The Technology of Punishment at the JRC
On this vacation at the beach 2007, my son Charlie has become such a good swimmer that for the first time ever, Jim and I can (for a time) stand on the sand and watch him swim in the mighty waves: This is the first major difference from last year’s visit.
The other? Charlie is no longer head-banging regularly.
Charlie’s self-injurious behavior lessened gradually over the past year of being in a highly structure school setting that uses ABA. Both his teachers at school and his therapists at home did a functional analysis and figured out “replacement behaviors” to teach him to do, that would not involve him hurting himself. Sensory needs as well as some wish for escape were among the reasons—head-banging used to be one of Charlie’s strongest ways of communication (he can talk, but minimally). It took a year and a half plus to teach Charlie to ask for a break instead of hitting his head: Charlie had to learn to anticipate that he might be getting upset, and also to ask for it.
The August 20th Mother Jones looks as the “aversive therapy” methods (=electric shock) used at the Judge Rotenberg School (JRC) in Canton, Massachusetts. Says Brian Iwata, professor of psychology and psychiatry at the University of Florida, after reviewing a description of the JRC’s “therapy”:
“The technology of punishment is unlike that used in any other program, whereas other technologies have been left behind.”
The fact that Professor Iwata uses the word “punishment” in reference to the JRC’s “teaching” procedures, says more than enough to me that the JRC’s methods are questionable, if not inhumane and cruel.
I felt terrible to see my son Charlie self-injure. I feel more than happiness at seeing how he has learned to manage this behavior and to monitor his worries.
I feel outrage everytime I read about the JRC, because I wonder if people have ever thought that my own son might have been (be……) a candidate for such “treatment.”
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POSTED IN: Education, Safety, Technology
11 opinions for The Technology of Punishment at the JRC
Leanne
Aug 20, 2007 at 4:20 pm
The word ‘punishment’ indeed says a lot.
Another Voice
Aug 20, 2007 at 4:41 pm
I am surprised that the state allows this place to stay open. I have never viewed Massachusetts as being that backward.
Regan
Aug 20, 2007 at 5:27 pm
Well, punishment in behaviorspeak is not definitionally the same as in plain english.
From a definitional standpoint it means either application of a stimulus (positive punisher) or removal of a stimulus (negative punisher) in order to reduce some dimension of behavior (frequency, intensity, duration, latency). The definition that it is a punisher is based observation of the above…otherwise you are applying or removing a stimulus, but it may not be a punisher unless it has that effect. Day to day life is filled with incidental punishers and reinforcers under no one’s control.
I think what Dr. Iwata might have been saying is that the “technology” of the JRC “punishment” is unlike that of any other program both in form and application, and that there are missing components of positive reinforcement and positive programming. Removing behavior without seeking a functional equivalent or contriving compensating opportunities for reinforcement is unethical. Skinner himself did not believe that behavioral control was ethical by punisher. Extended use of an aversive stimulus speaks to a failure of therapy, not a success.
Reading the Mother Jones article raised all kinds of alarm bells about abuse of power and priming the pump for “needing” to use the GED.
Kristina Chew, PhD
Aug 21, 2007 at 12:03 am
Regan, thanks for the analysis. Dr. Iwata’s work has been helpful in addressing my own son’s SIB’s—-and shows that a child can be taught replacement behaviors successfully to manage the SIBs.
Regan
Aug 21, 2007 at 6:11 am
Kristina, you are welcome.
Thank you for posting the Mother Jones article.
It was not pleasant, but was necessary reading.
I think that the situation is thrown into clear perspective when combined with this report of past and current practices of JRC and previously as BRI, as well as any other facility or program that might be claiming the use of aversive control (aversive procedures, forcible restraint and seclusionary timeout) as “therapeutic” interventions:
Towards the Elimination of the Use of Aversive Procedures To Control Individuals with Disabilities
Nancy R. Weiss, Executive Director
TASH-Disability Advocacy Worldwide
http://www.aprais.org/articles/ACallToActionFromTASH.pdf
Perhaps this will give folks one starting point if they have an active interest in the questions of ethical and humane treatment as a human rights issue:
The Alliance to Prevent Restraint, Aversive interventions, and Seclusion
http://www.aprais.org/
Matthew L. Israel
Sep 28, 2007 at 3:03 pm
An extensive response to Ms. Gonnerman’s article can be found here: http://www.judgerc.org/ResponsetoGonnermanArticle.pdf
Matthew L. Israel,Ph.D.
Executive Director
Judge Rotenberg Educational Center
http://www.judgerc.org
Regan
Sep 28, 2007 at 5:49 pm
Dr. Israel,
Thanks for listing your reply to Ms. Gonnerman’s article, which I read in the Boston papers at the time of the article.
Some points I agree were misrepresented. I also agree that these students did not drop out of the blue and that your school is called on to serve those who others are unable or unwilling to instruct or control except under conditions that might well rival the public concern leveled at JRC, and to wit, is it *really* something within the student, or are possibly seeing the logical conclusions of years of shaped behavior in other settings and facilities?
Another question that I have is whether our current knowledge of punishment really represents best practice as it could and should be? From my (limited) reading of JABA, esp. the 2002 issue with the paper by Lerman, and the replies, it appears that there is some work to be done in defining and understanding the potential tiger by the tail. Such was also alluded to in Tom Critchfield’s Presidential Address.
I don’t necessarily expect a reply or discussion on this, but these are the questions that continue to plague me when considering the question.
Derrick Jeffries
Oct 2, 2007 at 4:55 pm
To Dr. Israel,
In the future, it would be appreciated if you could post your articles, rebuttals, etc, in places where others can offer comments. The Mother Jones article was presented in this manner, and allows a forum for people to express agreement, disagreement or apathy regarding this subject matter. When information is presented honestly and accurately, there is no need to fear any oppositional opinion. Open respectful debate is healthy for advancement in all facets of learning.
