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School of Shock : Rotenberg Center Director Matthew Israel Responds

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EDITORS' RESPONSE TO MATTHEW ISRAEL REGARDING "SCHOOL OF SHOCK"

THE USE OF SKIN SHOCK

In support of JRC's use of skin shock, Israel and his defenders stress the violent and self-abusive behavior of some students, and argue that those students have not benefited from other forms of treatment. Israel writes: "It is well documented in scientific articles and in court findings that some special needs children and adolescents have behaviors that are so self-abusive, aggressive or destructive as to be life-threatening and self-maiming."

The facts:

The use of skin shock is not restricted to such "low functioning" students. A report of an investigation by the New York State Education Department states, "JRC employs a general use of Level III aversive behavioral interventions [which include skin shock] to students with a broad range of disabilities, many without a clear history of self-injurious behaviors. JRC employs a general use of Level III aversive behavioral interventions to students for behaviors that are not aggressive, health dangerous or destructive."

THE DEATH OF A STUDENT

Israel writes:

"Ms. Gonnerman discusses California student Danny Aswad's death as though it had something to do with JRC or me. It did not. JRC had ceased its operations in California a year or two prior to his death which was from natural causes."

The facts:

According to the 1982 complaint filed by the State of California, this student was in the care of the Behavior Research Institute at the time of his death. The complaint states that the student died while in restraints that kept him flat on his stomach in bed, and had been restrained on numerous occasions over the preceding seven months, despite the fact that such restraint was "contraindicated" because he suffered from a circulatory disorder. Dr. Israel helped found the Behavior Research Institute in California, which was a branch of the entity by the same name that he founded in Rhode Island (later renamed as JRC). Dr. Israel was a consultant to the Behavior Research Institute at or at least shortly before the time the student died. Dr. Israel has previously defended the Behavior Research Institute, saying that the death was not the result of treatment.

DR. IWATA'S VISIT

Israel writes:

"Her statement that Dr. Iwata has visited the Rotenberg Center is false."

The facts:

Dr. Iwata visited the Rotenberg Center to review its practices at the request of Massachusetts officials. A copy of the report he wrote in 1995 was obtained by Mother Jones. At the time, the Rotenberg Center was still located in Rhode Island, but it already employed the skin shock aversive treatment that it still uses today.

SOCIALIZING AND ISOLATION

Israel writes:

"Ms. Gonnerman incorrectly states that the only time that JRC students can socialize freely is in the Big Reward Store. This is not true. There are many other places where students can socialize with each other such as on the playground, on field trips, at their residences, etc."

The facts:

In an interview with Jennifer Gonnerman, Dr. Israel stated, "We need to marshal every possible reward you can find to reward desired behavior. So even opportunities for some of the high functioning students to socialize with other students or staff, instead of those being routinely provided, those actually have to be earned. Everything you want has to be earned." The report by the New York State Education Department states, "During five observations involving a total of 59 students, there were no instances of students socializing with other students and only five instances observed of students socializing with staff. Social interactions between students reportedly occur in the Big Reward Store where students go to select a reward for keeping contracts. When questioned about friendships and social interactions among students, the students interviewed stated that they were unable to socialize in a natural way."

Israel writes:

"The title page contains the word 'Isolation.' Isolation is never used as a punishment at JRC."

The facts:

Again, Dr. Israel himself has confirmed that some students must earn the opportunity to socialize with other students or staff. A report of an investigation by the New York State Education Department says that students may be restrained on four-point restraint boards or in chairs "for extensive periods of time (e.g. hours or intermittently for days)." Students are sometimes confined to "conference rooms," which in some cases isolate them from everyone except a single staff member.

FOOD DEPRIVATION

Israel writes:

"The title page contains the phrase 'Food Deprivation.' Food deprivation is never used as a punishment at JRC."

The facts:

According to JRC, about 10 percent of the students are in a "Contingent Food Program" or a "Specialized Food Program." These programs require students to meet behavioral requirements in order to earn food. The New York State Education Department report says that students must "earn" meals by not displaying certain behaviors, and that if they do not they are "made to throw a predetermined caloric portion of their food into the garbage."

Students in the Contingent Food Program are given "make-up meals" at the end of each day, but according to JRC "make-up food is deliberately intended to be an unattractive option." Students in the Specialized Food Program do not receive "make-up food" unless they have eaten less than 26 percent of their normal daily caloric target. These programs are part of the court-approved treatment plans for the students, and students' weight is monitored. The program is altered or suspended if the student drops below a certain weight.

