Article
October 10, 2007
Watch the Video
WASHINGTON, D.C., Oct. 10, 2007 (NBC) -- Desperate to help their troubled children, many parents have turned to so-called wilderness boot camps.
But a new study out Wednesday by the federal government warns that thousands of kids are being abused in the mostly unregulated programs and at least ten have died. Some lawmakers want the federal government to step in and stop what they call institutionalized child abuse.
The problem goes back at least to the 1990's, when Aaron Bacon died at a boot camp in Utah. Concerned about his pot smoking, Aaron's parents sent him for what they thought would be wilderness self-awareness. In fact, his father testified Wednesday, Aaron was force marched and starved to death.
Aaron's father, Bob Bacon said he suffered "twenty one days of ruthless and relentless physical and psychological abuse and neglect."
The government study released Wednesday found ten boot camp deaths.
Gregory Kutz of the General Accountability Office said, "Many of these kids died slowly while program management and staff continued to believe that they were faking it."
Erica Harvey collapsed and died at her Nevada camp in 2002.
Security video shows 14 year old Martin Anderson after being beaten in a Florida program last year. He died after the beating. Eight employees are on trial for manslaughter in that case.
The new study says parents of troubled teens are desperate.
The websites of camps like Alldredge Academy are reassuring. The programs look safe. But Alldredge was ordered closed after the suicide of 14-year-old, Ryan Lewis, who earlier slashed his arm.
Ryan's dad Paul Lewis said, "Ryan was ignored and consequently at 730 on a cold rainy night, desperate, alone and abandoned our son hung himself."
Alldredge has reopened.
An association of residential programs says it's cracking down. Jan Moss, executive director of the National Association of Therapeutic Schools and Programs said, "Clearly we still have a very long way to go."
Right now it is the states that regulate, or don't regulate, these tough love programs. Some lawmakers want to change that so that all boot camps are regulated.
Wednesday, October 10, 2007
GAO finds abuses at 'tough love' camps for troubled kids
Article
By Ken Dilanian, USA TODAY
October 10, 2007
WASHINGTON — Members of Congress from both parties reacted with outrage Wednesday to wrenching testimony from parents of children who died in residential programs for troubled teens, saying a federal law may be needed to remedy a lack of oversight.
"I can't think of any testimony that we have heard in this committee that has caused a greater sense of anger and sorrow," said Democrat George Miller of California, chairman of the Committee on Education and Labor, moments after hearing three parents recount the deaths of their teenagers in wilderness therapy programs designed to help them.
Rep. Buck McKeon, the ranking Republican, said he does not like to expand the role of the federal government, "but there are some times when it has to happen."
VIDEO: Parents detail torture at boot camps
Several states don't regulate private wilderness programs, boot camps and therapeutic boarding schools, which enroll thousands of children each year and have been the subject of what the Government Accountability Office (GAO) called "widespread" allegations of abuse and neglect. No law prevents operators who have been disciplined in one state from setting up shop in another — something investigators say happens often.
Jan Moss, executive director of the National Association of Therapeutic Schools and Programs, said the industry wants state regulation. Her group represents 180 facilities that serve 16,000 children.
"Among our goals is the complete elimination of the abuses and neglectful practices we have heard about today," she said. "Clearly, we have a long way to go."
The GAO on Wednesday presented the committee with the results of their investigation into the industry. The congressional investigative agency selected 10 deaths to examine in depth and found reckless practices, inadequate training and misleading marketing. It also found what Rep. Todd Platts, R-Pa., called "horrific" examples of abuse.
"If you walked in partway through my presentation, you might have assumed I was talking about human rights violations in a Third World country," said Gregory Kutz, a GAO investigator.
Kutz said there is no comprehensive nationwide data on deaths and injuries in residential treatment programs. The GAO identified 1,619 incidents of child abuse in such settings that were reported to the Department of Health and Human Services in 2005, but reporting is voluntary and not all states comply. Auditors found thousands of allegations in lawsuits, websites and state records, he said.
"Examples of abuse include youth being forced to eat their own vomit, denied adequate food, being forced to lie in urine or feces, being kicked, beaten and thrown to the ground," Kutz said, adding that one teen was reportedly "forced to use a toothbrush to clean a toilet, then forced to use that toothbrush on their own teeth."
In several cases examined by the GAO, staff was untrained to detect medical emergencies. "As a result, many of these kids died slowly while program management and staff continued to believe that they were faking it," Kutz said.
Kutz spoke forcefully, more in the manner of a prosecutor than a government auditor. Among the slides he presented to lawmakers was the grisly photo of a 15-year-old California girl who was left for 18 hours on a dirt road after collapsing from dehydration in 1990.
The three parents who testified — Bob Bacon, Cynthia Harvey and Paul Lewis — each choked up as they told of sending their troubled teenagers against their will into "tough love" wilderness programs. Each warned parents to avoid such programs until government rules can assure parents they are safe.
"His mother and I will never escape our decision to send our gifted 16-year-old son to his death," Bacon said, speaking of son Aaron, who died from an untreated perforated ulcer after weeks of punishing physical activity with very little food. "We were conned by their fraudulent claims and will go to our graves regretting our gullibility
By Ken Dilanian, USA TODAY
October 10, 2007
WASHINGTON — Members of Congress from both parties reacted with outrage Wednesday to wrenching testimony from parents of children who died in residential programs for troubled teens, saying a federal law may be needed to remedy a lack of oversight.
"I can't think of any testimony that we have heard in this committee that has caused a greater sense of anger and sorrow," said Democrat George Miller of California, chairman of the Committee on Education and Labor, moments after hearing three parents recount the deaths of their teenagers in wilderness therapy programs designed to help them.
Rep. Buck McKeon, the ranking Republican, said he does not like to expand the role of the federal government, "but there are some times when it has to happen."
VIDEO: Parents detail torture at boot camps
Several states don't regulate private wilderness programs, boot camps and therapeutic boarding schools, which enroll thousands of children each year and have been the subject of what the Government Accountability Office (GAO) called "widespread" allegations of abuse and neglect. No law prevents operators who have been disciplined in one state from setting up shop in another — something investigators say happens often.
Jan Moss, executive director of the National Association of Therapeutic Schools and Programs, said the industry wants state regulation. Her group represents 180 facilities that serve 16,000 children.
"Among our goals is the complete elimination of the abuses and neglectful practices we have heard about today," she said. "Clearly, we have a long way to go."
The GAO on Wednesday presented the committee with the results of their investigation into the industry. The congressional investigative agency selected 10 deaths to examine in depth and found reckless practices, inadequate training and misleading marketing. It also found what Rep. Todd Platts, R-Pa., called "horrific" examples of abuse.
"If you walked in partway through my presentation, you might have assumed I was talking about human rights violations in a Third World country," said Gregory Kutz, a GAO investigator.
Kutz said there is no comprehensive nationwide data on deaths and injuries in residential treatment programs. The GAO identified 1,619 incidents of child abuse in such settings that were reported to the Department of Health and Human Services in 2005, but reporting is voluntary and not all states comply. Auditors found thousands of allegations in lawsuits, websites and state records, he said.
"Examples of abuse include youth being forced to eat their own vomit, denied adequate food, being forced to lie in urine or feces, being kicked, beaten and thrown to the ground," Kutz said, adding that one teen was reportedly "forced to use a toothbrush to clean a toilet, then forced to use that toothbrush on their own teeth."
In several cases examined by the GAO, staff was untrained to detect medical emergencies. "As a result, many of these kids died slowly while program management and staff continued to believe that they were faking it," Kutz said.
Kutz spoke forcefully, more in the manner of a prosecutor than a government auditor. Among the slides he presented to lawmakers was the grisly photo of a 15-year-old California girl who was left for 18 hours on a dirt road after collapsing from dehydration in 1990.
The three parents who testified — Bob Bacon, Cynthia Harvey and Paul Lewis — each choked up as they told of sending their troubled teenagers against their will into "tough love" wilderness programs. Each warned parents to avoid such programs until government rules can assure parents they are safe.
"His mother and I will never escape our decision to send our gifted 16-year-old son to his death," Bacon said, speaking of son Aaron, who died from an untreated perforated ulcer after weeks of punishing physical activity with very little food. "We were conned by their fraudulent claims and will go to our graves regretting our gullibility
Tough-Love Teen Camps A "Nightmare"
Article
The Skinny: Inquiry Into Boot Camps For Trouble Teens Finds Many Abuses, GAO Report Says
By Keach Heagy
CBS News
October 10, 2007
For years, people have complained about abuses at so-called boot camps and other wilderness programs where frustrated parents send their troubled teens to get straightened out.
Today, USA Today gets a sneak peak at the findings from the first federal inquiry into the programs, and the results reveal a lot of tough love -- minus the love.
The Government Accountability Office cataloged 1,619 incidents of abuse in 33 states in 2005, according to a study to be released later today. It also looked at a sample of 10 deaths since 1990 and found untrained staff, inadequate food or reckless operations were factors. In half of those cases, the teens died of dehydration or heat exhaustion.
"This nightmare has remained an open secret for years," said Rep. George Miller, D-Calif, who has designed a bill to encourage states to enact regulations. "Congress must act, and it must act swiftly."
Investigators counted thousands of cases of abuse, using Web sites and news reports. Five of the 10 programs where teens died are still operating.
The GAO didn't release names, but USA Today pieced together a few of the cases from news reports.
In one particularly haunting case, Anthony Haynes, 14, died in 2001 while at American Buffalo Soldiers boot camp in Arizona. Children there were fed an apple for breakfast, a carrot for lunch and a bowl of beans for dinner.
Haynes became dehydrated in 113-degree heat and vomited up dirt, according to witnesses. The program closed, and the director, Charles Long, was sentenced in 2005 to six years in prison for manslaughter.
The Skinny: Inquiry Into Boot Camps For Trouble Teens Finds Many Abuses, GAO Report Says
By Keach Heagy
CBS News
October 10, 2007
For years, people have complained about abuses at so-called boot camps and other wilderness programs where frustrated parents send their troubled teens to get straightened out.
Today, USA Today gets a sneak peak at the findings from the first federal inquiry into the programs, and the results reveal a lot of tough love -- minus the love.
The Government Accountability Office cataloged 1,619 incidents of abuse in 33 states in 2005, according to a study to be released later today. It also looked at a sample of 10 deaths since 1990 and found untrained staff, inadequate food or reckless operations were factors. In half of those cases, the teens died of dehydration or heat exhaustion.
"This nightmare has remained an open secret for years," said Rep. George Miller, D-Calif, who has designed a bill to encourage states to enact regulations. "Congress must act, and it must act swiftly."
Investigators counted thousands of cases of abuse, using Web sites and news reports. Five of the 10 programs where teens died are still operating.
The GAO didn't release names, but USA Today pieced together a few of the cases from news reports.
In one particularly haunting case, Anthony Haynes, 14, died in 2001 while at American Buffalo Soldiers boot camp in Arizona. Children there were fed an apple for breakfast, a carrot for lunch and a bowl of beans for dinner.
Haynes became dehydrated in 113-degree heat and vomited up dirt, according to witnesses. The program closed, and the director, Charles Long, was sentenced in 2005 to six years in prison for manslaughter.
