Judge Rotenberg Educational Center

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The Judge Rotenberg Center (JRC, founded in 1971 as the Behavior Research Institute) is a residential facility in Canton, Massachusetts, that uses behavioral treatments, methodologies, and educational services to work with children and adults with severe developmental disabilities and emotional or behavioral disorders, through day, residential, and respite programs. The center applies the science and technologies of behavioral psychology to the education and treatment of severe behavior disorders, using several basic principles, including near-zero rejection and expulsion policy regardless of severity of behavior or disability, active treatment rather than warehousing, and decreased use of medications and varied rewards programs.

JRC is one of the few schools in the United States currently using aversives (unpleasant stimuli to punish behavior), and the only one using electric skin shocks as aversives, a controversial practice that has attracted considerable criticism from educators, governmental bodies, and disability rights and human rights groups. While JRC contends that electric skin shocks are used as a last resort only in cases of violent and self-injurious behavior, a 2006 report by the New York State Education Department found that the shocks were used for minor episodes of noncompliance, and that students were not provided with positive behavior supports, contrary to JRC's claims. There is limited peer-reviewed research on the effectiveness and safety of the devices that administer these shocks. In its 2006 Private Special Education School Program Review Report of Findings, the Massachusetts Department of Education found that unsigned Individualized Education Programs (IEPs) were being utilized for students at JRC, and that the school did not have a written policy indicating that it must obtain consent before revising or changing an IEP.[1]

History[edit]

The center was founded as the Behavior Research Institute in 1971 by Dr. Matthew L. Israel, a psychologist who trained with B. F. Skinner. In 1994, the center changed its name to the Judge Rotenberg Educational Center "to honor the memory of the judge [who] helped to preserve [the] program from extinction at the hands of state licensing officials in the 1980s. JRC moved from its original location near Providence, Rhode Island to its current facilities in Canton, Massachusetts in 1996. The move allowed an expansion of the numbers of individuals served, as well as a new location in one of the center's major service areas (Massachusetts).

Behavior modification[edit]

The Judge Rotenberg Center provides behavioral treatment using the methodologies of Applied Behavior Analysis (ABA). JRC's goals include a near-zero rejection/expulsion policy regardless of severity of behaviors and/or disability; active treatment with a behavioral approach directed exclusively towards normalization; frequent use of behavioral rewards and occasional use of punishments; minimal or zero use of psychotropic medications; video monitoring of staff; and the option to use aversives, including electric shocks on the skin using a device called a Graduated Electronic Decelerator (GED).[2] JRC is the only institution in the US known to use skin shocks as aversives.[3] There is limited peer-reviewed research on the effectiveness and safety of GEDs,[4][5][6] which may be banned as a result of their modification from an FDA-approved device.[7]

Use of rewards and aversives[edit]

The reinforcement, or reward system, used on a daily basis with all residents, offers them the opportunity to earn money through academic achievement, as well as earning participation in desired activities such as on-site arcades, movies, an Internet café, holiday activities, and time spent on both indoor and outdoor basketball courts and playgrounds. Residents also earn special outings with favorite staff members, and off-site field trips to local attractions such as the New England Aquarium and the Franklin Park Zoo, parks and playgrounds, museums, and other trips.

Rewards also include special take-out meals or snacks such as smoothies and lattes. The center also maintains a "contract store" where items of interest to the population, such as clothing, jewelry, and electronic devices such as MP3 players, are available for purchase with money earned as rewards for positive behavior and academic achievement.

Residents can also earn the chance to work onsite, earning money for their efforts while learning how to succeed in the outside world. They also occasionally volunteer locally or work for pay at offsite businesses.

Aversives used to modify negative and unwanted behaviors include: loss of privileges (LOP), restraint, and in some cases the GED skin shock.

The GED was invented to administer the shocks by remote control through electrodes worn against the skin.[2] The center states that the GEDs are only employed after positive behavioral intervention have not been proven to alleviate violent, self-injurious behaviors.[8][2] By contrast, a 2006 report by the New York State Education Department found that JRC's use of aversives took place without a significant positive behavioral support program, and that students were not provided positive behavioral supports.[9]:8 The report also found that the GEDs are used when there is no threat of serious physical harm or injury, including failing to follow directions, failing to be neat, slouching in a chair, "nagging", stopping work for more than 10 seconds, and other similar acts of noncompliance.[9]:13–15,19 The report claims that one student received 18 shocks in April 2005, with 8 of them (44%) having nothing to do with aggression.[9]:13–15,19

According to William Pelham, a behavioral specialist and director of the Center for Children and Families at the State University of New York at Buffalo, "[p]eople don't use... shock anymore because they don't need to. It is not the standard of care. There are alternative procedures that do not involve aversives like electric shock."[10]

