The Rotenberg Center’s methods are undoubtedly unorthodox. But they work.
by Lawrence Harmon
You can read the article at the Boston Globe site. Here is the final paragraph:
THE JUDGE Rotenberg Center in Canton, which stands alone in its use of painful skin shocks to eradicate self-mutilation and sudden assault, is a storehouse of ethical and medical dilemmas. But it’s no shock – and no shame – that the parents of some autistic and mentally retarded children embrace this controversial school.
There are some very impassioned comments after the article. I won’t quote the JRC parents who posted without permission, but I would encourage you to read the comments.
One comment is by Nancy Weiss, who worked with the coalition of disability advocacy groups that filed the complaint against JRC is below:
The Judge Rotenberg Center likes to make the point that there are no other options for people with severe, dangerous behaviors, however not only are there people just like the people at the Judge Rotenberg Center who are being supported humanely and effectively all over the United States; there are people who were at the Judge Rotenberg Center who are doing wonderfully with positive behavior supports in community settings across the country. These are people who JRC warned would never make it outside of their center, people they said would need to be hooked to the shock devices for life, people who were moved in spite of the Judge Rotenberg Center’s dire warnings that they would be violent and dangerous. As I said to Mr. Harmon in a lengthy conversation prior to his writing his column, logic tells us that the 193 people at JRC can’t be the only people in the country with behaviors this severe. I’m sorry he didn’t take me up on the contacts I provided him so he could learn how people with behaviors just as severe are supported successfully without resorting to painful methods.
The Judge Rotenberg Center would like visitors to believe that painful electric shocks are used only infrequently and only for the kinds of extreme behaviors Harmon lists in his article: eye gouging, head banging and the like – but a New York State report found students as young as nine years old subjected to sudden, painful, repeated electric shocks for such harmless behaviors as “refusing to follow staff directions”, “failing to maintain a neat appearance”, “stopping work for more than ten seconds”, “getting out of seat”. “interrupting others”, “nagging”, “swearing”, “whispering” and “slouching in chair”, and “moving conversation away from staff..” The Boston Globe itself reported on the testimony of former employees who spoke about a student who received as many as 350 shocks in one day, a figure the Globe reported was confirmed by the school. That Globe article reported a former employee to testify, “the shock is more painful than described by school officials. I got hit accidentally on my thumb and I had a tingling up to my elbow, on the inner part of my arm, I would say for four hours. I was saying I can’t believe these kids can do this. My hand was shaking. I wanted to go home, that’s how bad it was.”1
The director of the Judge Rotenberg Center testified at a Massachusetts 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 strapped to a board and subjected to an average of one shock every 16 seconds.2 A 2007 New York Times article notes, “a former teacher from the school …said he had seen children scream and writhe on the floor from the shock.” The Times article also speaks to how painful the shocks are, “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”.3 And, even more frightening, all of the statements above were made before JRC came out with its newest shock device – the GED-4 which, according to a 2006 Boston Globe article, “deliver(s) 45 milliampere shocks4 1/2 times stronger than the standard shocks” According to that article, ”Greg Miller, a former teacher’s assistant for more than three years, said one boy with autism was shocked by the higher-powered device so often that he had ‘burn scabs all over his torso, legs, and arms,’ forcing nurses to remove the electrodes for weeks so that his skin could heal”
Just a bee sting, used only occasionally in the most extreme circumstances? Harmon may have bought this but the facts don’t support it.
Harmon seems to think that these practices are OK because they are approved by parents and a probate judge. Let’s be clear that the Judge Rotenberg Center is a lucrative business. On their 2008 IRS forms (the most recent ones publicly available) JRC reported $390,301 in compensation for their Director. The Center was so beholding to the Judge who approved all the aversive procedures for their students that when he died, they re-named their facility in his honor. The facility used to be called the Behavior Research Institute but advocates would ask, “where’s the research?” Yes, the courts approve these practices, but one wonders how much they know about humane, effective alternatives.