U.S. Rep wants fed probe of Mo. boot-camp death
Article
By Megan Boehnke
ST. LOUIS POST-DISPATCH
10/10/2007
WASHINGTON -- A powerful U.S. House member called today for the Justice Department to look into the death of a 15-year-old boy at a Missouri “boot camp” in 2004 following release of a report that pointed to evidence of abuse.
Rep. George Miller, D-Calif., chairman of the Education and Labor Chairman, asserted during a hearing that conditions in many residential treatment programs – better known as youth boot camps – are “inhumane.”
He said he hopes the Justice Department will examine the fatality at the Thayer Learning Boot Camp and Boarding School in northwest Missouri considering that no criminal charges ever were filed.
The Government Accountability Office, the investigative arm of Congress, studied the Missouri case and others for a report released on Wednesday.
The GAO said it had found thousands of allegations of abuse at the boot camps and closely examined ten cases in which teen-agers enrolled in the programs had died, including the case at Thayer.
“Ineffective program management played a key role in most of these deaths, Greg Kutz, who led the investigation, testified. Advertisement
Kutz said later in an interview that the Missouri death was “one of the worst three” of the cases.
Roberto Reyes, of Santa Rosa, Calif., had been at Thayer Learning Boot Camp and Boarding School in Kidder, for less than a week when he died after being bitten by a spider in November 2004, according to his autopsy. The Caldwell County coroner said at the time that the autopsy concluded that the death was an accident and said Reyes could have been bitten before he arrived at the camp.
The GAO report presented to the committee yesterday said Reyes had more than 30 cuts and bruises on his body when he died. The staff had interpreted Reyes’ symptoms – including falling down frequently, complaining of muscle soreness, vomiting and involuntarily urinating and defecating on himself – as rebellion.
After complaining of illness, Reyes was forced to the ground and held there on several occasions, according to the report. On one occasion, he had a 20-pound sandbag tied around his neck when he was too sick to exercise.
Reyes was placed in the “sick bay” the morning of the day he died, where a staff member checked on him mid-afternoon and found he had no pulse. The staff then called 911 and Reyes was taken to the hospital, where he was pronounced dead.
A state investigation found that Reyes might have survived if he had earlier medical attention and that records at the camp may have been falsified. No criminal charges were ever filed, though Reyes’ parents filed a wrongful death suit that was settled out of court for about $1 million, according to the GAO.
Shawn Hornbeck and Ben Ownby abducted: Devlin Gets Life Sentences in Abuse Case
Article
By CHRISTOPHER LEONARD, Associated Press Writer
3 hours ago
ST. LOUIS - The long trail of pain inflicted by Michael Devlin drew toward a close with him describing in court how he assaulted an abducted boy, seemingly oblivious to the anguished parents seated in the courtroom for his confession.
Devlin has received dozens of life sentences after pleading guilty to child kidnapping and sodomy charges in state proceedings related to his abduction and sexual abuse of young Shawn Hornbeck and Ben Ownby.
After recounting some of his acts during testimony given just feet away Shawn's weeping parents Tuesday, Devlin faces additional charges in federal court Wednesday morning. He is expected to plead guilty to charges of videotaping himself torturing Shawn after kidnapping him, and transporting the boy across state lines.
The hearing will be the last in a series of proceedings this week that revealed how he kidnapped Shawn and turned him into a captive who was forced to follow Devlin's horrific orders to stay alive.
Devlin also admitted abducting and abusing Ben before both victims were discovered alive in Devlin's apartment.
The hearings were part of an elaborate deal his attorneys struck in four jurisdictions where Devlin was charged with more than 80 counts, including sexual assault, kidnapping and attempted murder.
Devlin's life sentences assure he will spend the rest of his life in prison. He is expected to serve his time in the state prison system.
Devlin said through his attorneys that he accepted his punishment because he knew what he did was wrong _ a statement quickly dismissed by prosecutors and the boys' families.
"He pleaded guilty because he does not want the world to know the full extent of what he did," said St. Louis County prosecutor Robert McCulloch.
Prosecutors laid out new evidence showing that Devlin tortured Shawn during his first days in captivity and made the boy promise not to flee in order to stay alive. It was a "devil's bargain" that kept Shawn under Devlin's sway for more than four years, even when the boy had phone and Internet access, said Shawn's stepfather, Craig Akers.
"We know now the details that made him not run away," Akers said after the hearings.
Devlin pleaded guilty to six counts at a Washington County hearing Tuesday, accepting the maximum sentence of three life terms in prison plus 60 years for kidnapping, sexually assaulting and attempting to murder Shawn in 2002.
During that hearing, Devlin admitted in graphic detail how he abducted Shawn in 2002 and described the point at which Shawn apparently turned from a kidnap victim into a powerless captive.
After Shawn was abducted at gunpoint while riding his bike in rural Washington County, Devlin took the then-11-year-old boy to his apartment in suburban St. Louis where he repeatedly sexually assaulted him. Days later, Devlin took Shawn back to rural Washington County in his pickup truck, apparently intent on killing the boy.
He said he pulled Shawn from his truck and began to strangle him, but Shawn resisted.
"I attempted to kill (Shawn) and he talked me out of it," Devlin said.
Devlin stopped the choking, but then sexually assaulted the boy again. Prosecutors say Shawn told Devlin he would do whatever was asked of him to stay alive.
Prosecutors also said that Devlin began abusing Ben Ownby immediately after abducting him Jan. 8. Devlin abused the boy each day until authorities found Ben and Shawn in Devlin's apartment and rescued them Jan. 12, as Devlin, a pizzeria manager, worked the day shift at his shop.
After the Washington County hearing, Devlin pleaded guilty to 71 counts in St. Louis County Circuit Court _ two counts of kidnapping and 69 counts of forcible sodomy of Ben and Shawn. He was then sentenced to 18 consecutive life sentences in St. Louis County. He pleaded guilty to other charges at a hearing in Franklin County on Monday.
Rupp said he was satisfied with the sentences. "You heard it from his own mouth. You've heard what kind of a monster he is."
While it is The Associated Press' policy not to identify suspected victims of sexual abuse in most cases, the story of Shawn and Ben has been widely publicized and their names are well known.
Monday, October 8, 2007
Congressional Hearing: Tough Love or Teen Torment: Will the Industry Finally Be Regulated?
Article
Posted October 8, 2007
By Maia Szalavitz
Congress is finally looking into the "troubled teen" industry and the deaths, human rights abuses and other problems that have occurred in teen "boot camps" "wilderness programs" and other "tough love" residential settings. In many states, these institutions are less regulated than dog kennels and nail salons.
On Wednesday, Rep. George Miller (D-CA), Chair of the House Education and Labor Committee, will hold a full committee investigative hearing and present results from a Government Accountability Office report that he commissioned. The investigation promises to be revealing-- and may be highly unfavorable to industry claims that it can regulate itself.
My book, Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids (Riverhead, 2006), was the first to expose systematic problems in the industry and the complete lack of regulatory oversight on programs that are essentially private jails for kids. The book helped spur Miller's push for legislation.
As it stands now, there is more federal regulation protecting mule deer than there is preserving the rights of children in these institutions. Anyone can open one-- there are no qualifications required, nor criminal background checks. Some owners have even made deals with prosecutors and regulators to stay away from their facilities, due to accusations of sexual and other kinds of child abuse. But they were not made to leave the industry!
And no legal authority is required to inspect these facilities or see to it that kids are well-treated in them.
Teens placed in these settings do not have any right to appeal their confinement: they may be held without contact with the outside world until they turn 18.
Moreover, in the programs, they are often subject to "therapies" that many consider torturous: food deprivation, sleep deprivation, total isolation, punitive restraint and constant emotional and even sexual humiliation. When such tactics are used on suspected terrorists, there is a human rights outcry-- but these programs have done everything short of water-boarding kids with impunity for decades.
For example, one girl was made to dress as a prostitute, wearing a nametag that said "Shameful Slut." "Slut, 25 cents" was written on her skin in lipstick. Boys had to yell "slut" and "ho" and "bitch" at her. Others were made to wear diapers and boys were dressed in drag and called "faggot." In another program, a girl was gagged with Kotex; another was made to clean toilets with her bare hands. Some children had to use their toothbrushes first to scrub the floors, then their teeth.
That's not to mention the dozens of gruesome deaths that have occurred because "tough love" ideology does not accept the idea that teens ever have legitimate medical complaints. One boy lost control of his urine and bowels as he began to die-- and was humiliated for it by program staff, saying he was doing it deliberately. Another, also accused of faking, had two and a half quarts of pus in his chest when he was autopsied.
Right now, of course, seven boot camp guards and a nurse in Florida are on trial for manslaughter in another death-- that of a 14-year-old boy who couldn't complete required exercises and was beaten and forced to inhale ammonia to prove he wasn't faking. He died proving it.
I hope that these hearings will bring national attention to this issue. Hundreds of thousands of teens have been sent over the last 30 years-- and the industry continues to grow. There is no proof that its "product" helps anyone-- and a great deal of research suggesting that the programs may be causing significant harm.
We don't allow amateurs to diagnose and treat physical illnesses-- so why are we letting untrained people have total control, with no checks and balances, over vulnerable teens who have no way of contesting their confinement? I will have more after the hearings.
Posted October 8, 2007
By Maia Szalavitz
Congress is finally looking into the "troubled teen" industry and the deaths, human rights abuses and other problems that have occurred in teen "boot camps" "wilderness programs" and other "tough love" residential settings. In many states, these institutions are less regulated than dog kennels and nail salons.
On Wednesday, Rep. George Miller (D-CA), Chair of the House Education and Labor Committee, will hold a full committee investigative hearing and present results from a Government Accountability Office report that he commissioned. The investigation promises to be revealing-- and may be highly unfavorable to industry claims that it can regulate itself.
My book, Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids (Riverhead, 2006), was the first to expose systematic problems in the industry and the complete lack of regulatory oversight on programs that are essentially private jails for kids. The book helped spur Miller's push for legislation.
As it stands now, there is more federal regulation protecting mule deer than there is preserving the rights of children in these institutions. Anyone can open one-- there are no qualifications required, nor criminal background checks. Some owners have even made deals with prosecutors and regulators to stay away from their facilities, due to accusations of sexual and other kinds of child abuse. But they were not made to leave the industry!
And no legal authority is required to inspect these facilities or see to it that kids are well-treated in them.
Teens placed in these settings do not have any right to appeal their confinement: they may be held without contact with the outside world until they turn 18.
Moreover, in the programs, they are often subject to "therapies" that many consider torturous: food deprivation, sleep deprivation, total isolation, punitive restraint and constant emotional and even sexual humiliation. When such tactics are used on suspected terrorists, there is a human rights outcry-- but these programs have done everything short of water-boarding kids with impunity for decades.
For example, one girl was made to dress as a prostitute, wearing a nametag that said "Shameful Slut." "Slut, 25 cents" was written on her skin in lipstick. Boys had to yell "slut" and "ho" and "bitch" at her. Others were made to wear diapers and boys were dressed in drag and called "faggot." In another program, a girl was gagged with Kotex; another was made to clean toilets with her bare hands. Some children had to use their toothbrushes first to scrub the floors, then their teeth.