It has also been my observation that you tend to avoid exposure to peer review, and that most literature you offer in support of your practices is self written, or produced by your employees. You do refer to some old behavioral literature, some of which has since been rejected by the original authors.
I was quite surprised by some of the factual inaccuracies within your rebuttal of Jennifer’s article. One of them, your attempt to distance yourself from the death of Danny Aswad SHOCKED me! Yes, Danny did die while restrained and laying face down, and unsupervised at your California Behavioral Research Institute.
Factual inaccuracies also abound on your website! The following is found in the FAQ section of your website:
“”Is it true that five students have died at JRC?”
Yes. Each died from natural causes that had nothing to do with our use of aversives. JRC’s policy has always been willing to admit students even though they may have pre-existing life-threatening medical conditions. JRC has an excellent record of maintaining the health and safety of its students over JRC’s 34 year history. JRC is proud of this record because JRC accepts the most physically and mentally disabled students in the nation and maintains their safety regardless of their age and physical condition upon admission and despite the fact that many of these students suffer severe behavior disorders that cause them to try to inflict mortal injury to themselves. Any program that operates for as long as JRC has under these conditions will have at least some students who die from natural causes. No program can prevent that.”
Okay, that is what you claim. Now let’s consider a couple of incidents at your facilities:
Let’s consider Linda Cornellison.
“On December 19, 1990, Linda Cornelison, a patient who was mentally retarded and non-verbal, died of causes related to stomach perforations and ulcers. The Center failed to properly diagnose these apparently pre-existing conditions, and failed to provide an appropriate diet and treatment. When symptoms occurred that should have provided an opportunity for further examination, the JRC instead opted to punish her with a plethora of aversive treatments, including 61 that were administered on the day of her death. Linda, who had weighed 120 pounds when she began the Center’s food program, weighed just 90 pounds at the time of her death, which was less than one year later. A subsequent report on the investigation of her death was released by the Disabled Person’s Protection Commission (DPPC), and the Massachusetts Department of Mental Retardation. Report information is also available at this link: http://normemma.com/lcorneli.htm The investigation included the interviews of 72 witnesses, the review of hundreds of documents, and reports by four experts. The report contained descriptors such as, “egregious” and “inhumane beyond reason” in describing the actions of several specific staff members. Some of the treatment was said to violate “universal standards of human decency”. Abuse and violations of DMR regulations were also found in the woman’s treatment by JRC/BRI prior to her death. **The writer of this letter highly recommends that you click on the link included with this paragraph to understand the severity of the inhumane treatment that Linda endured. My letter is only an overview, but the link provides very detailed information.”
Guess what? Your aversives did not cure her ills!
Then there was Vincent Milletich. Here is the truth about Vincent:
“On the 23rd of July, 1985, Vincent Milletich, a 22 year old student with Autism, died while he was a resident at the JRC’s (Then Behavior Research Institute) group home in Seehonk, Mass. According to a New York Times article, “he (Vincent) had been shackled, fitted with a helmet and forced to listen to static noise through earphones. The Rhode Island medical examiner who performed an autopsy on Mr. Milletich said the victim died of asphyxiation but said it was not known what cut off his oxygen supply.” The article goes on to say, “Judge Ryan said Mr. Israel ”was negligent in authorizing the use of this helmet without having an expert in helmet construction design the helmet or subject it to a safety inspection.”
http://query.nytimes.com/gst/fullpage.html?sec=health&res=9B0DE0D7153BF93BA35752C0A961948260
On page 153 of Joseph P. Shapiro’s book, No Pity: People with Disabilities forging a New Civil Rights Movement, Crown Publishing Group (January 1994), the writer reveals, “Vincent Milletich died after BRI workers `pushed his head between his legs, cuffed his hands behind his back, put a helmet on his head with radio static hissing into his ears and masked his face. He went limp and was declared dead on arrival minutes later at Rhode Island Hospital in Providence.’
According to Director Matthew Israel’s own words, posted on JRC’s Website, “The cause of death (Vincent’s) was ultimately determined to be natural causes related to his condition of tardive dyskinesia and not due to the restraint procedure that had been employed.” http://www.judgerc.org/history.html However, his claim is not substantiated in the coroner’s report or the findings of the court, which explicitly stated that asphyxiation was the cause. Vincent’s parents have said that he suffered from epilepsy. Regardless of what other diagnosis Vincent may or may not have had, Judge Ryan did declare Mr. Israel “negligent” in regards to the helmet that was used in his treatment on the day of his death. This fact is a linkage between the JRC staff and the death of Vincent Milletich that Matt Israel cannot evade with clever words.”
Yes, Mr. Israel, I am the one who wrote the words contained in that paper that has been circulating the internet. Your factual inaccuracies (I would like to use a four letter word here beginning with L, but have been advised not to) are abundant! In the end it just may be your own pride that brings about your fall. All anyone needs to do is look closely at what you do and what you say, and then compare that with facts, and then the truth is revealed. Your many words will not save you when the day of your reckoning is here. That day may not be so very far off!
Kristina Chew, PhD
Oct 2, 2007 at 5:04 pm
Thanks, Derrick.
Regan
Oct 2, 2007 at 7:10 pm
2007-2008 Legislative session
See H109 An Act to Ensure the Humane Treatment of Disabled Persons*
Link, testimony and fact sheet on the bill
http://www.arcmass.org/StateHousePolicy/Bills/tabid/135/Default.aspx
Cliff
Oct 2, 2007 at 7:45 pm
Derek, on a very personal level, thank you very much. I will work where I can to make sure this doesn’t go unheard.
Cliff
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