And, in terms of parents approving the electric shock? Just ask parents like Evelyn Nicholson. In 2006, The Boston Globe reported that, “Evelyn Nicholson initially approved the shocks, but said she changed her mind as her son became more desperate, complaining that the shocks knocked him to the floor. Previously, she said, ‘I was advised that the shock . . . felt like a small pinch,’ and that the devices were rarely used.” Nicholson, like numbers of parents, when they found out what was being done to their sons and daughters, told JRC that they did not have their permission to use painful procedures on their kids and were told that if permission for the shock was not given they could come and take their son or daughter home. Parents giving permission? Not with any element of the free will that the term ‘permission’ usually implies.
Harmon speaks of other schools – schools he was told kids like these might be at if not for the Judge Rotenberg Center; schools where these kinds of students would instead be subjected to mechanical restraints. That might make a reader think that the Judge Rotenberg Center doesn’t use these restrictive techniques. The New York State investigational report on JRC states, “With mechanical movement limitation the student is strapped into/onto some form of physical apparatus. For example, a four-point platform board designed specifically for this purpose; or a helmet with thick padding and narrow facial grid that reduces sensory stimuli to the ears and eyes. Another form of mechanical restraint occurs when the student is in a five-point restraint in a chair. Students may be restrained for extensive periods of time (e.g., hours or intermittently for days) when restraint is used as a punishing consequence. Many students are required to carry their own “restraint bag” in which the restraint straps are contained.”4 The same report notes, “Some of these students were observed to be fully restrained in restraint chairs and wearing movement limiting helmets. One student left the school building in full restraint (hands and feet restrained with Velcro straps in a restraint chair), clearly agitated and upset, and returned the following morning carried to the conference room fully restrained in what appeared to be the same chair.”5
When I spoke to Mr. Harmon he seemed particularly swayed by the video called “Before and After” that almost every visitor sees. A 2007 Mother Jones article described the “before” footage shot in 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.” The Mother Jones reporter goes on to say, “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.”
And here we have perhaps the most important point that Mr. Harmon missed. If these methods worked – if their inhumanity was justified by their success, you wouldn’t have students still there after 33 years. You wouldn’t need to continually develop devices that deliver a stronger and stronger shock or methods to spread the electrodes so the electrical current passes through more flesh for the purpose of assuring greater and greater amounts of pain. Positive behavioral approaches are proven to have more staying power; they give people tools that they can use for life and they help them to change dangerous behaviors in ways that value, enhance, and include people rather than through the use of methods that are coercive, controlling, and inhumane. While the “after” portion of the tape Mr. Harmon watched might have seemed compelling, did he ask why, if these methods worked, people are still there 33 years later, still hooked up to the devices that are touted as being so effective?
I’m sorry Harmon was taken in, as so many casual visitors before him have been. It’s easy to spend a few hours and accept what you’re being told at face value. It’s easy when you’re under deadline to buy into the belief that no alternatives exist. Mr. Harmon said he feels that the concerns of the 31 disability organizations that signed the letter that motivated the Department of Justice investigation seem “too pat.” I hope it is clear that these organizations did not take lightly the decision to sign this letter. These groups represent the major, mainstream developmental disability organizations in the country including the American Association on Intellectual and Developmental Disabilities, The Arc of the United States, Easter Seals, United Cerebral Palsy and 27 others which together represent the most respected researchers in the country.
No one should be deluded into thinking that Mr. Harmon’s visit to the Judge Rotenberg Center told the whole story. The Judge Rotenberg Center has a business to run; they are not going to tell a reporter that humane options exist, but the several hundred thousand professionals and advocates represented by the 31 disability organizations that called for the Department of Justice investigation, know full well that they do. And because they do, this treatment of our most vulnerable citizens should not be tolerated by a society grounded in a commitment to the ethical treatment of all people.
I would make a simple statement: the Judge Rotenberg Center is paid with over $50M of taxpayer money. Why shouldn’t the taxpayers spend a little more money (and a little more than the few hours Mr. Harmon spent) to insure that the Center is within the laws? For all it’s clients. All the time.
If you want to reference this post in your site, use the code below to link to me from your website.