That's not to mention the dozens of gruesome deaths that have occurred because "tough love" ideology does not accept the idea that teens ever have legitimate medical complaints. One boy lost control of his urine and bowels as he began to die-- and was humiliated for it by program staff, saying he was doing it deliberately. Another, also accused of faking, had two and a half quarts of pus in his chest when he was autopsied.
Right now, of course, seven boot camp guards and a nurse in Florida are on trial for manslaughter in another death-- that of a 14-year-old boy who couldn't complete required exercises and was beaten and forced to inhale ammonia to prove he wasn't faking. He died proving it.
I hope that these hearings will bring national attention to this issue. Hundreds of thousands of teens have been sent over the last 30 years-- and the industry continues to grow. There is no proof that its "product" helps anyone-- and a great deal of research suggesting that the programs may be causing significant harm.
We don't allow amateurs to diagnose and treat physical illnesses-- so why are we letting untrained people have total control, with no checks and balances, over vulnerable teens who have no way of contesting their confinement? I will have more after the hearings.
Abuse allegations, apathy show need for ‘boot camp’ regulations
October 7, 2007
Perhaps a federal investigation will lead to better protection for children in Missouri boarding schools. Officials in the state have failed miserably in their role.
The U.S. Government Accountability Office is interviewing students and employees of Thayer Learning Center, a “boot camp” for troubled teenagers in Kidder, Mo., about 50 miles north of Kansas City.
A 15-year-old boy died there in 2004. A coroner said the most likely cause was a spider or insect bite, but a state investigation found that the center denied proper medical care to Roberto Reyes, who was weak and ill in the days before his death.
A 2005 investigation by The Kansas City Star found that at least seven people had reported abuse allegations to the Caldwell County sheriff’s office in a period of a little over two years.
Employees alleged that teenagers were doused with cold water while tied up on a concrete floor and denied access to bathrooms. One girl was forced to sit in a tub of urine, and a boy was tethered to a four-wheeler and dragged on a sand track, according to the allegations. Thayer’s owners have denied all charges.
The sheriff’s office turned the reports over to Jason Kanoy, who at the time was serving as Caldwell County prosecutor.
Kanoy’s handling of the allegations can most charitably be described as apathetic. He appeared to do little work on the case and chose not to take advantage of assistance offered by Missouri Attorney General Jay Nixon’s office. Kanoy has since been elected associate judge in Caldwell County.
His successor as prosecutor, Brady Kopek, told The Star he is investigating a recent report by a former Thayer employee, who alleged that a student was choked and brutalized by a “drill sergeant.”
Despite the serious concerns about Thayer, the Missouri legislature continues to resist calls to require such boarding schools to be licensed and inspected.
The federal probe of Thayer and other “boot-camp” programs was requested by U.S. Rep. George Miller, a California Democrat. Miller wants Congress to mandate close oversight of the programs.
Based on the allegations of abuse at Thayer — and the reluctance of state and local officials to take them seriously — that remedy appears appropriate.
Perhaps a federal investigation will lead to better protection for children in Missouri boarding schools. Officials in the state have failed miserably in their role.
The U.S. Government Accountability Office is interviewing students and employees of Thayer Learning Center, a “boot camp” for troubled teenagers in Kidder, Mo., about 50 miles north of Kansas City.
A 15-year-old boy died there in 2004. A coroner said the most likely cause was a spider or insect bite, but a state investigation found that the center denied proper medical care to Roberto Reyes, who was weak and ill in the days before his death.
A 2005 investigation by The Kansas City Star found that at least seven people had reported abuse allegations to the Caldwell County sheriff’s office in a period of a little over two years.
Employees alleged that teenagers were doused with cold water while tied up on a concrete floor and denied access to bathrooms. One girl was forced to sit in a tub of urine, and a boy was tethered to a four-wheeler and dragged on a sand track, according to the allegations. Thayer’s owners have denied all charges.
The sheriff’s office turned the reports over to Jason Kanoy, who at the time was serving as Caldwell County prosecutor.
Kanoy’s handling of the allegations can most charitably be described as apathetic. He appeared to do little work on the case and chose not to take advantage of assistance offered by Missouri Attorney General Jay Nixon’s office. Kanoy has since been elected associate judge in Caldwell County.
His successor as prosecutor, Brady Kopek, told The Star he is investigating a recent report by a former Thayer employee, who alleged that a student was choked and brutalized by a “drill sergeant.”
Despite the serious concerns about Thayer, the Missouri legislature continues to resist calls to require such boarding schools to be licensed and inspected.
The federal probe of Thayer and other “boot-camp” programs was requested by U.S. Rep. George Miller, a California Democrat. Miller wants Congress to mandate close oversight of the programs.
Based on the allegations of abuse at Thayer — and the reluctance of state and local officials to take them seriously — that remedy appears appropriate.
Gulf Coast Academy: Parents want academy closed
Article
Parents want academy closed
October 8, 2007
By ROYCE ARMSTRONG
LUCEDALE - Barbara Ramirez of Chicago wants a Lucedale home for troubled youth shut down because of poor living conditions, student abuse and the inability of the school's officials to prevent students from escaping.
Ramirez said she began the campaign to shut down the Gulf Coast Academy after a recent visit to the school where her daughter, Tianna, 17, is enrolled.
Ramirez attended a seminar at the school but found what she considers intolerable conditions.
"I was appalled," Ramirez said. "The seminar was held in the chapel. I went into the bathroom and it was filthy. Three roaches were crawling up the wall. I almost got sick."
That was just the beginning.
Her daughter told her stories about poor food, abusive discipline, student fights and escapes. While Ramirez could not confirm the stories, she did see broken glass in the school yard and broken windows patched with plastic garbage bags. She also learned that her daughter was not seeing a psychologist each month as promised or having weekly counseling sessions.
"I don't have any idea what the kids were doing for recreation," Ramirez said. "I never saw any of the kids outside and weeds are growing in the swimming pool."
Ramirez also said there was no security and that the staff lied to the parents attending the seminar.
"We found out several of the kids had escaped the week before," said Ramirez. "They told us that only one was still missing. That was not true. Three were missing."
The academy has a checkered past. It dates to 1988 when it was opened as the Bethel Children's Home by the Rev. Herman Fountain. Over the years, the home has been plagued by a series of troubles, including riots, students running away and allegations of child abuse. The home was closed by court order in 1990 and later reopened by Fountain as the Bethel Boy's Academy. More abuse allegations followed with Fountain and others losing a $900,000 child abuse suit in federal court last year.
The home has also been known as the Eagle Point Christian Academy and then as the Pine View Academy with Fountain's son, John, listed as the owner.
The school is affiliated with World Wide Association of Specialty Programs and Schools, which serves as an umbrella organization for several similar schools across the United States and in the Caribbean.
Ramirez enrolled her daughter Tianna in the school for troubled teens in late July. She had not seen the campus but enrolled her daughter there based upon recommendations from counselors at Teen Help LLC, with which the school is affiliated.
From the very beginning, things just did not seem right, Ramirez said. Communication with school staff was poor. She called and left messages but never had her calls returned.
She was also concerned about her daughter's education.
"Tianna was failing her junior year in April," Ramirez said. "Now, after only two months, they are telling me that she has completed both her junior and senior years and has graduated from high school."
Ramirez is one of eight sets of parents who has contacted the Hattiesburg American in recent weeks about problems they have found with the school.
Another was Janine Jannicelli of Raleigh, N.C., who withdrew her 14-year-old son during the Labor Day weekend when she visited the school.
Her concerns had been growing all weekend, but when she saw a much larger boy being dragged by three staff members from one dorm area to her son's dorm, she became alarmed for her son's safety. The older boy had been involved in a fight.
The Jannicellis asked school administrator Harold Dabel if he could guarantee the safety of their son. He told them he could not.
Dabel did not respond to telephone calls or e-mail questions about the parents' concerns.
Safety was just one of Jannicelli's concerns after the visit with her son. Other concerns included the quality of the education he was receiving and his living conditions.
Among other things, Jannicelli said she personally saw roaches inside the dormitories and filth in dorm rooms, showers and the weight room. She said she believes e-mails from her son were edited by the staff, that the quality of the food was not good and students were allowed to get on the Internet to view pornography.
At least one parent, however, did not feel Jannicelli's concerns were justified.
"I don't want to sound like a cheerleader - the school definitely has kinks to work out," said Colleen Edwards of Phoenix. "But I feel strongly that there is no intentional harm or danger happening and that the staff are trying to run a legitimate program that helps kids. It's a very tough population of kids."
Edwards said her son has recently completed the program at Gulf Coast Academy.
Colleen Fleming of Mastic, N.Y., whose son has been at the school for almost three months, complained that she called the school but her calls were not returned. When she was able to talk with her son, she said, the conversations were monitored by the staff. She said his e-mails were edited.
"We did not receive any reports from the school and I do not believe he received the counseling we were paying for," Fleming said.
Tuition for the 12-month program is $32,340, parents say.
In addition to the tuition, parents pay for medical and dental treatments, clothing and uniforms, hair cuts, postage, phone calls, supervision and transportation costs and psychiatric treatment and counseling. The total cost for a year is roughly $50,000, according to Fleming.
The school has experienced a number of problems since Labor Day. A student fight broke out Sept. 8, with eight students arrested and taken to the Forrest County Juvenile Detention Center in Hattiesburg. A series of student escapes also have occurred with four students disappearing for nearly a week. Finally, on Sept. 21, the 33 boys at the co-educational school were transferred to another facility in South Carolina, leaving 13 girls at the school.
Since that time, at least four of the remaining girls have been withdrawn. Four sets of parents are also in the process of initiating a class action suit, Jannicelli said.
"My daughter is out of there and safe," Ramirez said. "I am worried about the other girls who are still there. I want that place closed for good."
School of Shock : Rotenberg Center Director Matthew Israel Responds
Article
October 5, 2007
RESPONSE TO JENNIFER GONNERMAN'S ARTICLE, "SCHOOL OF SHOCK"
Matthew Israel
Response
Every surgical, dental or medical treatment involves discomfort, risks or costs on the one hand, and expected benefits on the other. For most persons a reasonable approach is to weigh the discomfort/risks/costs against the potential benefits in deciding whether to undergo or approve the treatment. In the case of certain treatments, however, there are some persons who, for religious or philosophical reasons, are unwilling to weigh the negative aspects of those treatments against the potential benefits. These persons view the treatment in question as Wrong with a capital "W," regardless of the potential benefits the treatment might produce. For example, Christian Scientists oppose the use of medical interventions, and Scientologists oppose the use of psychiatric drugs, regardless of what potential benefits may ensue.
Opponents of behavior modification treatment that involves aversives (sometimes referred to as "aversive therapy") are similarly unwilling to weigh the discomfort, risks or costs associated with aversives against the potential benefits—even when those benefits could be lifesaving, life-improving or life-extending. Such persons prefer to brand aversives as "Wrong," refusing to recognize them as part of a relatively new behavior modification treatment procedure2, and many of them sometimes do whatever they can to prevent anyone else from using them. It is clear from Ms. Gonnerman's article that she is one of those persons.