Controversy and investigations[edit]

There has been considerable controversy around the use of the GEDs, including calls from some disability rights groups for legal protections against the use of aversives, including Disability Rights International,[11] the Autistic Self Advocacy Network,[12][13][14] and the Community Alliance for the Ethical Treatment of Youth.[15][16][17] Numerous advocates from the neurodiversity and self-advocacy movements, including Ari Ne'eman,[18] Shain Neumeier,[19][20] and Lydia Brown[21][22] have also repeatedly condemned the Judge Rotenberg Center's use of the GED and other forms of behavioral modification, including restraint and seclusion, in testimony to United States federal and state legislative and regulatory bodies and in public protests.

The center is one of few facilities in the United States making use of aversives, and the only using the GED,[23] in its treatment to punish undesirable behaviors. However, existing protections in place include:[24]

  • A probate court judge must pre-approve an individualized treatment plan authorizing the use of the skin shock and reviews the plan and its results yearly, on a case-by-case basis
  • Parents must give their prior informed consent
  • The use of skin shock must be included in the student's Individual Service, Education, or Habilitation Plan, and
  • A physician, clinician, human rights committee, and peer review committee must also give prior approval

Concerns about the treatment regimen prompted 2005 and 2006 investigations by the New York State Education Department. The resulting report from the final 2006 visit was highly critical of both processes and oversight at the facility.[9] The report found that shocks were used for minor episodes of noncompliance, and that students were not initially provided with positive behavior supports, contrary to JRC's claims.

At various points in its history, investigations and lawsuits have been brought against the center's operations. In December 2007, the center was found by the Massachusetts Department of Early Education and Care to have been abusive towards residents and failing to protect their health, after two residents were shocked using a GED on the behest of a former student posing as a staff member in an August 2007 telephone call. Video surveillance revealed that one resident was restrained on a 4-point board, a type of mechanical restraint that was court-approved in his treatment plan, but was not authorized by trained staff for use in that moment.[25]

In 2010, the American human rights organization Mental Disability Rights International (now Disability Rights International, DRI), filed an appeal with the office of the United Nations Special Rapporteur on Torture, stating they believed the residents were being subjected to human rights abuses due to the center's use of aversives.[11] The then-Special Rapporteur, Manfred Nowak, sent what he described as "an urgent appeal to the U.S. government asking them to investigate."[26] In 2012, a follow-up investigation was undertaken by the United Nations' Special Rapporteur on Torture, Juan E. Méndez, who stated, "It raises a very serious concern. The passage of electricity through anybody's body is clearly associated with pain and suffering. Now it depends on the level and time and whether there's any rationale for it."[27] At that time, the United States Senate's Health, Education, Labor, and Pension Committee also held a hearing on alternatives to aversive therapies.[27]

JRC replied to a news story on the contents of the DRI appeal, calling the story "nothing more than a regurgitation of the outdated, false, and unproven accusations that have been made against JRC". JRC stated that their treatments were often the last form of treatment for severely affected individuals, and that the treatments free them from "restraint, drugs, self-abuse, and all the severe pain it was causing them, through the use of safe, effective, and far less intrusive behavioral treatment". The reply also stated that the evidence cited in the [M]DRI request grossly misstated information found on JRC website, and misquoted statements made by former students to only show the interventions used while ignoring statements by students that the treatments were effective and permitted them to live better lives, and that "It would be torture to not treat these students and allow them to be chemically restrained and warehoused for the rest of their lives."[28]

In 2002, an incident occurred in which an autistic student from New York City was restrained for seven hours and shocked many times for disobeying staff members when refusing to take off his coat and hid underneath a table. The day after the incident, his mother drove him to the hospital as he could no longer speak, and had third-degree burns on many parts of his body, due to the shocks. The doctor told the boys' mother that her son was suffering from acute stress disorder, a mild form of posttraumatic stress disorder (PTSD), which was the direct result of the school's aversive treatment.

Anderson Cooper on CNN in 2011 revealed video footage of the incident and his mother—with help from a former teacher who used to work at JRC—launching a civil lawsuit against the center after noting having "signed approval for the electric shocks if it ever got to the point where they couldn't restrain him" and how the school physician took him off Risperdal, an FDA-approved antipsychotic medication for the treatment of autism spectrum disorder (ASD), twice. The first time he was taken off the medication, his mother reported him being depressed when he came home and did much better when they put him back on it. She also claimed that "there is no counseling for the [students] there... and the staff there lied to (her) all these years..."[29] A trial finally came about in this lawsuit in April 2012, with both sides claiming satisfaction with the outcome.[30]