<a href="http://leftbrainrightbrain.co.uk/2010/03/the-boston-globe-defends-the-judge-rotenberg-center/">The Boston Globe defends the Judge Rotenberg Center</a>
The negative references to the Judge Rotenberg Educational Center that appeared on WellSphere on March 11, 2010 have been brought to my attention. To providing some balance to your readers, I would appreciate your bringing the following information to the attention of your readers.AVERSIVE THERAPY SAVES LIVESJRC is a residential behavior modification school in Canton, Mass., for individuals whose severe, often life-threatening behavior disorders are not effectively treated by psychotropic drugs, counseling, or rewards-only procedures. Through the use of safe, parent-requested, individually
scientifically validated aversive therapy – while avoiding or minimizing psychotropic drugs – the center has, to cite just a few cases, saved the life of a child who vomited so frequently that he was in danger of starving to death; restored the eyesight of two children whose head-banging was so severe that each detached both retinas and risked permanent blindness; and saved the life of a boy whose severe, compulsive self-scratching placed him at risk of dying from blood and bone infections.The center’s program consists, overwhelmingly, of
positive rewards and educational procedures. However, as
research has shown, such procedures alone are effective in only 60 percent of cases at best. Consequently, positive procedures at JRC need to be supplemented, in the most difficult cases, with the use of
shock to the surface of the skin. This feels like a hard pinch and is administered as an immediate corrective consequence for the problem behaviors. Behavioral skin shock bears no resemblance to electroconvulsive therapy treatment (psychiatric brain stimulation that causes seizures) or police stun guns (JRC’s skin shock uses 60 volts; a stun gun generates 350,000 volts). This form of treatment is extremely effective, and a
peer reviewed study found that there are no negative side effects. The procedure is far less aversive and far less painful than the damaging self-abusive, aggressive, and dangerous behaviors that it eliminates. The procedure is so effective that it is applied infrequently (on average fewer than three times per week), and is used only until the student’s problem behaviors decrease and positive behaviors take their place. Aversive therapy: ·Eliminates the need for cocktails of mind-numbing psychotropic medications which, instead of treating behaviors, often put the user into a semi-comatose state in which the individual sleeps most of the day. They also expose the user to frightening short- and long-term side effects such as permanent tics, obesity, diabetes, organ damage, metabolic changes that can shorten life expectancy.·Eliminates the need for manual and mechanical restraints, which most programs use to control aggressive and self-abusive behaviors. In a
published study in which we treated aggression in 60 students, once our skin-shock aversive was employed, the use of manual restraints dropped to zero and psychotropic medications dropped by 98 percent.·Eliminates the need for time-out rooms and isolation.·Is used with only 27 of the Judge Rotenberg Center’s 145 school age students and only after JRC has tried, for an average period of approximately one year, to accomplish the treatment goals using only positive rewards and educational procedures. ·Is pre-approved, individually, by the parent and a physician, and by a judge at a hearing in which the child is represented by his/her own court-appointed attorney. ·Is aprocedure that
numerous parents and students have credited with saving lives. ·Is used with students whose behaviors are so severe that
they have been rejected and expelled by other treatment programs that pride themselves on using “positive-only” procedures.·Enables JRC to maintain a policy of near-zero rejections and expulsions. Parents do not have to fear a call asking them to “come take your too-difficult-to-handle-child home.”Most if not all critics of JRC have never visited the center or spoken with any of our current clinicians, staffers and students, or those students' parents. Most of the opposition to the center’s skin-shock aversive treatment reflects an ignorance of its effectiveness and a refusal to rationally weigh the benefits against the disadvantages. The boy we saved from life-threatening blood infections
died at age 25 from a resumption of those same self-scratching-caused blood infections after he was removed from JRC by advocates who made the same claim as Ms. Ahern, that his severe self-injurious behaviors could be treated successfully without aversives. By contrast, two independent, tenured, full professors of special education who took the trouble to visit the center and saw first-hand what it has accomplished recently wrote a textbook (Williams, B.F. & Williams, R.L., Effective Programs for Treating Autism Spectrum Disorder: Applied Behavior Analysis Model) that
devotes a chapter to JRC and that cites the center as one of a handful of effective, nationally-recognized behavioral treatment programs for children with autism spectrum disorders.
The writer, a behavioral psychologist, is the executive director of the Judge Rotenberg Educational Center, a residential special-needs school in Canton, Mass. which he founded in 1971. His email address is