Ms. Gonnerman is so intent on indicting the Judge Rotenberg Center ("JRC"), the only special needs school in the country that offers this form of therapy, that she violates the normal journalistic ethics of presenting both sides of a controversial issue. Out of a total of 265 column inches that her article occupies, only 15 inches (six percent of the article) presents any of the benefits of JRC's treatment. Even those few accounts of parents (characterized as "desperate parents") or students who speak positively about JRC are presented with snide comments, disparaged by unfavorable observations or reported in the least favorable light possible. For a more accurate picture of JRC, the reader is encouraged to consult http://www.judgerc.org/introtojrc.html. Ms. Gonnerman grossly misrepresents JRC's treatment. The treatment is overwhelmingly based on an innovative, unique and comprehensive system of rewards and behaviorally-designed educational procedures that feature self-instructional software that each student accesses through his or her own computer. The treatment eliminates or minimizes the use of psychotropic drugs—a form of treatment that is far more dangerous and intrusive than anything done at JRC.
Aversives, in the form of a brief, two-second skin shock to the surface of, typically, the arm or leg, are added to this treatment for only certain extremely difficult-to-treat behaviors of that have failed to respond to positive-only treatment in the student's previous placements as well as at JRC. The procedure feels like a hard pinch and, unlike the heavy and often ineffective psychotropic drugging that this procedure typically replaces, has no negative side effects. Rewards and educational procedures alone are tried for an average of 11 months at JRC before JRC considers the addition of aversives. In addition, the use of aversives has to be pre-approved, on an individual basis, by the child's school system (through the IEP process), the parent, a physician, a psychiatrist, a human rights committee, a peer review committee and a Massachusetts Probate Court judge.
Currently, only a minority of JRC's school-age students receive skin shock as an aversive and even in these cases its use is very infrequent, less than once per week in the average case. In many cases the student progresses so well with this treatment that the aversives can eventually be removed entirely and the student can be returned to his/her local school system.
Ms. Gonnerman devotes extensive space at the very beginning of her article to the stories of two students whose parents became dissatisfied with JRC and withdrew their students (a routine event in every residential school). No comparable space is given to the hundreds of students whose parents are thrilled with the changes in their children that JRC was able to accomplish and that no previous program was able to achieve. Ms. Gonnerman also devotes space to the fact that during JRC's 35-year history, a few students have died from natural causes that had nothing to do with the treatment they received at JRC. The only apparent purpose of this inclusion is to cast negative aspersions on JRC that have no basis in fact. The reader is not told that JRC has a unique no-rejection, no-expulsion policy that means it accepts students who have pre-existing, life-shortening medical conditions.
Ms. Gonnerman reports on the views of a few psychologists who are opposed to JRC's treatment. No space is given to the many psychologists who admire JRC's work and who wish their own agency had the ability to provide the treatment procedures that JRC is able to offer. Ms. Gonnerman publishes anonymous critical comments made by some former employees of JRC, eight of whom she interviewed. One of these was probably Greg Miller, a disgruntled former employee who appeared with Ms. Gonnerman on National Public Radio , a piece that was stimulated by her article. Mr. Miller worked enthusiastically for JRC for three years during which he failed to raise any objections to JRC's treatment to anyone. If he had seen anything abusive and failed to report it while employed at JRC, he violated his duty to report any suspected abuse to the appropriate state agency. After three years of employment, he was disciplined for insubordinate actions and then promptly resigned. No space is given to the hundreds or thousands of current or former staff members who have positive things to say about JRC.
The reader is not told that JRC is the only program in the country that is able to offer effective, lifesaving treatment to students with severe self-abuse and aggression or that other programs that try to serve such students, but which are unable to serve them successfully, often expel those students and refer them to JRC for successful treatment (see here).
Ms. Gonnerman objects to JRC's use of aversive therapy to treat the self-destructive or aggressive behaviors of "higher functioning" special needs students who have the ability to speak and interact normally. Yet these students are often the most eloquent defenders of this therapy; many credit it with saving their lives or turning their lives around in a positive direction. Why prevent such youngsters from benefiting from this therapy just because they have relatively normal cognitive functioning? Normal adults can obtain aversive therapy from a psychologist to treat behavior problems such as excessive smoking, gambling or eating. Why should special needs students with normal cognitive functioning be unable to obtain aversive therapy for their particular behavior problems?
Ms. Gonnerman quotes from an inaccurate report by the New York State Education Department, but does not tell the reader that it was prepared as part of a campaign to deny New York students the possibility of benefiting from aversive therapy—a campaign that is currently being challenged in federal court by 50 JRC parents from New York State. She also fails to note that three Massachusetts agencies have investigated JRC and found no support for the major findings of that report. Ms. Gonnerman objects to the fact that effective behavioral treatment requires aggressive treatment of the earliest recognizable stages of problematic behaviors and of the behaviors that typically precede problem behaviors ("antecedents") even though those behaviors may, if viewed out of context, appear to be benign. This practice is comparable to the need to provide early detection and treatment for cancer and other serious diseases. The early forms of such diseases may look benign, but if left untreated can grow into life-threatening forms. The same is true of certain seriously problematic behaviors.
And, most important, Ms. Gonnerman fails to put the risks/intrusiveness of aversive therapy with skin-shock into proper perspective. Behavioral treatment with skin shock at JRC involves a brief, two-second period of discomfort that has no significant side effects. It is a procedure which, when combined with a program that is overwhelmingly based on rewards and educational procedures, enables JRC to take students off of all psychotropic medication, give them an education for the first time in their lives, and give them and their parents hope and optimism for their future where none had previously existed.
Without aversive therapy, the alternatives, for many of the students who are referred to JRC, are being heavily drugged with life-shortening and medically dangerous psychotropic medications,3 being warehoused in institutions or jails without receiving any treatment at all, being confined and/or frequently restrained in padded isolation rooms, bouncing in and out of psychiatric hospitals with no improvement, killing or maiming themselves or others with their own self-abusive behaviors or aggressive behaviors, or simply ending up homeless on the streets.
More Detailed Response
Jennifer Gonnerman's article "School of Shock" (Mother Jones, September/October 2007) is a biased and misleading account of the Judge Rotenberg Center ("JRC") that is best characterized as a hatchet job. Ms. Gonnerman persuaded JRC and the Parents of the JRC students to allow her to come to JRC and observe the school and the students by very cleverly and falsely pretending to be sympathetic to the cause of the JRC students and their parents. She asserted that she had read all the letters from the parents on the JRC web site and had cried while reading them. In addition, she represented that the article she was writing would be published in the New York Times Sunday Magazine, a magazine that has a reputation for printing serious, balanced, non-sensational articles. The Times even flew a very artistic photographer and assistant from San Francisco to do the photography. After the article was written it did not appear in the Times. When we asked Ms. Gonnerman why, she said the Times had rejected it because it was not of sufficiently national interest.
Now that we have seen the article, it seems more likely that the Times rejected the article as a biased, unfair and misleading hatchet job. Ms. Gonnerman has shamefully exploited the severely disabled JRC students and their parents. She ignores or glosses over JRC's treatment successes, all the evidence that supports the use of aversives, and the plight of its students before attending JRC. The many court victories won by the JRC parents to preserve the JRC treatment program are a matter of public record and should have been investigated by Mother Jones before the magazine printed Ms. Gonnerman's fallacious article.
This type of a dishonest article could have been written about any topic, no matter how benign. Ms. Gonnerman could have written such a negative article about freshman life at any university, for instance. She could write about the cramped and cluttered conditions of the dormitory, the terrible food, the homesickness, the late nights with little sleep, the incredible long lines at the registrar's office and the bookstore, the overcrowded classrooms, the high tuition, and the exposure to underage drinking. She could also add lies to further sensationalize her story, as she did with the JRC article, by reporting that most students cry themselves to sleep because they are so depressed and many are dangerously gaunt due to the bad food. Ms Gonnerman could make college sound like a horrible, abusive place by not mentioning all the positive aspects of college life—for example, all of the interesting subjects the students learn about, the exposure to talented and fascinating professors and other lecturers, exposure to the arts, learning how to do research and write on a college level, learning about and choosing a career, meeting and getting to know fellow students from around the world, meeting the people who will be friends for life, and learning how to live independently from their parents.
This distorted report of college life is similar to the distorted report of JRC that Ms. Gonnerman created. A fraudulent article about college life is not as harmful as a distorted report on JRC, however, because many people have attended college and will know right away that the article is dishonest. What makes Ms. Gonnerman's article so harmful and exploitive is the fact that only a tiny fraction of the population has had any exposure to severe behavior disorders. In order to understand JRC in its proper context, the following points must be made, none of which were explained in Ms. Gonnerman's article.
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. Consider, for example, just one type of behavior—self-abuse. Some special needs children referred to JRC have shown self-abusive behaviors such as banging their head to the point of brain damage, biting off their own fingertips, pulling out their teeth, vomiting and refusing food to the point of starvation, biting a hole through their cheek, biting off part of their own tongue, scratching their heel to the point of blood, bone infection and eventual death, breaking their own arm, cutting off their own earlobe with a scissor, running into moving traffic, punching their eyes causing detached retinas and blindness, pulling out their hair to the point of baldness, swallowing X-Acto knives, and cutting their skin with a knife so often that the skin becomes too tough to suture.
Children with such very severe problem behaviors usually cannot be successfully educated in public schools. When a public school encounters such a student, the school will refer the student to a psychiatric hospital or to a nonpublic, special needs school where the student is often not effectively treated. Instead, the student is usually drugged into a stupor. If students are given high enough dosages of psychotropic drugs, these drugs will sedate them so much that the students are incapable of hurting themselves or anyone else—but such students are also incapable of participating in education or even communicating with their family. These drugs also have many debilitating side-effects including kidney damage, liver damage, tremors, obesity, and lock jaw and many effects are permanent. Unfortunately many so-called experts in this field will refer to this drug stupefaction as a treatment success.
Other so-called effective treatments for severe behavior disorders that JRC has seen in the histories of newly admitted students include lobotomy, removal of teeth (for severe biters), constant seclusion, constant mechanical restraint, and many others that experts refer to as "more humane and effective" alternatives to JRC's aversive therapy procedures. The lack of effective alternatives and the sheer cruelty of drugging a child into a near coma is why parents turn to a non-public, special needs school such as the Judge Rotenberg Educational Center that is specially equipped to manage and educate the student, and has a proven track record of saving students from the ravages of constant heavy sedation. A real journalist would have mentioned these facts and, more importantly, investigated why the anti-aversive experts are hiding the fact that there are no effective treatment alternatives for severe behavior disorders. A real journalist would have asked why the JRC students have, prior to coming to JRC, spent so many wasted months or years sedated in a psychiatric ward and why their parents had to fight to get their child out of a psychiatric ward and into a special needs school such as JRC. Finally, a real journalist would have investigated why schools and clinicians fear being blackballed if they use, or admit to using aversives. As a result of this fear, children are forced to suffer with untreated painful behavior disorders, to receive no education and to have no social life of any kind.
Most nonpublic, special needs schools that try to educate and treat such students use rewards, education and positive-only procedures. Unfortunately, studies show that positive-only treatment procedures are effective in only 6o percent of the cases at most and cannot handle the most severe behavior problems.
Actually, although most nonpublic, special needs schools pride themselves on using "positive-only" treatment procedures, the truth is that such programs really do use aversives without calling them by that name. In other words, such schools use hidden aversives such as these:
Five to eight staff members wrestle the student to the floor, each time he/she is aggressive, and hold him/her there until he/she stops struggling. The procedure could last an hour or more. This is a procedure that JRC is able to eliminate entirely whenever it is able to use effective aversives such as the two-second skin-shock procedure.
If a student is aggressive, staff members may grab the student and take him/her, against his/her will, into a "time-out" isolation room and leave him/her there for a specified period of time. This is a procedure that JRC never uses.
Staff members may hold the student tightly (manual restraint) each time he/she is aggressive and thereby prevent the student from doing anything at all.
Staff members may grab the student forcefully by the shoulder or arm and squeeze hard while giving the student a so-called "physical prompt" to engage in a certain action.
Staff members may force the student to engage in some physical action against the student's will over and over. This is called "overcorrection" or "positive practice" but it will only work to decelerate a behavior if it done in a manner that is aversive.
JRC does not use hidden aversives such as these preferring, instead, the more honest course of using fully-disclosed and more effective aversives such as skin-shock.
The typical nonpublic, special needs school will, in addition to the use of such hidden aversives, have a psychiatrist prescribe large quantities and a wide variety of psychotropic drugs to students with severe behavior problems. If a student is given enough drugs, he or she will essentially be put into a drug-induced stupor for much or all of the day. Such medication can be so drugging that the student may not be able to recognize his own parents and might fall face-first into his food at mealtime. Unfortunately, for some students even large quantities of drugs are insufficient to control their aggressive or self-abusive behaviors. By contrast, JRC's policy is to avoid totally, or at least minimize, the use of psychotropic medication.
For some students the typical nonpublic special needs school may find that if the school places no educational or behavioral demands on the student, the student will refrain from aggression, self-abuse or destructive behaviors. If this is the case, such a school may choose to solve the problem by essentially "warehousing" the student—i.e., keeping the student safe and adequately fed, but not undertaking any serious attempt to educate the student or change the student's behaviors.
In extreme circumstances, the typical nonpublic, special needs school might do things such as call in the police to handcuff the student when he or she is aggressive, or send the student to a psychiatric hospital. JRC never calls in the police to deal with aggressive or otherwise disruptive students and JRC is an effective alternative to psychiatric hospitals.
In the case of certain students with case-hardened problem behaviors, the school may try all of the above procedures—positive-only procedures, hidden aversives, seclusion, restraint, drugs, warehousing, calling in the police and sending the student to a psychiatric hospital—and may find that none of them are successful in controlling the student's problem behavior. In addition, the school may at some point simply tire of seeing the student continually harm the school's staff members, other students, and property. At that point many such schools will expel the student. Sometimes, however, some students are aggressive even to their own parents. Consequently, at that point the parents, may even be unable or afraid to allow the students to come home. This leaves the parent with essentially no options. Such students are then left to live in the street, to languish in homeless shelters, to bounce in and out of psychiatric hospitals again or to commit some offense and be jailed. These students, i.e., those who are expelled from such schools that use positive-only treatment procedures, are the ones that are referred to JRC, where they finally can receive effective treatment.
Before JRC uses aversives with any student, only positive and educative procedures are employed for an average of 11 months to try to change serious problematic behaviors. The positive procedures that JRC employs include many rewarding and educational procedures. The extent and variety of the reward systems at JRC will not be found at any other program. They include the following:
- an all school arcade-type reward lounge
- a retail store in which students can purchase desired items for themselves or others
- a reward corner in many of the classrooms in which the student can relax, watch tv, play games, etc.
- a reward box in many classrooms containing items that students can earn through their behaviors
- a reward afternoon once per week that features a barbecue and games; (6) frequent field trips used as rewards
- electronic game devices in each bedroom
- opportunities to order food out from local restaurants
- internet usage
- a student discussion board
- various sports activities, etc.
JRC's positive and educational procedures alone are currently effective with about half of its school-age students. For the other half, however, positive and educational procedures need to be supplemented with the use of a brief aversive. The most effective aversive available is a two-second, harmless shock to the surface of the skin, typically of the arm or leg. It is extremely effective. For example, in treating aggression, we are able to accomplish a 95 percent reduction in 96 percent of the cases, within a matter of weeks. As a result, students can begin to receive an education and benefit from positive programming for the first time in their lives. Unlike drugs, the treatment has no significant side effects and the treatment can be discontinued for many students as their behavior improves. Parents and students describe the improvement as life-saving.
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. More information about these safeguards may be found on JRC's website.
Only a minority (43 percent) of JRC's school-age students are currently receiving skin shock treatment. And for those who are being treated with skin-shock, the average student receives only one application per week. More information about the frequency with which skin-shock is used at JRC may be found on JRC's website.
To summarize:
JRC treats severe problem behaviors of special needs children and adults who have failed in every other program that has been tried with them.
Programs that use "positive-only" treatment procedures expel students with really severe behavior problems and these students are often then referred to JRC.
JRC removes students from psychotropic drugs and applies a highly consistent behavioral program of positive rewards and educational procedures for an average of 11 months before considering the use of any aversive.
If rewards and educational procedures alone prove to be insufficiently effective, they are supplemented, when necessary, with a two-second shock to the surface of the skin, used as a corrective consequence for the problem behavior.
Before employing skin-shock, JRC obtains consent from the child's parent and individualized approval from a probate court judge, a physician, a psychiatrist, a peer review committee and a human rights committee.
JRC's skin-shock procedure is extremely effective, has no significant side effects and can be removed entirely in many cases as the student's behavior improves
JRC's positive behavioral program is so effective that the skin shock procedure is currently being used for only 43 percent of JRC's school-age students
JRC's treatment enables its students to do the following: stop taking harmful psychotropic drugs; avoid restraint, seclusion, warehousing and takedowns; avoid having to be placed in psychiatric hospitals or arrested by police for aggression and other destructive behaviors; start learning in school for the first time in their lives; avoid death or self-maiming by receiving effective and rapid treatment of self-abusive behaviors; have hope and optimism for their future where previous there was none; and enjoy the company of their parents and family for the first time in years.
Additional Comments from Matthew Israel
The title page sets the tone of the article by referring to JRC as a "School of Shock." The overwhelming reliance at JRC is on positive rewards and educational programs and ninety nine percent or more of a student's time is spent in educational and rewarding experiences. Less than half of the school-age students at JRC have parent- and court-approved supplementary skin shock as a possible treatment option in their treatment programs. Those that do receive an average of one harmless (no significant side effects) two-second application to the surface of the skin, usually of the arm or leg, per week. As time goes on, many are able to graduate completely from needing this therapy.
The title page contains the phrase "Food Deprivation." Food deprivation is never used as a punishment at JRC. In the case of a small number of students food is used, with full parental and court approval, in the form of "mini-meals" that are earned as rewards in the the training of new skills. When this is done, elaborate steps are taken to either provide make-up meals at the end of the day or to otherwise insure proper nutrition and avoid any weight loss.
The title page contains the word "Isolation." Isolation is never used as a punishment at JRC.
The title page says "Treats American kids like enemy combatants." This statement, like the cover material and drawing, reflects an attempt to sensationalize JRC's treatment and evidences a refusal to recognize the use of supplementary aversives as a scientifically proven and accepted form of behavioral treatment.
The cover page shows a child in an Abu Ghraib torture-type position on a box with wires leading from the hands. Skin-shock is never used at JRC in the manner depicted in that drawing and is never used for the purpose implied (torture). Skin-shock is used at JRC as one small part of a behavior modification treatment program, based overwhelmingly on positive rewards and educational procedures, to help save and extend lives, to take students off of psychotropic drugs, and to help youngsters turn their lives around. Students whose problematic behaviors were so great that they were expelled or refused admission to every other available school, and who were headed for a prematurely short or miserable life of drugs, restraint and warehousing in a psychiatric hospital, in an institution, in a jail or on the streets are, through effective education and treatment at JRC based on scientifically-validated behavior modification procedures, given hope and optimism for their future where previously they had none. To compare this with Abu Ghraib-type torture is like equating a surgeon's use of a knife in life-saving surgery to a felon's use of a knife in a murderous stabbing.
JRC has a unique set of rewarding features that is found in no other program. These rewards start with beautifully decorated school buildings that make coming to school a visually interesting and rewarding experience (many of our students have refused to attend school in the past). It continues with: an arcade-type Rewards Lounge; a "retail store" where students can purchase attractive personal items with the money they earn each week by displaying appropriate behaviors and learning; a lounge/reward corner in many classrooms; a reward afternoon once per week; Reward Boxes in many classrooms that contain desired items that students can earn each day; a personal computer and self-instructional software for every student; frequent field trips used as rewards; healthy and nutritional foods and no junk foods and soda machines; health-club type exercise facilities; community residences with wide-screen televisions, stereos and electronic games; and an open visiting policy in which parents or visitors can visit at any time of the day or night. To imply that a program that does all this for its students and parents is similar to the Abu Ghraib prison, as the cover and text of this article does, is to perpetuate a journalistic fraud on the readers.
The article devotes the initial two pages to two former students whose parents changed their minds and decided to remove their son from JRC. JRC parents are always free to change their minds and withdraw their consent to JRC to employ aversives with their child. In both of the cases Ms. Gonnerman describes, the students made major progress while they attended JRC (a fact not reported by Ms. Gonnerman), and were removed prematurely before their treatment had been completed. The overwhelming majority of JRC parents have been extremely positive about JRC and thankful for the changes they have seen in their children. The fact that the first two pages focus on two former parents or students who have no verifiable evidence that the JRC program caused them any harm is further evidence of the bias that pervades the article.
"To change their behavior, he developed a large repertoire of punishments..." Here, as in the article as a whole, there is a failure to give adequate space to JRC's innovative and wide-ranging use of rewards and educational procedures, which is the background against which aversives are introduced, if needed in some cases, as an occasional (once per week, on average) supplement in the programs of a minority of our school-age students. No mention is made of the fact that all of these aversive procedures were parent- and court-approved.
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 this student's death which was from natural causes.
"Three quarters of the articles were published more than 20 years ago…" Ms. Gonnerman fails to explain that the reason for the decrease in the number of recent professional articles dealing with skin-shock is that the procedure has become increasingly controversial during the last few decades. During the past 10 years, however, five papers involving the clinical use of skin shock, or reviewing research in which skin shock has been used, have appeared in the professional literature
Ms. Gonnerman presents negative comments about JRC or me from three psychologists, Drs. Axelrod, Iwata and Touchette. One of these (Dr. Touchette) has never visited JRC and the others (Drs. Iwata and Axelrod) have not visited JRC during the last 12 and 18 years respectively. Ms. Gonnerman never asked me to provide her with the names of psychologists who support the use of aversives and who have taken the time to visit the current JRC program and observe our current treatment at first-hand.
In a sidebar that appears on the Mother Jones web site, but not in the printed article, Dr. Iwata criticizes us for not using his approach to functional analysis/assessment. We are aware of Dr. Iwata's approach and have tried it at JRC. The main problem is that the students who come to JRC have, by and large, already had the benefit of extensive functional analysis/assessment and despite this still have major behavior problems that were not solved with this approach alone. In that respect the situation is similar to the use of psychotropic drugs—the students who come to JRC have already been treated with psychotropic drugs and the drugs have been found insufficient. Despite this, JRC does do a comprehensive functional assessment of each student and takes the results into account in designing a program for the student and in designing the general treatment procedures employed in JRC's program. In a comprehensive review of the literature on Positive Behavior Support, an approach that is opposed to the use of aversives, Carr et al found that the studies that use positive-only treatment procedures, even when functional analysis is included, were effective in only 60 percent of the cases. JRC's population is largely taken from the remaining 40 percent.
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. They are not allowed to socialize with each other in the classroom, however, which is the rule in most schools.
A former teacher, Jessica Croteau, complains of the fact that a lot of the education at JRC takes place through self-instructional software and personal computers. This is a very valuable application of behavioral psychology to education and is probably unique to JRC, where each student is given his/her own computer. Most of our teachers, parents and students value this self-instructional aspect of the program very much, which is provided in addition to classroom discussion. Their point of view was not presented. Why did Ms. Gonnerman not interview some former teachers who are positive about our program?
Former student Rob Santana made great progress while at JRC which was a huge improvement when compared to his plight prior to his admission to JRC. It is unfortunate that Rob's parent chose to remove him from JRC prematurely and it is unfortunate that he has been arrested and jailed since his discharge from JRC.
Ms. Gonnerman complains that she did not have the opportunity to speak privately with JRC's students. She never asked for such opportunities.
Ms. Gonnerman objects to the fact that direct care staff members are not given the authority and flexibility to decide when to apply skin shocks and when not to. But to allow that to happen would mean that the treatment would not be applied consistently as it must be in order to be effective. More importantly, to allow that would be similar to allowing nurses in a hospital to decide whether and how much medication should be administered, instead of keeping such decisions under the control of the supervising physician. Direct care staff at JRC are encouraged and required to convey suggestions and concerns about treatment to the student's treatment team at JRC, but the final decision as to what behaviors need to be treated with an aversive, and when this treatment should be administered, is properly placed under the control of the supervising clinician.
Ms. Gonnerman objects to the fact that JRC discourages staff members from socializing with each other while on duty. It is vital, however, that the staff members give their undivided attention to the students. If a staff member socializes with other staff members when he or she should be attending to the students, this can create an unsafe situation.
Ms. Gonnerman interviewed eight former staff members who were critical of how the GED was used. These alleged witnesses have no credibility because they refused to be identified. Furthermore, how did she happen to choose these former staff members and why did she not interview some of the many former staff members who are not critical? She did not ask JRC to recommend any former or current employees for possible interviews.
Ms. Gonnerman makes much of the June 2006 New York State Department of Education Report that contained numerous criticisms of JRC. She fails to mention the fact that subsequent to that report three Massachusetts agencies have investigated JRC and found no support for the major findings of that report.
The squib about Ms. Gonnerman characterized her article as resulting from a "yearlong investigation." In fact her "investigation" was both brief and one-sided. She spent only two days visiting JRC in September of 2006 and did not witness even a single application of skin-shock to a student (despite giving the incorrect impression in her article that such applications are frequent occurrences). She went to great lengths to interview hostile former parents, teachers and staff (eight disgruntled former staff members—one for eight hours—out of thousands of possible former JRC staff members). She failed to interview any former parents, teachers and staff members with favorable opinions about JRC. Ms. Gonnerman devoted 10 column inches to describing students who died from natural causes entirely unrelated to their treatment (one 26 years ago and not even a JRC student, one 22 years ago, and one 17 years ago), but no column inches at all to students whose lives have been saved by JRC's treatment procedures and no column inches to the case of a former JRC student (a case that I brought to her attention) who died from inadequately treated self-abuse when he was abruptly transferred from JRC to a program that used positive-only procedures.
She failed to inform the reader that all large treatment facilities for the severely disabled experience deaths, especially facilities like JRC that have been in operation for over 35 years and that treat the most fragile and dangerous population. JRC actually has experienced very few deaths, all of which were investigated by the proper state authorities, and none of which were found to be caused by JRC's treatment program. She devoted 36 column inches to three disgruntled former parents and only 4 inches to parents who are among the hundreds who are extremely favorable to JRC. We heard no reports of her speaking to any supportive JRC parents other than the few that she interviewed for an hour or two during her visit to JRC.
Ms. Gonnerman's article was originally written for the New York Times Sunday Magazine. The Times rejected it, a fact that she learned in early April of this year. She then apparently tried to find some other magazine which would buy the article. Consequently, much of the so-called "year-long investigation" was probably spent in trying to find a magazine willing to publish such a biased story.
Ms. Gonnerman's objective (which the Mother Jones editors joined in on) was apparently to incite opposition to JRC and agitate for laws to prohibit aversives. At least one mother was not persuaded as evidenced from this email that was sent to the JRC website recently.
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
October 5, 2007
RESPONSE TO JENNIFER GONNERMAN'S ARTICLE, "SCHOOL OF SHOCK"
Matthew Israel
Response
Every surgical, dental or medical treatment involves discomfort, risks or costs on the one hand, and expected benefits on the other. For most persons a reasonable approach is to weigh the discomfort/risks/costs against the potential benefits in deciding whether to undergo or approve the treatment. In the case of certain treatments, however, there are some persons who, for religious or philosophical reasons, are unwilling to weigh the negative aspects of those treatments against the potential benefits. These persons view the treatment in question as Wrong with a capital "W," regardless of the potential benefits the treatment might produce. For example, Christian Scientists oppose the use of medical interventions, and Scientologists oppose the use of psychiatric drugs, regardless of what potential benefits may ensue.
Opponents of behavior modification treatment that involves aversives (sometimes referred to as "aversive therapy") are similarly unwilling to weigh the discomfort, risks or costs associated with aversives against the potential benefits—even when those benefits could be lifesaving, life-improving or life-extending. Such persons prefer to brand aversives as "Wrong," refusing to recognize them as part of a relatively new behavior modification treatment procedure2, and many of them sometimes do whatever they can to prevent anyone else from using them. It is clear from Ms. Gonnerman's article that she is one of those persons.
Ms. Gonnerman is so intent on indicting the Judge Rotenberg Center ("JRC"), the only special needs school in the country that offers this form of therapy, that she violates the normal journalistic ethics of presenting both sides of a controversial issue. Out of a total of 265 column inches that her article occupies, only 15 inches (six percent of the article) presents any of the benefits of JRC's treatment. Even those few accounts of parents (characterized as "desperate parents") or students who speak positively about JRC are presented with snide comments, disparaged by unfavorable observations or reported in the least favorable light possible. For a more accurate picture of JRC, the reader is encouraged to consult http://www.judgerc.org/introtojrc.html. Ms. Gonnerman grossly misrepresents JRC's treatment. The treatment is overwhelmingly based on an innovative, unique and comprehensive system of rewards and behaviorally-designed educational procedures that feature self-instructional software that each student accesses through his or her own computer. The treatment eliminates or minimizes the use of psychotropic drugs—a form of treatment that is far more dangerous and intrusive than anything done at JRC.
Aversives, in the form of a brief, two-second skin shock to the surface of, typically, the arm or leg, are added to this treatment for only certain extremely difficult-to-treat behaviors of that have failed to respond to positive-only treatment in the student's previous placements as well as at JRC. The procedure feels like a hard pinch and, unlike the heavy and often ineffective psychotropic drugging that this procedure typically replaces, has no negative side effects. Rewards and educational procedures alone are tried for an average of 11 months at JRC before JRC considers the addition of aversives. In addition, the use of aversives has to be pre-approved, on an individual basis, by the child's school system (through the IEP process), the parent, a physician, a psychiatrist, a human rights committee, a peer review committee and a Massachusetts Probate Court judge.
Currently, only a minority of JRC's school-age students receive skin shock as an aversive and even in these cases its use is very infrequent, less than once per week in the average case. In many cases the student progresses so well with this treatment that the aversives can eventually be removed entirely and the student can be returned to his/her local school system.
Ms. Gonnerman devotes extensive space at the very beginning of her article to the stories of two students whose parents became dissatisfied with JRC and withdrew their students (a routine event in every residential school). No comparable space is given to the hundreds of students whose parents are thrilled with the changes in their children that JRC was able to accomplish and that no previous program was able to achieve. Ms. Gonnerman also devotes space to the fact that during JRC's 35-year history, a few students have died from natural causes that had nothing to do with the treatment they received at JRC. The only apparent purpose of this inclusion is to cast negative aspersions on JRC that have no basis in fact. The reader is not told that JRC has a unique no-rejection, no-expulsion policy that means it accepts students who have pre-existing, life-shortening medical conditions.
Ms. Gonnerman reports on the views of a few psychologists who are opposed to JRC's treatment. No space is given to the many psychologists who admire JRC's work and who wish their own agency had the ability to provide the treatment procedures that JRC is able to offer. Ms. Gonnerman publishes anonymous critical comments made by some former employees of JRC, eight of whom she interviewed. One of these was probably Greg Miller, a disgruntled former employee who appeared with Ms. Gonnerman on National Public Radio , a piece that was stimulated by her article. Mr. Miller worked enthusiastically for JRC for three years during which he failed to raise any objections to JRC's treatment to anyone. If he had seen anything abusive and failed to report it while employed at JRC, he violated his duty to report any suspected abuse to the appropriate state agency. After three years of employment, he was disciplined for insubordinate actions and then promptly resigned. No space is given to the hundreds or thousands of current or former staff members who have positive things to say about JRC.
The reader is not told that JRC is the only program in the country that is able to offer effective, lifesaving treatment to students with severe self-abuse and aggression or that other programs that try to serve such students, but which are unable to serve them successfully, often expel those students and refer them to JRC for successful treatment (see here).
Ms. Gonnerman objects to JRC's use of aversive therapy to treat the self-destructive or aggressive behaviors of "higher functioning" special needs students who have the ability to speak and interact normally. Yet these students are often the most eloquent defenders of this therapy; many credit it with saving their lives or turning their lives around in a positive direction. Why prevent such youngsters from benefiting from this therapy just because they have relatively normal cognitive functioning? Normal adults can obtain aversive therapy from a psychologist to treat behavior problems such as excessive smoking, gambling or eating. Why should special needs students with normal cognitive functioning be unable to obtain aversive therapy for their particular behavior problems?
Ms. Gonnerman quotes from an inaccurate report by the New York State Education Department, but does not tell the reader that it was prepared as part of a campaign to deny New York students the possibility of benefiting from aversive therapy—a campaign that is currently being challenged in federal court by 50 JRC parents from New York State. She also fails to note that three Massachusetts agencies have investigated JRC and found no support for the major findings of that report. Ms. Gonnerman objects to the fact that effective behavioral treatment requires aggressive treatment of the earliest recognizable stages of problematic behaviors and of the behaviors that typically precede problem behaviors ("antecedents") even though those behaviors may, if viewed out of context, appear to be benign. This practice is comparable to the need to provide early detection and treatment for cancer and other serious diseases. The early forms of such diseases may look benign, but if left untreated can grow into life-threatening forms. The same is true of certain seriously problematic behaviors.
And, most important, Ms. Gonnerman fails to put the risks/intrusiveness of aversive therapy with skin-shock into proper perspective. Behavioral treatment with skin shock at JRC involves a brief, two-second period of discomfort that has no significant side effects. It is a procedure which, when combined with a program that is overwhelmingly based on rewards and educational procedures, enables JRC to take students off of all psychotropic medication, give them an education for the first time in their lives, and give them and their parents hope and optimism for their future where none had previously existed.
Without aversive therapy, the alternatives, for many of the students who are referred to JRC, are being heavily drugged with life-shortening and medically dangerous psychotropic medications,3 being warehoused in institutions or jails without receiving any treatment at all, being confined and/or frequently restrained in padded isolation rooms, bouncing in and out of psychiatric hospitals with no improvement, killing or maiming themselves or others with their own self-abusive behaviors or aggressive behaviors, or simply ending up homeless on the streets.
More Detailed Response
Jennifer Gonnerman's article "School of Shock" (Mother Jones, September/October 2007) is a biased and misleading account of the Judge Rotenberg Center ("JRC") that is best characterized as a hatchet job. Ms. Gonnerman persuaded JRC and the Parents of the JRC students to allow her to come to JRC and observe the school and the students by very cleverly and falsely pretending to be sympathetic to the cause of the JRC students and their parents. She asserted that she had read all the letters from the parents on the JRC web site and had cried while reading them. In addition, she represented that the article she was writing would be published in the New York Times Sunday Magazine, a magazine that has a reputation for printing serious, balanced, non-sensational articles. The Times even flew a very artistic photographer and assistant from San Francisco to do the photography. After the article was written it did not appear in the Times. When we asked Ms. Gonnerman why, she said the Times had rejected it because it was not of sufficiently national interest.
Now that we have seen the article, it seems more likely that the Times rejected the article as a biased, unfair and misleading hatchet job. Ms. Gonnerman has shamefully exploited the severely disabled JRC students and their parents. She ignores or glosses over JRC's treatment successes, all the evidence that supports the use of aversives, and the plight of its students before attending JRC. The many court victories won by the JRC parents to preserve the JRC treatment program are a matter of public record and should have been investigated by Mother Jones before the magazine printed Ms. Gonnerman's fallacious article.
This type of a dishonest article could have been written about any topic, no matter how benign. Ms. Gonnerman could have written such a negative article about freshman life at any university, for instance. She could write about the cramped and cluttered conditions of the dormitory, the terrible food, the homesickness, the late nights with little sleep, the incredible long lines at the registrar's office and the bookstore, the overcrowded classrooms, the high tuition, and the exposure to underage drinking. She could also add lies to further sensationalize her story, as she did with the JRC article, by reporting that most students cry themselves to sleep because they are so depressed and many are dangerously gaunt due to the bad food. Ms Gonnerman could make college sound like a horrible, abusive place by not mentioning all the positive aspects of college life—for example, all of the interesting subjects the students learn about, the exposure to talented and fascinating professors and other lecturers, exposure to the arts, learning how to do research and write on a college level, learning about and choosing a career, meeting and getting to know fellow students from around the world, meeting the people who will be friends for life, and learning how to live independently from their parents.
This distorted report of college life is similar to the distorted report of JRC that Ms. Gonnerman created. A fraudulent article about college life is not as harmful as a distorted report on JRC, however, because many people have attended college and will know right away that the article is dishonest. What makes Ms. Gonnerman's article so harmful and exploitive is the fact that only a tiny fraction of the population has had any exposure to severe behavior disorders. In order to understand JRC in its proper context, the following points must be made, none of which were explained in Ms. Gonnerman's article.
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. Consider, for example, just one type of behavior—self-abuse. Some special needs children referred to JRC have shown self-abusive behaviors such as banging their head to the point of brain damage, biting off their own fingertips, pulling out their teeth, vomiting and refusing food to the point of starvation, biting a hole through their cheek, biting off part of their own tongue, scratching their heel to the point of blood, bone infection and eventual death, breaking their own arm, cutting off their own earlobe with a scissor, running into moving traffic, punching their eyes causing detached retinas and blindness, pulling out their hair to the point of baldness, swallowing X-Acto knives, and cutting their skin with a knife so often that the skin becomes too tough to suture.
Children with such very severe problem behaviors usually cannot be successfully educated in public schools. When a public school encounters such a student, the school will refer the student to a psychiatric hospital or to a nonpublic, special needs school where the student is often not effectively treated. Instead, the student is usually drugged into a stupor. If students are given high enough dosages of psychotropic drugs, these drugs will sedate them so much that the students are incapable of hurting themselves or anyone else—but such students are also incapable of participating in education or even communicating with their family. These drugs also have many debilitating side-effects including kidney damage, liver damage, tremors, obesity, and lock jaw and many effects are permanent. Unfortunately many so-called experts in this field will refer to this drug stupefaction as a treatment success.
Other so-called effective treatments for severe behavior disorders that JRC has seen in the histories of newly admitted students include lobotomy, removal of teeth (for severe biters), constant seclusion, constant mechanical restraint, and many others that experts refer to as "more humane and effective" alternatives to JRC's aversive therapy procedures. The lack of effective alternatives and the sheer cruelty of drugging a child into a near coma is why parents turn to a non-public, special needs school such as the Judge Rotenberg Educational Center that is specially equipped to manage and educate the student, and has a proven track record of saving students from the ravages of constant heavy sedation. A real journalist would have mentioned these facts and, more importantly, investigated why the anti-aversive experts are hiding the fact that there are no effective treatment alternatives for severe behavior disorders. A real journalist would have asked why the JRC students have, prior to coming to JRC, spent so many wasted months or years sedated in a psychiatric ward and why their parents had to fight to get their child out of a psychiatric ward and into a special needs school such as JRC. Finally, a real journalist would have investigated why schools and clinicians fear being blackballed if they use, or admit to using aversives. As a result of this fear, children are forced to suffer with untreated painful behavior disorders, to receive no education and to have no social life of any kind.
Most nonpublic, special needs schools that try to educate and treat such students use rewards, education and positive-only procedures. Unfortunately, studies show that positive-only treatment procedures are effective in only 6o percent of the cases at most and cannot handle the most severe behavior problems.
Actually, although most nonpublic, special needs schools pride themselves on using "positive-only" treatment procedures, the truth is that such programs really do use aversives without calling them by that name. In other words, such schools use hidden aversives such as these:
Five to eight staff members wrestle the student to the floor, each time he/she is aggressive, and hold him/her there until he/she stops struggling. The procedure could last an hour or more. This is a procedure that JRC is able to eliminate entirely whenever it is able to use effective aversives such as the two-second skin-shock procedure.
If a student is aggressive, staff members may grab the student and take him/her, against his/her will, into a "time-out" isolation room and leave him/her there for a specified period of time. This is a procedure that JRC never uses.
Staff members may hold the student tightly (manual restraint) each time he/she is aggressive and thereby prevent the student from doing anything at all.
Staff members may grab the student forcefully by the shoulder or arm and squeeze hard while giving the student a so-called "physical prompt" to engage in a certain action.
Staff members may force the student to engage in some physical action against the student's will over and over. This is called "overcorrection" or "positive practice" but it will only work to decelerate a behavior if it done in a manner that is aversive.
JRC does not use hidden aversives such as these preferring, instead, the more honest course of using fully-disclosed and more effective aversives such as skin-shock.
The typical nonpublic, special needs school will, in addition to the use of such hidden aversives, have a psychiatrist prescribe large quantities and a wide variety of psychotropic drugs to students with severe behavior problems. If a student is given enough drugs, he or she will essentially be put into a drug-induced stupor for much or all of the day. Such medication can be so drugging that the student may not be able to recognize his own parents and might fall face-first into his food at mealtime. Unfortunately, for some students even large quantities of drugs are insufficient to control their aggressive or self-abusive behaviors. By contrast, JRC's policy is to avoid totally, or at least minimize, the use of psychotropic medication.
For some students the typical nonpublic special needs school may find that if the school places no educational or behavioral demands on the student, the student will refrain from aggression, self-abuse or destructive behaviors. If this is the case, such a school may choose to solve the problem by essentially "warehousing" the student—i.e., keeping the student safe and adequately fed, but not undertaking any serious attempt to educate the student or change the student's behaviors.
In extreme circumstances, the typical nonpublic, special needs school might do things such as call in the police to handcuff the student when he or she is aggressive, or send the student to a psychiatric hospital. JRC never calls in the police to deal with aggressive or otherwise disruptive students and JRC is an effective alternative to psychiatric hospitals.
In the case of certain students with case-hardened problem behaviors, the school may try all of the above procedures—positive-only procedures, hidden aversives, seclusion, restraint, drugs, warehousing, calling in the police and sending the student to a psychiatric hospital—and may find that none of them are successful in controlling the student's problem behavior. In addition, the school may at some point simply tire of seeing the student continually harm the school's staff members, other students, and property. At that point many such schools will expel the student. Sometimes, however, some students are aggressive even to their own parents. Consequently, at that point the parents, may even be unable or afraid to allow the students to come home. This leaves the parent with essentially no options. Such students are then left to live in the street, to languish in homeless shelters, to bounce in and out of psychiatric hospitals again or to commit some offense and be jailed. These students, i.e., those who are expelled from such schools that use positive-only treatment procedures, are the ones that are referred to JRC, where they finally can receive effective treatment.
Before JRC uses aversives with any student, only positive and educative procedures are employed for an average of 11 months to try to change serious problematic behaviors. The positive procedures that JRC employs include many rewarding and educational procedures. The extent and variety of the reward systems at JRC will not be found at any other program. They include the following:
- an all school arcade-type reward lounge
- a retail store in which students can purchase desired items for themselves or others
- a reward corner in many of the classrooms in which the student can relax, watch tv, play games, etc.
- a reward box in many classrooms containing items that students can earn through their behaviors
- a reward afternoon once per week that features a barbecue and games; (6) frequent field trips used as rewards
- electronic game devices in each bedroom
- opportunities to order food out from local restaurants
- internet usage
- a student discussion board
- various sports activities, etc.
JRC's positive and educational procedures alone are currently effective with about half of its school-age students. For the other half, however, positive and educational procedures need to be supplemented with the use of a brief aversive. The most effective aversive available is a two-second, harmless shock to the surface of the skin, typically of the arm or leg. It is extremely effective. For example, in treating aggression, we are able to accomplish a 95 percent reduction in 96 percent of the cases, within a matter of weeks. As a result, students can begin to receive an education and benefit from positive programming for the first time in their lives. Unlike drugs, the treatment has no significant side effects and the treatment can be discontinued for many students as their behavior improves. Parents and students describe the improvement as life-saving.
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. More information about these safeguards may be found on JRC's website.
Only a minority (43 percent) of JRC's school-age students are currently receiving skin shock treatment. And for those who are being treated with skin-shock, the average student receives only one application per week. More information about the frequency with which skin-shock is used at JRC may be found on JRC's website.
To summarize:
JRC treats severe problem behaviors of special needs children and adults who have failed in every other program that has been tried with them.
Programs that use "positive-only" treatment procedures expel students with really severe behavior problems and these students are often then referred to JRC.
JRC removes students from psychotropic drugs and applies a highly consistent behavioral program of positive rewards and educational procedures for an average of 11 months before considering the use of any aversive.
If rewards and educational procedures alone prove to be insufficiently effective, they are supplemented, when necessary, with a two-second shock to the surface of the skin, used as a corrective consequence for the problem behavior.
Before employing skin-shock, JRC obtains consent from the child's parent and individualized approval from a probate court judge, a physician, a psychiatrist, a peer review committee and a human rights committee.