According to the New York State Education Department report, "The Contingent Food Program and Specialized Food Program may impose unnecessary risks affecting the normal growth and development and overall nutritional/health status of students subjected to this aversive behavior intervention."

USE OF OTHER THERAPIES BEFORE SHOCK TREATMENT

Israel writes:

"Before JRC uses aversives with any student, positive and educative procedures are tried for an average of 11 months to try to change serious problematic behaviors."

The facts:

The article does not assert that other treatments are not tried before aversives are used. However, according to the New York State Education Department report, "JRC may decide prior to a student's acceptance into the program that he/she requires aversive procedures based on historical and current behavioral information provided by parents, the CSE and other records/reports." In addition, in some cases, "the use of aversive procedures may be a condition of the student's acceptance and continued enrollment in the program." Letters from parents of students at JRC appear to support these findings.

SAFEGUARDS

Israel writes:

"There are many safeguards at JRC to make sure that the skin-shock procedure is used carefully, professionally and properly. They include prior parental consent, prior individualized court authorization (the judge appoints an attorney to represent the child's interests in this process), prior approval by a Human Rights Committee and a Peer Review Committee, clearance from a physician and a psychiatrist to insure that there are no medical contraindications, etc."

The facts:

The article discusses parental and court consent, and expressly reports that court approval is required in all cases. (Attorneys who have represented students in approval proceedings have told Mother Jones that court approval is routinely granted, sometimes over their objections.) The article doesn't suggest that other safeguards are not also employed in deciding to use or in monitoring the use of skin shock treatment. However, some of the procedures are apparently required as the result of JRC's settlement with the State of Massachusetts, and according to the New York State Education Department report, "the integrity of the behavioral programming at JRC is not sufficiently monitored by appropriate professionals at the school and in many cases the background and preparation of staff is not sufficient to oversee the intensive treatment of children with challenging emotional and behavioral problems."

FADING OUT SKIN SHOCK TREATMENT

Israel writes:

"As time goes on, many [students] are able to graduate completely from needing this [skin shock] therapy."

The facts:

Data provided by Israel indicates that 43% of school-age students are receiving skin shocks, while only 3% percent have "graduated" or been "faded off" the shock devices. Among adult residents, 85% are attached to the shock device, while only 6% have been "faded off." According to the New York State Education Department report, "JRC's policy states, 'GED fading will not occur until the student has gone a minimum of one year with no major behaviors.'...The criterion of one year without a 'major disruptive behavior' is extremely long and is not determined based on the circumstances for each individual student...Many NYS students remain on the GED for the entire time they attend the center."

Monika Bauerlein and Clara Jeffery


 