Massachusetts state authority officials investigated the school, and all investigating parties viewed the video tapes multiple times before the originals of the surveillance tapes were destroyed by Israel, who believed that there was no further need for them. Nonetheless, the state assistant attorney general claimed that Israel had been ordered to keep them.[31]

By May 2011, Israel was charged with "child endangerment" and "obstructing justice" for misleading a grand jury over the school's destruction of those tapes, as well as being an accessory after the fact. Israel resigned his position at JRC in a deferred prosecution plea deal with the Massachusetts State Attorney General's office and moved back to Los Angeles, California to retire with his wife.[31][32] Then-assistant director Glenda Crookes has since taken over as executive director following Israel's resignation.[33]

As the result of a 2011 ruling by the Massachusetts Department of Early Education and Care, governor Deval Patrick's administration imposed regulations that only residents whose treatment plans approved the GED before that time were still permitted to receive it, but new students and residents enrolling into JRC were no longer allowed, by law, to receive the GED as part of their treatment plan.[34][35]

In April 2014, the United States Food and Drug Administration announced a public hearing where a panel of neurological devices experts would consider whether or not the FDA should issue a ban of electric shock aversive conditioning devices like the GED.[36] In response, many disability rights advocacy groups gave testimony condemning the GED and asking for a regulatory ban, while the Judge Rotenberg Center brought supportive parents and clinicians to oppose a potential ban. During the testimony, Jennifer Msumba and Ian Cook, two former residents of the Judge Rotenberg Center who had received GED shocks, testified in favor of a potential ban while Aracelis Sanchez, Brian Avery, and Marcos Pucha, three additional former residents, testified against a potential ban.[37] Autistic attorney Shain Neumeier authored comments from the Autistic Self Advocacy Network outlining a legal basis for a ban based on disability rights and human rights principles.[14]

In April 2016, the Food and Drug Administration took the further step of formally proposing a regulatory ban on electric shock aversive conditioning devices, but never finalized the ban.[38][12]

Parents' reactions[edit]

Parents of difficult and aggressive children have been both highly supportive and critical of the center's practices, even winning lawsuits against their local school districts to keep their child enrolled at JRC; the center has been both praised for the progress that residents have made,[39] while others have criticized and even sued the school based on their use of aversives.[27][35]

References[edit]

