies Michelle, that was an error. Thanks for pointing it out.
  The correct journal was Research in Developmental Disabilities, and the citation is
  van Oorsouw, WMW.J, Israel, M.L., vonHeyn, R.E. and Duker, P.C. (2007 article in press/corrected proof). Side effects of contingent shock treatment. Research in Developmental Disabilities.
  http://dx.doi.org/10.1016/j.ridd.2007.08.005

  For my own purposes, I noted the citation co-authored by Brian Iwata, that you cited and here is the links if anyone has interest in reading it:
  Williams, D.E., Kirkpatrick-Sanchez, S., Iwata, B.A. ( 1993). A comparison of shock intensity in the treatment of longstanding and severe self-injurious behavior. Research in Developmental Disabilities.
  http://dx.doi.org/10.1016/0891-4222(93)90031-E

  As a sidebar to the Vondran and Lerman paper on the status of punishment, I thought that Rob Horner’s thoughts might be apt because of his stance of positive behavioral support:
  Horner, R.E. (2002 )On the status of knowledge for using punishment: A Commentary. JABA, 35(4). 465-467.http://dx.doi.org/10.1901/jaba.2002.35-465.

  The question that I still return to, is what is the alternative or next step proposed? This is a sincere question, esp. in view that a practical equivalent speaking to replacement, granted more socially acceptable and socially validated and not because I have a better thesis myself. I am not looking for a behavior-analytic solution–anything from any field, psychology, medicine would apply.
  Michelle, as you are well acquainted with the literature and have first hand research experience–what would you say from your study and work, the ethical and effective equivalent would be? Putting it in brass tacks–if you were in the position of being able first hand to help a person with an already long established history (from any source) of severe SIB, agression or self-rumination, what would you do?

• Regan
  Dec 20, 2007 at 5:52 am

  Okay,
  The further details of this sound pretty bad.
  I agree–this is unacceptable.
  http://www.boston.com/news/local/articles/2007/12/20/staff_faulted_in_use_of_shock/?page=1

• Regan
  Dec 20, 2007 at 6:07 am

  Also,
  which includes
  Investigation Report for
  The Commonwealth of Massachusetts
  Department of Early Education and Care
  Date: Nov. 1, 2007
  http://ledger.southofboston.com/articles/2007/12/19/news/news000.txt

  The bill(s) currently in the MA legislature include
  H2245, SD1988 - An Act creating a special commission on behavior modification, and
  H109 - An Act to Ensure the Humane Treatment of Disabled Persons
  Fact sheets and text at
  http://www.arcmass.org/StateHousePolicy/Bills/tabid/135/Default.aspx

• Kristina Chew, PhD
  Dec 20, 2007 at 10:49 am

  Regan and Michelle, thank you for all of these references. I know how we have been able to reduce self-injurious behavior in my son; I have to say, it took a lot of effort, a lot of time, and a lot of coordination among home, school, medical professionals, us.

• Another Voice
  Dec 20, 2007 at 9:26 pm

  The fact remains that in any other setting what occurred at the JRC would have been considered a criminal act. The staff at JRC went to this teenager’s room, bound his arms and legs and proceeded to punish him over the next couple of hours with electric shock. Criminal act or therapy?

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