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I think 'modern psychiatry' is an evolving field that's been developed to try to basically medicate the human condition into submission and social conformity. I think, if your kid needs electro-shock therapy, get him/her a job apprenticing as an auto mechanic. The first time they touch that hot ignition coil, well, there ya go, and you didn't even have to sign one of your kidneys over to an HMO! LOL DEVO said it, years ago, 'someday we'll only be able to sit in our dens, and slip in our cassettes'. You can dole out the happy pills all you want, but living in a giant diesel-powered Habitrail basically sucks. That's not mental illness, that's 'progress' on the march, there.... Don't feed your kids drugs and pills, get them involved in a hobby, job skill, explore Patagonia, something they can DO. We're doers, not sitters, sit around long enough, and you'll get sick, both mentally, and physically. Don't dope the kids, get em out the door and get em busy, get em involved in something...tell the quacks to get day-jobs...
Posted by:BertOctober 6, 2007 9:50:14 AMRespond ^
Dr. Israel is right about the importance of limiting discussion to the benefits and risks of treatment. But in my opinion, research establishing any possible benefits or risks of "skin shock" doesn't exist. The JRC website refers parents to so-called "research," apparently meant to impress those not familiar with what good research entails by the massive size of JRC's "data." But a vital part of real research is passing through the peer review process, with publication in a professional journal. Not bothering with this step is a huge red flag that something is amiss. The value of good research is so we don't rely on our personal impressions of what work or not. Frankly, all people are to some degree prone to fool themselves. This may be particularly true of parents who want desperately to believe they are making the best decisions for their children and look hard for signs of improvement that may not be there -- or may be explained by other factors, such as children simply getting older. What we do know is that there is good and convincing research for the value of positive reinforcements in dealing with difficult behaviors. At best, skin shock can only be considered an experimental treatment. (I suspect, however, that no human subject review board would ever allow actual experimentation with skin shock on children or adults.) But as experimental, JRC is essentially using children as guinea pigs and violating research ethics by charging for "treatment". People with wild hair theories -- and adherents who swear by them -- will always be among us. What is truly disturbing is that legislators and state authorities haven't put an end to this torture of helpless children long ago.
Posted by:ReaderOctober 6, 2007 10:25:31 AMRespond ^
It is hard to put into words the atrocities that take place at the Judge Rotenberg Center. Everything is treated as a "behavior", shocks are the answer for everything. So, it doesn't matter if a behavior is symptomatic of a disorder, or developmentally appropriate, children are shocked nonetheless. Children with the developmental age of a toddler are shocked for soiling themselves. Ironically, this is called "having an inappropriate". Aphasic children are shocked for having the symptom of repeating themselves, a common aphasic tendency. Dr. Israel convinces people that this is a sign of aggression, and labels it as "nagging". He absolutely treats these children like guinea pigs, and seems to perceive himself as above the laws of basic human decency. One girl was shocked for the so-called behavior of calling staff "Mommy". He claims the use of shock is limited to severe aggression, and that is a lie. You shock children for, say, "having an untidy appearance" and expect people to believe you are reserving this treatment for self-abusive or violent behavior. It's a blatant lie. I hope people can see through the lies, and do what needs to be done to stop this sick man.
Posted by:SarahOctober 6, 2007 4:08:41 PMRespond ^
I took Psychology classes in college. The professor lectured on theories like Positive Reinforcements. Punishments were not used. Pain was not used. The cause and effect were written in textbooks for positive reinforcements vs pain stimulants. Have the proven theories changed to punishment and pain in the medical field? Is this torture? What is the child learning. Will he go to Harvard? Is this torture?
Posted by:Sheryl SkoglundOctober 7, 2007 9:00:57 AMRespond ^
Withhold breakfast and then have their teachers zap them when their blood sugar gets low. Make the teachers so scared to stand up for a student that they will zap any student without question when some anonymous voice on the phone direct directs them to do so. Take high functionling children who are given the choice of jail or aversive treatments at JRC. How is this constitutional? Avoid all peer review. Why does it continue? Lobbying. How will it be stopped? Lobbying. Why is this in MJ rather than being dealt with by the APA? If you know a phycologist, suggest they get their professional societies get involved.
Posted by:JackieOctober 8, 2007 10:37:32 AMRespond ^
RE: MATTHEW ISRAEL RESPONSE In your response to Ms. Gonnerman's "School of Shock" article you mention that Christian Scientists view medical procedures as wrong with a capital "W." Actually, Christian Scientists have the option to choose whatever healthcare system they feel will best meet their needs. It's more a matter of opting for a system they've found practical and reliable--Christian Science--than taking a stance against another form of treatment. And of course Christian Scientists, like others in the healing profession, want to choose the option that is most effective and comfortable for the patient and causes the least amount of suffering. I've found this method to be Christian Science. Russ Gerber Committee on Publication Media Manager First Church of Christ, Scientist Boston, Massachusetts 02115
Posted by:Russ GerberOctober 9, 2007 8:57:59 AMRespond ^
I agree with Dr Israel and what he does for the few children with such a severe form of autism. JRC is not for all children with this affliction, only the ones who have tried all other treatment options with no success. What they do at JRC helps greatly improve the quality of life for those who need it. For those who say it must be bad because it's the only school in the country to use G.E.D therapy is not looking at the whole picture. Would you rather the number of children with this severe form of autism increase to support 2, 3 or 100 schools like JRC, then it would be acceptable treatment? I’m thankful we only need one school like JRC at this time.
Posted by:Brian DavisOctober 9, 2007 9:22:34 PMRespond ^
RESPONSE TO THE MOTHER JONES EDITORS…………………………………………………………… ……………………………………………………………………………… ……………………………………………………………………………………. [This is Part 1 of a 2-part document. For part 2, see the following post. For a properly formatted version of the entire document, please see http://www.judgerc.org/ResponsetoMJEditorsReply.pdf ] …………………………………………………………………………………………… ……………………………………………………………………………………………………………………………………. Mother Jones editors Monika Bauerlein and Clara Jeffery, in their reply to my response to Jennifer Gonnerman’s “School of Shock” article, rely primarily on a report issued by the New York State Department of Education (“NYSED”) on June 9, 2006 as to what is true about the Judge Rotenberg Center (“JRC”). Unfortunately they have placed their reliance on a faulty report that is filled with inaccuracies and that was commissioned by the New York State Education Department in a hasty effort to justify NYSED’s (so far) failed attempt to get the New York Board of Regents to remove JRC from its list of approved schools and to ban, immediately and completely, the use of aversives with New York students. This attempt was frustrated due largely to the persuasive letters from JRC’s parents (see http://www.judgerc.org/parentletters.html.) ……………………………………………………………………………… ……………………………………………………………………………… ………………………………………………………………….MOTHER JONES’RELIANCE ON A BIASED AND INACCURATE JUNE 9, 2006 NYSED REPORT …………………………………………………………………………………………… ……………………………………………………………………………………………………………………………………. In September of 2005, members of NYSED’s own education staff visited JRC as part of their normal periodic review process and wrote a very positive and favorable review of JRC (see http://www.judgerc.org/NYSEDNov05report.pdf) that was issued in November 2005. The visiting team concluded in that report that JRC was doing an excellent job treating and educating New York students. …………………………………………………………………………………………… …………………………………………………………………………………………………………………………………….On March 20, 2006, however, NYSED urged the Board of Regents to reverse its 30-years of approval and use of JRC and to take an anti-aversive position, apparently as a panic reaction to negative media attention about one frivolous claim by a former New York parent. At that point, NYSED’s own November 2005 report proved to be a significant embarrassment. …………………………………………………………………………………………… …………………………………………………………………………………………………………………………………….In order to generate a result that would be different from the November, 2005 review, NYSED conducted two new special visits to JRC, in April and May 2006 that were not part of their normal review process. This time NYSED invited, as key members of the new review team, three outside psychologist consultants. Unfortunately for JRC, they were also individuals who had already taken a strong philosophically-based stand against the use of aversives, who had never themselves used aversives, and who, when they visited JRC, refused to receive an explanatory tour of the program or even discuss any of their major concerns with JRC’s clinical staff. This new review team visited JRC for parts of only five days. The three psychologist members visited for only 1 ½ days (two of them) or 2 ½ days (the third); however, they claimed to be informed and qualified to make conclusions about the quality and efficiency of the treatment plans and IEPs of over 140 New York students who suffered from the severest forms of behavior disorders in New York State. JRC complained to NYSED at the time of the visit that the team was obviously biased (see http://www.judgerc.org/LettertoMills51906.pdf ), but to no avail. …………………………………………………………………………………………… …………………………………………………………………………………………………………………………………….JRC has discussed the bias of the June 9, 2006 NYSED Report in detail and has responded to every single inaccuracy at http://www.judgerc.org/ReplytoJuneReport.pdf. We provided Ms. Gonnerman with a copy of that response but it is not clear whether she read it before writing her article. We also pointed out to her that three Massachusetts agencies, who visited JRC to investigate the charges in the June 9, 2006 NYSED Report, failed to confirm any of the major charges (see http://www.judgerc.org/ThreeAgencies.pdf.) …………………………………………………………………………………………… …………………………………………………………………………………………………………………………………….In hiring a biased, anti-aversive group of consultants to do its June 9, 2006 report, NYSED made the same mistake that two previous state agencies (Massachusetts Office for Children in 1986 and Massachusetts Department of Mental Retardation in 1993) had made. In both cases, this biased selection process came out during a trial. In both cases the judge found that the agency had acted in bad faith in commissioning the review by a consultant group whose members had an anti-aversives bias and whose bias was known to the agency when they were selected. In both cases the judge ruled in favor of the JRC parents who were seeking to preserve the availability of JRC’s treatment for their children. NYSED’s June 12, 2006 report is currently being challenged, in part for these same reasons, in a federal lawsuit that the current JRC parents have brought against NYSED. …………………………………………………………………………………………… …………………………………………………………………………………………………………………………………….USE OF REWARDS/SKIN SHOCK THERAPY FOR OTHER THAN SELF-ABUSIVE BEHAVIORS …………………………………………………………………………………………… …………………………………………………………………………………………………………………………………….Ms. Bauerline and Jeffery (“the editors”) state that “the use of skin shock is not restricted to such ‘low functioning’ students. Nowhere in my reply did I claim that it is so restricted at JRC. I stated that higher functioning former as well as current students are often eloquent in crediting reward/skin shock treatment with their (sometimes life-saving) recovery and that its use with these students is parallel to the fact that normal adults can request aversive therapy to treat problems such as excessive smoking, gambling and eating. …………………………………………………………………………………………… …………………………………………………………………………………………………………………………………….The editors quote from the NYSED Report to accuse JRC of treating behaviors that are not overtly aggressive, self-abusive or destructive. I answered this in my response where I pointed out that it is often important to treat the earliest forms, the partially-treated altered forms, and the antecedents of problem behaviors, even if those behaviors might seem, when viewed by themselves and out of their total treatment context, to be harmless. Certain behavior problems, if not treated aggressively at their earliest possible stage, can grow quickly into severely problematic forms. A similar approach is taken in the treatment of diseases such as cancer where it is recognized that treatment should be applied at the earliest possible stage. …………………………………………………………………………………………… …………………………………………………………………………………………………………………………………….THE DEATH, FROM NATURAL CAUSES, OF A STUDENT NOT IN JRC’S CARE. …………………………………………………………………………………………… …………………………………………………………………………………………………………………………………….The student in question, at the time of his death, was in the care of Behavior Research Institute of California, and not in the care of Behavior Research Institute, the forerunner of JRC. Behavior Research Institute of California was never a branch of JRC and never had any formal connection with JRC. Furthermore, an inquest jury found that the student died from natural causes that had nothing to do with aversives or with his treatment. …………………………………………………………………………………………… ……………………………………………………………………………………………………………………………………. DR. IWATA’S HOSTILE VISIT TO JRC 12 YEARS AGO. …………………………………………………………………………………………… ……………………………………………………………………………………………………………………………………. In 1995 Dr. Iwata visited JRC briefly when he was hired as a consultant by the Massachusetts Department of Mental Retardation as part of that Department’s effort to close JRC –an effort that ultimately failed. When I wrote the first draft of my reply, I had forgotten that visit which took place when I was not present at JRC. The version of my reply that currently appears on the JRC website (see http://www.judgerc.org/ResponsetoGonnermanArticle.pdf.) acknowledges his visit and has done so since September 11.……………………………………………………………………… ……………………………………………………………………………… ………………………………………………………………………….INACCURATE REPORTING OF JRC’S POLICY ON STUDENT SOCIALIZING, AND MISCHARACTERIZING A PROCEDURE AS “ISOLATION.” …………………………………………………………………………………………… …………………………………………………………………………………………………………………………………….The editors quote me as saying that opportunities to socialize at JRC for some students must be earned. They also note that in my reply I stated that there were many opportunities for students to socialize other than when they are in the Big Reward Store. The editors’ implication is that these two statements are in conflict. They are not. It is true that many students must earn access to field trips, visits to the Big Reward Store, participation in the weekly barbecue, visits to the Contract Store, opportunities to enjoy the playground, and other opportunities for free and leisure time activities. Once they have earned access to these opportunities, however, they are free to socialize normally while they are enjoying the activity. …………………………………………………………………………………………… ……………………………………………………………………………………………………………………………………. (continued on next post)
Posted by:Matthew L. IsraelOctober 12, 2007 8:48:42 AMRespond ^
RESPONSE TO THE MOTHER JONES EDITORS…………………………………………………………… ……………………………………………………………………………… ……………………………………………………………………………………. [This is Part 2 of a 2-part document. For part 1, see the following post. For a properly formatted version of the entire document, please see http://www.judgerc.org/ResponsetoMJEditorsReply.pdf ] ……………………………………………………………………………… ……………………………………………………………………………… ………………………………………………………………….(Continued from previous post) The authors of the New York Report asserted that they did not see a lot of students socializing. This is largely because they chose to observe the students in the classroom setting where they are expected to study rather than socialize. Had they observed the students on field trips, in the residences, on the playground, etc., they would have had a very different report. The authors of the New York Report were consultants with an anti-aversive philosophy who were sent to do a negative report of JRC. It is not surprising, therefore, that they tried to characterize the fact that students were busily engaged in their academic work in a negative way—i.e., that they were not socializing sufficiently. …………………………………………………………………………………………… …………………………………………………………………………………………………………………………………….The editors try to justify their sensationalized use of the term “isolation” on the front page of Mother Jones in two ways. First, they quote me as stating that JRC students must earn the opportunity to socialize. But earning the opportunity to socialize clearly does not mean that one is in isolation at other times, prior to earning that opportunity. Students who have not earned such opportunities may simply be in their classroom or residence with ten other students. Second, the editors correctly note that disruptive students are sometime shifted to conference rooms where they do their work with a staff member present in the room. But if a staff member or teacher is present in a conference room, supervising the student as he/she does assigned academic work, in what sense can this properly be called “isolation?” …………………………………………………………………………………………… ……………………………………………………………………………………………………………………………………. USE OF MINI-MEALS TO TEACH NEW SKILLS …………………………………………………………………………………………… …………………………………………………………………………………………………………………………………….The use of mini-meals to reward desired behaviors is a well-accepted procedure in applied behavior analysis. For example in teaching new skills to an autistic child, it is desirable to be able to reward the student for imitating speech sounds or displaying other skills with a small portion of food. In order for these food portions to be effective as rewards it is important that the student not be satiated with food when this teaching is conducted. …………………………………………………………………………………………… …………………………………………………………………………………………………………………………………….In order for JRC to be able to use mini-meal rewards in this way or as rewards for behavioral contracts in which student refrains from problem behaviors for a pre-set period of time, JRC must obtain approval from a Probate Court for this aspect of the treatment program. Numerous safeguard measures are taken to make sure that the student enjoys good nutrition and maintains good health and weight when such procedures are used. To characterize this court-authorized use of mini-meal rewards as “food deprivation” is to sensationalize and falsely portray this procedure as an extreme disciplinary punishment rather than as the carefully monitored and medically supervised motivating program that it really is. …………………………………………………………………………………………… …………………………………………………………………………………………………………………………………….USE OF OTHER THERAPIES BEFORE ADDING SKIN-SHOCK TO A STUDENT’S POSITIVE-ONLY PROGRAM. …………………………………………………………………………………………… …………………………………………………………………………………………………………………………………….The editors quote me correctly as stating that the average student, with whom skin shock is employed at JRC, is first tried on a program that consists only of positive rewards and educational procedures for an average of eleven months before JRC considers adding skin shock to the student’s program. The editors then note, again correctly, that JRC might sometime decide, based on the severity of a prospective student’s problems, that it is very likely that JRC will need to employ supplementary aversives shortly after the student arrives. These two statements are not in conflict. In some cases, it might be two or three years before the need to supplement with aversives is recognized. In other cases we might recognize the need much more quickly. The average amount of time before aversives are supplemented is eleven months. In either case—whether JRC’s clinicians recognize the need shortly after admission or only after several years of trying positive-only procedures—JRC must obtain permission from the parent (who can withdraw permission at any time), a probate court, a physician, a psychiatrist, a Human Rights Committee and a Peer Review Committee before aversives can be employed. ……………………………………………………………………………… ……………………………………………………………………………… ………………………………………………………………….SAFEGUARDS …………………………………………………………………………………………… …………………………………………………………………………………………………………………………………….The editors denigrate the safeguards that JRC has put in place by asserting that they “are apparently required as the result of JRC’s settlement with the State of Massachusetts.” The Settlement Agreement we entered with Massachusetts requires us to go to court for the use of any aversives. It does not require the pre-approval by a physician, psychiatrist, Human Rights Committee, Peer Review Committee, and parent. And even if it did, isn’t the important thing that the safeguards are in place and working rather than that they might be required by regulation or court settlement? ……………………………………………………………………………… ……………………………………………………………………………… ………………………………………………………………….Regarding the statement from the NYSED Report questioning JRC’s level of professional monitoring, the statement quoted was made without factual basis. JRC employs fourteen Doctoral and Masters level clinicians, (in addition to myself,) each of whom oversees the treatment of the 5-20 students in their case load. Each has been trained in behavioral psychology, some are licensed psychologists and many are Board Certified Behavior Analysts. ……………………………………………………………………………… ……………………………………………………………………………… ………………………………………………………………….FADING OUT REWARDS/SKIN-SHOCK TREATMENT …………………………………………………………………………………………… …………………………………………………………………………………………………………………………………….The editors quote correct statistics of students currently at JRC; however, they neglect to inform the reader that most of the students who have progressed to the point where they no longer need skin shock have also graduated from JRC and therefore are not included in the statistics that they cite. This criticism is like criticizing a hospital because it does not have many patients who no longer need to be in the hospital. Those whom the hospital served successfully have already left the hospital. Those who are still in the hospital are obviously still there because they continue to need its services. JRC is essentially a behavior hospital. …………………………………………………………………………………………… …………………………………………………………………………………………………………………………………….As for the fact that some students do need the continued availability of skin shock on a more than temporary basis, this is just an unfortunate fact of life. Some impairments require a “prosthetic” type of treatment that may be needed on a long-term basis. This is true, for example, for persons who have require an artificial limb, need eyeglasses to correct their vision, need a hearing aid, need insulin for diabetes treatment or require the long-term use of psychiatric medication. ……………………………………………………………………………… ……………………………………………………………………………… ………………………………………………………………….OMITTED PORTION OF MY RESPONSE TO “SCHOOL OF SHOCK.” …………………………………………………………………………………………… …………………………………………………………………………………………………………………………………….In publishing, online, my reply to the School of Shock article, the editors omitted the following email which appeared at the very end of my reply: …………………………………………………………………………………………… ……………………………………………………………………………………………………………………………………. -----Original Message----- From: website@judgerc.org [mailto:website@judgerc.org] Sent: Thursday, September 27, 2007 3:53 PM……………………………………………………………………………………… …………………………………………………………………………………………………………………………………………. To: Burt, Sarah………………………………………………………………… ……………………………………………………………………………… ………………………………………………………………………………. Subject: Comments Submitted by Prefer to be Anonymous……………………………………………………… ……………………………………………………………………………… ………………………………………………………………………………………….Comments: ……………………………………………………………………………… ……………………………………………………………………………… ………………………………………………………………….Dear Judge Rotenberg Center, …………………………………………………………………………………………… …………………………………………………………………………………………………………………………………….I am glad that you exist. I became aware of your organization from an article critical of your organization forwarded to me by my son. The author's intent in this "Mother Jones" article was quite clear but I'm afraid it had the opposite effect; I'm a parent of an autistic child and I know things about children like these that most people just don't understand. ……………………………………………………………………………… ……………………………………………………………………………… ………………………………………………………………….Please let Dr. Israel know that even if his work isn't understood and appreciated by everyone, those of us who have been there understand. Submitted by: Prefer to be Anonymous Title: Agency: N/A Interested in: Learned of JRC from: News article Address: PO Box 0 City: Wichita State: KS Zip Code: 67202
Posted by:Matthew L. IsraelOctober 12, 2007 8:50:04 AMRespond ^
Geez, people also used to believe throwing disabled and disturbed people into a snake pit was effective treatment. How far have we NOT come from those days? / Unfortunately for children today, politicians and officials are prone to kowtow to small groups of vocal parents who are utterly devoted to useless and even dangerous practices. / "Skin Shock" would, in my opinion, constitute a violation of the United Nations Convention on Torture. Might that give another country good reason to invade the USA? Alas, I can imagine that many of the children -- those receiving electric shocks and being abused nutritionally -- hope everyday for someone to save them.
Posted by:Linda Rosa, RNOctober 12, 2007 11:25:38 AMRespond ^
On Tuesday of this week I submitted by email my responses to the Editors' Reply to my original response to the "School of Shock" article. I asked the editors to publish these further responses in this online version of Mother Jones, in the spirit of giving both sides of the issues and of not engaging in censorship. As of this morning, three days letter, the editors had chosen not to honor my request. For that reason I have posted my responses in this Comment section (See the two long posts from me just preceding the post before this one.)
Posted by:Matthew L. IsraelOctober 12, 2007 3:31:57 PMRespond ^
Dr Israel, of course the editors won’t comply sensationalism sells papers not logic.
Posted by:Brian D.October 18, 2007 11:58:32 PMRespond ^
I have identical twin brothers with severe life-threatening behaviors extreme and rare even for persons on the autism spectrum. I have been practicing psychiatry over ten years and I specialize in persons on the autism spectrum. Yet, I have only seen a handful of cases which can be classified as severe as my brothers. My daughter is also autistic. She is five, nonverbal but I am thankful she does not have the behaviors which my brothers exhibited, although I am in tremendous debt paying $90,000 for one year tuition for her school, plus speech, occupational and physical therapy. For her first month of school I had to drive her every morning and start my job at 11 AM, leave at 7:30 PM, get home at 9PM and do the same the next day. Thank goodness my extended family has been supportive. Her school does not employ the use of aversives and she does not need it. I did try to get her into a public school which was appropriate for her, but they only accepted seven children from all of New York City last year and my daughter ended up on the lottery wait list. When I attended the lottery there were many parents in tears. If NYSED (New York State Education Department) truly cared about these children there would be an appropriate placement for each and every child. Public school programs here many times are not providing the services which are in the child's federally mandated Individual Education Plan. New York City public school autism programs are also using methods with no scientific evidence such as the Miller method and the Option method when there are methods with scientific evidence. Using an invalidated method when there are validated methods to treat a condition is unethical. I do not understand how people can take NYSED reports seriously when many of their own public schools are not in order. Regarding my brothers, one twin has lived at JRC for almost twenty years. Before arriving there he banged his head so severely he had to have surgery to close it. He would bang his head suddenly, even during the night without a clear reason. He was in a hospital for over five months, and my parents were told his insurance was running out and they would have to flip the bill. He had no education in the hospital because he attacked the teacher. He also became very sick from the medications used to try to control his behavior. He had obesity, drooling, sedation and tardive dyskinesia. At one point he could have died from neuroleptic malignant syndrome from his haldol. The medications did not control his behavior. In the hospital he had one to one at all hours and he still needed repeat suturing for repeated head banging. The board of education requested my parents waive my brother's right to an education. They said there was no place which would take him. My mother found out through her internist about the Judge Rotenberg Center. We got him transferred within a few days of the insurance running out. He was taken off all his medications there although he still has permanent tardive dyskinesia. He is happy there and states he wants to "stay at JRC forever." He enjoys the reward store and going on trips such as the zoo, museums and special olympics. I am calm to put him in the back seat of my car with my small children and take him out. (Prior to arrival at JRC he would attack my mother while driving). He does receive skin shock on average once to twice a month. At times he will actually ask to wear the device because he knows it gives him boundaries. Most of all, head banging is a thing of the past. I will now discuss my other twin brother. He once did very well. He had full time job for two and a half years and traveled independently. He moved into a group home during this time. One day another worker was teasing him and repeatedly was telling him he had to work until 5 PM when my brother knew that he leaves at 4 PM. This was a fixed routine for him. My brother became so agitated he grabbed the other worker's butcher knife. I understand that my brother had to be fired. Since then, he has gone down hill completely. He started to develop a compulsion regarding fires and tried to place himself and someone else on fire. He has run into traffic. He also was aggressive, tried to punch and choke others for a minor problem, i.e. a staple being out of place on a chair. He was placed on about fifteen different psychotropic medications in various combinations. He developed obesity, sedation, hypotension, tardive dyskinesia and generalized seizures, once on a subway platform during a snowstorm. The medication has not been helping his symptoms. He has been hospitalized since July. His group home understandably is unwilling to take him back and as New York does not want to fund Judge Rotenberg Center for him (and he cannot live with his closest relative) he has nowhere to go. I think even the Judge Rotenberg Center positive behavior program may be sufficient for him as there is consistency there. He did well in his day school when he was younger. Unfortunately in New York State the agencies funded to treat persons over the age of 21 do not have direct care staff appropriately trained in the principles of applied behavior analysis and consistency of a behavior plan is a problem in the agencies. My brother never required medication when he was in his structured and consistent day school program before he was 21 or when he had his job. My parents tried different approaches to my brothers, even took them to a doctor in Europe for a treatment. My grandfather spent about half his life savings to finance the trip. There is no medication which has shown to be 100% effective to control behavior like my brothers have. Positive behavior interventions are not sufficiently effective in all cases to suppress problem behaviors and there is a meta-analysis in 1999 that clearly shows this. As far as other methods proposed such as TEACCH and sensory integration, I think they can be helpful for some symptoms but they have never been shown to sufficiently treat the types of behaviors my brothers' have. In fact a small study on sensory integration resulted in an 11% decrease in the frequency of self-stimulatory behaviors. This does not cut it for a life threatening condition. However, there have been 111 peer reviewed articles on behavioral skin shock. I received the New York Medical College Award for Academic Excellence for my research on medication and behavioral skin shock to control life-threatening behaviors in persons with mental retardation or autism. Medication can sometimes be helpful but results are mild to moderate to decrease frequency of behavior. Behavioral skin shock gets on average an almost 100% decrease in frequency of behavior in subjects. My brother would be dead without this therapy and my other brother is dying. To have a family member with special needs is stress enough. To be in financial debt is more stress and to have to deal with life threatening behaviors is even more stressful. I find the criticism directed toward the Judge Rotenberg Center to be further stressful. I feel my family is being judged and marginalized after all we have already been through. I would also like to state that the reporter Ms. Gonnerman informed me that she was a reporter for the New York Times prior to questioning me although I later found out she was not an employee of the New York Times.
Posted by:Ilana Slaff, M.D.October 21, 2007 1:52:35 PMRespond ^
"The louder he talked of his honor, the faster we counted our spoons." - Ralph Waldo Emerson
Posted by:KJ ScottOctober 24, 2007 11:14:37 AMRespond ^
I have studied Psychology and I am well aware that there are very serious long term consequences of using adversive behavioral therapies. These children will have severe post traumatic stress disorders for the rest of thier lives. You can not reverse the intese psychological harm that you are inflicting.
Posted by:PattiNovember 1, 2007 2:20:46 PMRespond ^
Dear Bert, Clearly you have never met an unmedicated mentally ill person. You have no clue what you are talking about.
Posted by:PattiNovember 1, 2007 2:28:53 PMRespond ^
I find it disturbing that these children are dressed in ties. That is simply not "normal."
Posted by:PattiNovember 1, 2007 2:30:51 PMRespond ^
Perhaps someone should call cps for the kids in lock down, because they're certainly being abused...

I wasn't aware having an 'untidy appearance' necessitated electric shocks.

Perhaps they could scare them with some nice rats instead?
Posted by:Conform!May 5, 2008 9:43:40 PMRespond ^

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