  1. ^ "Program Review Report of Findings" (PDF). Archived from the original (PDF) on 2014-08-08. Retrieved 2014-07-31.
  2. ^ a b c "Pilkington", Ed. "Shock Tactics: Treatment or Torture?". The Guardian. Retrieved December 31, 2013.
  3. ^ "FDA Reconsiders Behavior Modifying Shock Devices". Archived from the original on 2014-04-26. Retrieved 2014-04-25.
  4. ^ "Side effects of contingent shock treatment". Research in Developmental Disabilities. 29: 513–523. doi:10.1016/j.ridd.2007.08.005. Retrieved 2014-11-20.
  5. ^ Kirk A. B. Newring (2010). "On the Reemergence of Behavioral Therapies with Juveniles and in the Juvenile Justice System: Introduction to the Journal of Behavior Analysis" (PDF). Journal of Behavior Analysis of Offender and Victim Treatment and Prevention. 2 (1): 20–36. Archived from the original (PDF) on 2015-05-28. Retrieved 2014-11-20– Offender and Victim Treatment and Prevention Special Issue: Children and Adolescents.
  6. ^ Matthew L. Israel; Nathan A. Blenkush; Robert E. von Heyn; Patricia M. Rivera (2008). "Treatment of Aggression with Behavioral Programming that Includes Supplementary Contingent Skin-Shock" (PDF). Journal of Behavior Analysis of Offender and Victim Treatment and Prevention. 1 (4): 119–166. Archived from the original (PDF) on 2012-03-14. Retrieved 2014-11-20.
  7. ^ "Device that shocks disabled for bad behavior may be banned". Retrieved 2014-11-20.
  8. ^ "History of JRC". Retrieved 2014-01-13.
  9. ^ a b c d "Observations and Findings of Out-of-State Program Visitation: Judge Rotenberg Educational Center" (PDF). New York State Education Department. June 9, 2006. Archived from the original (PDF) on May 8, 2014. Retrieved May 8, 2014.
  10. ^ Kaufman, L. (December 25, 2007). "Parents Defend School's Use of Shock Therapy". The New York Times.
  11. ^ a b "Torture not Treatment: Electric Shock and Long-Term Restraint in the United States on Children and Adults with Disabilities at the Judge Rotenberg Center" (PDF). Disability Rights International. Retrieved December 31, 2013.
  12. ^ a b "#StopTheShock". Autistic Self Advocacy Network. Retrieved 2018-05-17.
  13. ^ "ASAN Comments on FDA's Proposed Ban of Electric Shock Devices". Autistic Self Advocacy Network. Retrieved 2018-05-17.
  14. ^ a b "Written Comment to the Food and Drug Administration on the Banning of Electrical Aversive Conditioning Devices". Autistic Self Advocacy Network. Retrieved 2018-05-17.
  15. ^ "Letter in support of proposed amendment in MA to prohibit use of Level III aversives". 2013-01-20. Archived from the original on 2013-01-20. Retrieved 2018-05-17.
  16. ^ "NYer's ACTION ALERT - Anti-Aversives Legislation - Judge Rotenberg Cetner". 2013-01-20. Archived from the original on 2013-01-20. Retrieved 2018-05-17.
  17. ^ Girard, Christopher. "Advocates rally for a law to ban shock treatment at Canton special-needs school". Boston.com MetroDesk blog. Retrieved January 7, 2014.
  18. ^ "ASAN Testimony to the Neurological Devices Panel of the Medical Devices Advisory Committee of the FDA". Autistic Self Advocacy Network. Retrieved 2018-05-17.
  19. ^ "Activists Tell FDA Head: Ban Electric Shocks on People With Autism". Rewire.News. Retrieved 2018-05-17.
  20. ^ "Past time to ban skin shocks to disabled: Column". USA Today. Retrieved 2018-05-17.
  21. ^ Brown, Lydia (2014-07-22). "Perspective | It's illegal to torture prisoners and animals, but not disabled people". The Washington Post. Retrieved 2018-05-17.
  22. ^ Heather Adams (July 22, 2016). "Advocates hope FDA will ban electric shock devices used at Judge Rotenberg Center in Canton". masslive.com. Retrieved 2018-05-17.
  23. ^ Cortez, Michelle Fay. "Devices to Shock Disabled for Bad Behavior May Be Banned in U.S." Business Week. Retrieved April 22, 2014.
  24. ^ "FDA Warning Letter, 2012". FDA. Retrieved April 25, 2014.
  25. ^ "School Keeps License to Give Shock Therapy Despite Prank". The Washington Post. Associated Press. Retrieved January 1, 2014.
  26. ^ Hinman, Katie. "UN Calls Shock Treatment at Mass. School 'Torture'". ABC News. Retrieved December 30, 2013.
  27. ^ a b c Beaudet, Mike. "U.N. investigating Judge Rotenberg Center's use of shocks". Fox News. Archived from the original on October 17, 2013. Retrieved December 31, 2013.
  28. ^ "JRC Response Tim Minton's Story on WNBCTV on the MDRA Appeal" (PDF). Judge Rotenberg Center. Retrieved January 21, 2014.
  29. ^ Anderson, Karen. "Mother Sues Judge Rotenberg Center Over "Torture" Of Disabled Son". CBS Boston/WBZ-TV. Retrieved December 31, 2013.
  30. ^ Hanson, Fred. "Both sides satisfied with outcome of skin-shock therapy case". The Patriot Ledger. Retrieved December 31, 2013.
  31. ^ a b Wen, Patricia. "Head of Rotenberg Center agrees to leave post in deal with prosecutors". The Boston Globe. Archived from the original on February 23, 2014. Retrieved April 19, 2014.
  32. ^ Toness, Bianca. "Founder Forced to Leave Controversial Special Needs School". WBUR. Retrieved December 31, 2013.
  33. ^ Contreras, Russell. "Charges settled in prank-call shock therapy case". The Boston Globe. Retrieved January 2, 2014.
  34. ^ "School Questions Plan to Ban Shock Therapy". CBS Boston/WBZ. Associated Press. Retrieved January 3, 2014.
  35. ^ a b Wen, Patricia. "Center hasn't challenged aversion therapy rules". The Boston Globe. Retrieved January 3, 2014.
  36. ^ "FDA considers ban on electric shock conditioning for autistic patients". the Guardian. Associated Press. September 15, 2014. Retrieved 2018-05-17.
  37. ^ "Transcript of Neurological Devices Panel, Medical Devices Advisory Committee Public Hearing" (PDF). U.S. Food and Drug Administration. April 24, 2014 – via Lydia X. Z. Brown Laboring For Disability Justice and Liberation.
  38. ^ "Press Announcements - FDA proposes ban on electrical stimulation devices intended to treat self-injurious or aggressive behavior". FDA. Retrieved 2018-05-17.
  39. ^ "The FDA may ban the treatment keeping our daughter alive". The Washington Post. Retrieved August 12, 2014.

Further reading[edit]

External links[edit]

Coordinates: 42°10′38.41″N 71°06′42.94″W / 42.1773361°N 71.1119278°W / 42.1773361; -71.1119278