The Washington Post publishes debate on whether Judge Rotenberg Center tortures children.
Source: The Washington Post
The Washington Post
Disabled children at Mass. school are tortured, not treated
By Laurie Ahern
Saturday, October 2, 2010
"We don't torture," President Obama said just days after taking office. Perhaps he is not aware of what is happening in his backyard -- to children with disabilities in Massachusetts.
During investigations into treatment of detainees at Guantanamo Bay and Abu Ghraib, detainees reported being short-shackled, verbally abused, isolated, hooded and threatened in ways designed to induce fear of injury, pain and death -- including threats that they might be tortured with electric shocks.
State reviews of the techniques used at the Judge Rotenberg Center (JRC) in Canton, Mass., and the center's Web site have cited skin shocks, shock chairs, shock "holsters," shackles and social isolation -- some of which are applied to school-age children.
Known as a school of last resort, this taxpayer-funded residential facility -- at more than $220,000 per child per year as of 2007, according to Mother Jones -- has a controversial history. Started by Matthew Israel, a devotee of the behavioral psychologist B.F. Skinner, the school employs "aversive treatment," a program of behavior modification involving rewards and punishments.
Youths enrolled at JRC exhibit a variety of disabilities -- including attention-deficit disorder, bipolar disorder, autism, schizophrenia and post-traumatic stress disorder, according to a New York State Department of Education report -- emotional problems, and criminal and abuse histories. Forty-seven percent of the 213 residents were approved by the court for "Level III aversives," which include shock, according to a Massachusetts state review published in July. These painful punishments are used on anyone who does not respond adequately to "positive" interventions only.
JRC eschews medication -- its Web site notes that "Parents who strongly believe that their child requires the use of psychotropic medication and who are not interested in trying an approach [that] avoids or minimizes such medication, are encouraged to consider enrolling their child in such programs rather than in JRC" -- and traditional therapies, arguing that no other treatment can control children suffering from the most severe behaviors. Its examples include youths who have pulled out their own adult teeth, who have set fires or who bang their heads so much they have dislodged their retinas. Parents and the Massachusetts Probate Court must approve the punishments it administers as treatment.
But even if such practices are effective -- which is questionable -- neither courts nor parents should be permitted to subject children with disabilities to such severe levels of pain.
How powerful are the shocks administered at JRC? Around 1990, Israel invented a machine, which he calls the Graduated Electronic Decelerator, that emits a two-second shock at 15.5 milliamps. A stronger version, the GED-4 at 45 milliamps, was later made for those who become inured to the pain. By comparison, stun guns used by police deliver one to four milliamps. (Boston magazine reported in 2008 that Israel himself says the shocks are "very painful.")
Those approved for "aversives" -- JRC has 140 school-age children; some enrolled have become adult residents -- carry these devices in backpacks with electrodes attached to their arms, legs, feet, fingertips and torsos, and staff members administer the shocks remotely. Students, some of whom have been shocked this way for years, and in some cases for decades, don't know where on their bodies they will receive a jolt. The July Massachusetts report noted that as of April, six residents were receiving an average of more than 10 shocks a week. Reasons for the use of "Level III aversives" include picking food off the floor and spilling drinks.
In April, our organization filed a report with Manfred Nowak, the U.N. special rapporteur on torture, charging that the severe pain and suffering being inflicted on children violates the U.N. Convention Against Torture. Although JRC has pledged to review use of Level III aversives for "any seemingly minor behavior" cited by the Massachusetts review ("such as ignoring directions from staff, out of seat, leaving supervised area, eating food off of floor, etc."), in a lengthy reply to our report on its Web site it said: "There is no credible evidence that for these most severe forms of behavior disorders, there is any other pharmacological or psychological treatment that can treat these students as effectively as JRC's treatment." But consider Nowak's reaction to our findings:
"To be frank, I was shocked," he told ABC's "Nightline" in June, and sent "an urgent appeal to the U.S. government asking them to investigate." Asked if JRC's treatments constitute torture, Nowak responded, "Yes . . . I have no doubts about it. It is inflicted in a situation where the victim is powerless. And, I mean, a child in the restraint chair, being then subjected to electric shocks, how more powerless can you be?" Would the practices employed at JRC be allowed on a convicted terrorist? Nowak: "No, of course not."
"This is torture," he said. "Of course here they might say, But this is for a good purpose because it is for medical treatment. But even for a good purpose -- because the same is to get from a terrorist information about a future attack, is a good purpose. To get from a criminal a confession is a good purpose."
What is being justified as beneficial for children with disabilities at JRC is clearly torture, not treatment, and the Obama administration must act immediately to end these egregious abuses.
The writer is president of Disability Rights International and lead author of the report "Torture not Treatment: Electric Shock and Long-Term Restraints in the United States on Children and Adults with Disabilities at the Judge Rotenberg Center." Her e-mail address is email@example.com.
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The Washington Post
Aversive therapy cures behavior disorders and saves lives
By Matthew L. Israel
Saturday, October 9, 2010
To characterize the aversive therapy used at the Judge Rotenberg Educational Center (JRC) as torture, as Laurie Ahern of Disability Rights International did in an Oct. 2 op-ed, is like calling the work of a cancer surgeon "assault with a deadly weapon."
JRC 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 court-authorized and 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 a brief, harmless, two-second 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 seizure) 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.
-- Eliminates the need for cocktails of mind-numbing psychotropic medications, which, instead of treating behaviors, often put the user into a semicomatose 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 and 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 preapproved, 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 a procedure 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."
Ms. Ahern has never visited the Judge Rotenberg Center or spoken with any of our current clinicians, staffers and students, or those students' parents. Her opposition to the center's skin-shock aversive treatment reflects a dogmatic 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 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 visited the center and saw firsthand what it has accomplished recently wrote a textbook 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 e-mail address is M.Israel@Judgerc.org.
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MindFreedom International web info about Rotenberg: