School of Shock
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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.
A few minutes later, I meet 36-year-old Janine, who appears in much better shape. She's not wearing a helmet and has a full head of black hair. She's also got a backpack on her shoulders and canvas straps hanging from her legs, the telltale sign that electrodes are attached to both calves. For 16 years—nearly half her life—Janine has been hooked up to Israel's shock device. A couple years ago, when the shocks began to lose their effect, the staff switched the devices inside her backpack to the much more painful ged-4.
Rogue Science
In 1994, matthew israel had just 64 students. Today he has 234. This astonishing rate of growth is largely the result of a dramatic change in the types of students he takes in. Until recently, nearly all were "low functioning," autistic and mentally retarded people. But today slightly more than 50 percent are "high functioning," with diagnoses like add, adhd, and bipolar disorder. New York state supplies the majority of these students, many of whom grew up in the poorest parts of New York City. Yet despite this change in his population, Israel's methods have remained essentially the same.
Israel has long faced criticism that he has not published research about his use of electric shocks in peer-reviewed journals, where experts could scrutinize it. To defend his methods, he points to a bibliography of 110 research articles that he's posted on the Rotenberg Center website. This catalog seems impressive at first. Studied more closely, however, it is not nearly so convincing. Three-quarters of the articles were published more than 20 years ago. Eight were written or cowritten by Lovaas, the ucla-affiliated behaviorist. One of America's leading autism experts, Lovaas long ago stopped endorsing painful aversives. And Lovaas' old studies focus primarily on children with autism who engage in extreme self-injury—not on troubled teens who have been diagnosed with adhd or add.
But then, it would be hard for Israel to find contemporary research supporting his program, because the practice of treating self-abusive kids with pain has been largely abandoned. According to Dr. Saul Axelrod, a professor at Temple University and an expert on behavior modification, "the field has moved away from painful stimuli because of public outcry and because we've devised better techniques," including determining the cause of an individual's self-abuse.
Another expert Israel cites several times is Dr. Brian A. Iwata, a consultant on the development of sibis, the device Israel modified to create his ged. Now a professor of psychology and psychiatry at the University of Florida, he's a nationally recognized authority on treating severe self-abuse among children with developmental disabilities. Iwata has visited the Rotenberg Center and describes its approach as dangerously simplistic: "There appears to be a mission of that program to use shock for problem behaviors. It doesn't matter what that behavior is." Iwata has consulted for 25 states and says there is little relationship between what goes on at Israel's program and what goes on at other facilities. "He may have gotten his Ph.D. at Harvard, but he didn't learn what he's doing at Harvard. Whatever he's doing, he decided to do on his own."
Paul Touchette, who also studied with B.F. Skinner, has known Israel since the 1960s when they were both in Cambridge. Like Israel, Touchette went on to treat children with autism who exhibit extreme self-abuse, but he isn't a fan of Israel's approach either. "Punishment doesn't get at the cause," says Touchette, who is on the faculty of the University of California-Irvine School of Medicine. "It just scares the hell out of patients."
Over the decades, Touchette has followed Israel's career and bumped into him at professional conferences. "He's a very smart man, but he's an embarrassment to his profession," Touchette says. "I've never been able to figure out if Matt is a little off-kilter and actually believes all this stuff, or whether he's just a clever businessman."
Big Reward Store
At the rotenberg center, an elaborate system of rewards and punishments governs all interactions. Well-behaved kids can watch TV, go for pizza, play basketball. Students who've earned points for good behavior visit a store stocked with dvd players, cds, cologne, PlayStation 2, Essence magazine, knockoff Prada purses—anything the staff thinks students might want. But even more prized is a visit to the "Big Reward Store," an arcade full of pinball machines, video games, a pool table, and the most popular feature, a row of 42-inch flat-screen TVs hooked up to Xbox 360s.
Students like the "brs" for another reason—it's the only place many can socialize freely. At the Rotenberg Center, students have to earn the right to talk to each other. "We had to wait until we were in brs to communicate with others," says Isabel Cedeño, a 16-year-old who ran away from Rotenberg in 2006 after her boyfriend, a former student, came and got her. "That was the only time you really laughed, had fun, hung around with your friends. Because usually, you can't talk to them. It was basically like we had to have enemies. They didn't want us to be friendly with nobody."
Students live grouped together in homes and apartments scattered in nearby towns and are bused to the facility's headquarters every morning. They spend their days in classrooms, staring at a computer screen, their backs to the teacher. They are supposed to teach themselves, using self-instruction programs that include lessons in math, reading, and typing. Even with breaks for gym and lunch, the days can be incredibly dull. "On paper, it does look like they're being educated, because we have lesson plans," says former teacher Jessica Croteau, who oversaw a classroom of high-functioning teens for six months before leaving in 2006. But "to self-teach is not exciting. Why would the kids want to sit there and read a chapter on their own without any discussion?"
Croteau says teachers have to spend so much time monitoring misbehaviors there's often little time left for teaching. Whenever a student disobeys a rule, a staff member must point it out, using the student's name and just one or two rote phrases like, "Mark, there's no stopping work. Work on your task, please." Each time a student curses or yells, a staffer marks it on the student's recording sheet. Teachers and aides then use the sheet to calculate what level of punishment is required—when to just say "No!" and when to shock.
Employees carry students' shock activators inside plastic cases, which they hook onto their belt loops. These cases are known as "sleds," and each sled has a photo on it to ensure employees don't zap the wrong kid.
Behaviorism would seem to dictate that staff shock students immediately after they break the rules. But if employees learn about a misbehavior after it has occurred—by, say, reviewing surveillance footage—they may still administer punishment. Rob Santana recalls that Mondays were always the most stressful day of the week. He would sit at his desk all day, trying to remember if he had broken any rules over the weekend, waiting to see if he'd be shocked.
Employees are encouraged to use the element of surprise. "Attempt to be as discreet as possible and hold the transmitter out of view of the student," states the employee manual. This way, students cannot do anything to minimize the pain, like flipping over their electrodes or tensing their muscles. "We hear the sound of [a staffer] picking up a sled," says Isabel, the former student. "Then we turn around and see the person jump out of their seat."
Photo: Larry Sultan