JRC's skin-shock procedure is extremely effective, has no significant side effects and can be removed entirely in many cases as the student's behavior improves
JRC's positive behavioral program is so effective that the skin shock procedure is currently being used for only 43 percent of JRC's school-age students
JRC's treatment enables its students to do the following: stop taking harmful psychotropic drugs; avoid restraint, seclusion, warehousing and takedowns; avoid having to be placed in psychiatric hospitals or arrested by police for aggression and other destructive behaviors; start learning in school for the first time in their lives; avoid death or self-maiming by receiving effective and rapid treatment of self-abusive behaviors; have hope and optimism for their future where previous there was none; and enjoy the company of their parents and family for the first time in years.
Additional Comments from Matthew Israel
The title page sets the tone of the article by referring to JRC as a "School of Shock." The overwhelming reliance at JRC is on positive rewards and educational programs and ninety nine percent or more of a student's time is spent in educational and rewarding experiences. Less than half of the school-age students at JRC have parent- and court-approved supplementary skin shock as a possible treatment option in their treatment programs. Those that do receive an average of one harmless (no significant side effects) two-second application to the surface of the skin, usually of the arm or leg, per week. As time goes on, many are able to graduate completely from needing this therapy.
The title page contains the phrase "Food Deprivation." Food deprivation is never used as a punishment at JRC. In the case of a small number of students food is used, with full parental and court approval, in the form of "mini-meals" that are earned as rewards in the the training of new skills. When this is done, elaborate steps are taken to either provide make-up meals at the end of the day or to otherwise insure proper nutrition and avoid any weight loss.
The title page contains the word "Isolation." Isolation is never used as a punishment at JRC.
The title page says "Treats American kids like enemy combatants." This statement, like the cover material and drawing, reflects an attempt to sensationalize JRC's treatment and evidences a refusal to recognize the use of supplementary aversives as a scientifically proven and accepted form of behavioral treatment.
The cover page shows a child in an Abu Ghraib torture-type position on a box with wires leading from the hands. Skin-shock is never used at JRC in the manner depicted in that drawing and is never used for the purpose implied (torture). Skin-shock is used at JRC as one small part of a behavior modification treatment program, based overwhelmingly on positive rewards and educational procedures, to help save and extend lives, to take students off of psychotropic drugs, and to help youngsters turn their lives around. Students whose problematic behaviors were so great that they were expelled or refused admission to every other available school, and who were headed for a prematurely short or miserable life of drugs, restraint and warehousing in a psychiatric hospital, in an institution, in a jail or on the streets are, through effective education and treatment at JRC based on scientifically-validated behavior modification procedures, given hope and optimism for their future where previously they had none. To compare this with Abu Ghraib-type torture is like equating a surgeon's use of a knife in life-saving surgery to a felon's use of a knife in a murderous stabbing.
JRC has a unique set of rewarding features that is found in no other program. These rewards start with beautifully decorated school buildings that make coming to school a visually interesting and rewarding experience (many of our students have refused to attend school in the past). It continues with: an arcade-type Rewards Lounge; a "retail store" where students can purchase attractive personal items with the money they earn each week by displaying appropriate behaviors and learning; a lounge/reward corner in many classrooms; a reward afternoon once per week; Reward Boxes in many classrooms that contain desired items that students can earn each day; a personal computer and self-instructional software for every student; frequent field trips used as rewards; healthy and nutritional foods and no junk foods and soda machines; health-club type exercise facilities; community residences with wide-screen televisions, stereos and electronic games; and an open visiting policy in which parents or visitors can visit at any time of the day or night. To imply that a program that does all this for its students and parents is similar to the Abu Ghraib prison, as the cover and text of this article does, is to perpetuate a journalistic fraud on the readers.
The article devotes the initial two pages to two former students whose parents changed their minds and decided to remove their son from JRC. JRC parents are always free to change their minds and withdraw their consent to JRC to employ aversives with their child. In both of the cases Ms. Gonnerman describes, the students made major progress while they attended JRC (a fact not reported by Ms. Gonnerman), and were removed prematurely before their treatment had been completed. The overwhelming majority of JRC parents have been extremely positive about JRC and thankful for the changes they have seen in their children. The fact that the first two pages focus on two former parents or students who have no verifiable evidence that the JRC program caused them any harm is further evidence of the bias that pervades the article.
"To change their behavior, he developed a large repertoire of punishments..." Here, as in the article as a whole, there is a failure to give adequate space to JRC's innovative and wide-ranging use of rewards and educational procedures, which is the background against which aversives are introduced, if needed in some cases, as an occasional (once per week, on average) supplement in the programs of a minority of our school-age students. No mention is made of the fact that all of these aversive procedures were parent- and court-approved.
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 this student's death which was from natural causes.
"Three quarters of the articles were published more than 20 years ago…" Ms. Gonnerman fails to explain that the reason for the decrease in the number of recent professional articles dealing with skin-shock is that the procedure has become increasingly controversial during the last few decades. During the past 10 years, however, five papers involving the clinical use of skin shock, or reviewing research in which skin shock has been used, have appeared in the professional literature
Ms. Gonnerman presents negative comments about JRC or me from three psychologists, Drs. Axelrod, Iwata and Touchette. One of these (Dr. Touchette) has never visited JRC and the others (Drs. Iwata and Axelrod) have not visited JRC during the last 12 and 18 years respectively. Ms. Gonnerman never asked me to provide her with the names of psychologists who support the use of aversives and who have taken the time to visit the current JRC program and observe our current treatment at first-hand.
In a sidebar that appears on the Mother Jones web site, but not in the printed article, Dr. Iwata criticizes us for not using his approach to functional analysis/assessment. We are aware of Dr. Iwata's approach and have tried it at JRC. The main problem is that the students who come to JRC have, by and large, already had the benefit of extensive functional analysis/assessment and despite this still have major behavior problems that were not solved with this approach alone. In that respect the situation is similar to the use of psychotropic drugs—the students who come to JRC have already been treated with psychotropic drugs and the drugs have been found insufficient. Despite this, JRC does do a comprehensive functional assessment of each student and takes the results into account in designing a program for the student and in designing the general treatment procedures employed in JRC's program. In a comprehensive review of the literature on Positive Behavior Support, an approach that is opposed to the use of aversives, Carr et al found that the studies that use positive-only treatment procedures, even when functional analysis is included, were effective in only 60 percent of the cases. JRC's population is largely taken from the remaining 40 percent.
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. They are not allowed to socialize with each other in the classroom, however, which is the rule in most schools.
A former teacher, Jessica Croteau, complains of the fact that a lot of the education at JRC takes place through self-instructional software and personal computers. This is a very valuable application of behavioral psychology to education and is probably unique to JRC, where each student is given his/her own computer. Most of our teachers, parents and students value this self-instructional aspect of the program very much, which is provided in addition to classroom discussion. Their point of view was not presented. Why did Ms. Gonnerman not interview some former teachers who are positive about our program?
Former student Rob Santana made great progress while at JRC which was a huge improvement when compared to his plight prior to his admission to JRC. It is unfortunate that Rob's parent chose to remove him from JRC prematurely and it is unfortunate that he has been arrested and jailed since his discharge from JRC.
Ms. Gonnerman complains that she did not have the opportunity to speak privately with JRC's students. She never asked for such opportunities.
Ms. Gonnerman objects to the fact that direct care staff members are not given the authority and flexibility to decide when to apply skin shocks and when not to. But to allow that to happen would mean that the treatment would not be applied consistently as it must be in order to be effective. More importantly, to allow that would be similar to allowing nurses in a hospital to decide whether and how much medication should be administered, instead of keeping such decisions under the control of the supervising physician. Direct care staff at JRC are encouraged and required to convey suggestions and concerns about treatment to the student's treatment team at JRC, but the final decision as to what behaviors need to be treated with an aversive, and when this treatment should be administered, is properly placed under the control of the supervising clinician.
Ms. Gonnerman objects to the fact that JRC discourages staff members from socializing with each other while on duty. It is vital, however, that the staff members give their undivided attention to the students. If a staff member socializes with other staff members when he or she should be attending to the students, this can create an unsafe situation.
Ms. Gonnerman interviewed eight former staff members who were critical of how the GED was used. These alleged witnesses have no credibility because they refused to be identified. Furthermore, how did she happen to choose these former staff members and why did she not interview some of the many former staff members who are not critical? She did not ask JRC to recommend any former or current employees for possible interviews.
Ms. Gonnerman makes much of the June 2006 New York State Department of Education Report that contained numerous criticisms of JRC. She fails to mention the fact that subsequent to that report three Massachusetts agencies have investigated JRC and found no support for the major findings of that report.
The squib about Ms. Gonnerman characterized her article as resulting from a "yearlong investigation." In fact her "investigation" was both brief and one-sided. She spent only two days visiting JRC in September of 2006 and did not witness even a single application of skin-shock to a student (despite giving the incorrect impression in her article that such applications are frequent occurrences). She went to great lengths to interview hostile former parents, teachers and staff (eight disgruntled former staff members—one for eight hours—out of thousands of possible former JRC staff members). She failed to interview any former parents, teachers and staff members with favorable opinions about JRC. Ms. Gonnerman devoted 10 column inches to describing students who died from natural causes entirely unrelated to their treatment (one 26 years ago and not even a JRC student, one 22 years ago, and one 17 years ago), but no column inches at all to students whose lives have been saved by JRC's treatment procedures and no column inches to the case of a former JRC student (a case that I brought to her attention) who died from inadequately treated self-abuse when he was abruptly transferred from JRC to a program that used positive-only procedures.
She failed to inform the reader that all large treatment facilities for the severely disabled experience deaths, especially facilities like JRC that have been in operation for over 35 years and that treat the most fragile and dangerous population. JRC actually has experienced very few deaths, all of which were investigated by the proper state authorities, and none of which were found to be caused by JRC's treatment program. She devoted 36 column inches to three disgruntled former parents and only 4 inches to parents who are among the hundreds who are extremely favorable to JRC. We heard no reports of her speaking to any supportive JRC parents other than the few that she interviewed for an hour or two during her visit to JRC.
Ms. Gonnerman's article was originally written for the New York Times Sunday Magazine. The Times rejected it, a fact that she learned in early April of this year. She then apparently tried to find some other magazine which would buy the article. Consequently, much of the so-called "year-long investigation" was probably spent in trying to find a magazine willing to publish such a biased story.
Ms. Gonnerman's objective (which the Mother Jones editors joined in on) was apparently to incite opposition to JRC and agitate for laws to prohibit aversives. At least one mother was not persuaded as evidenced from this email that was sent to the JRC website recently.
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
Rotenberg: School of shock
NEWS: Eight states are sending autistic, mentally retarded, and emotionally troubled kids to a facility that punishes them with painful electric shocks. How many times do you have to zap a child before it's torture?
By Jennifer Gonnerman
August 20, 2007
Rob Santana awoke terrified. He'd had that dream again, the one where silver wires ran under his shirt and into his pants, connecting to electrodes attached to his limbs and torso. Adults armed with surveillance cameras and remote-control activators watched his every move. One press of a button, and there was no telling where the shock would hit—his arm or leg or, worse, his stomach. All Rob knew was that the pain would be intense.
Every time he woke from this dream, it took him a few moments to remember that he was in his own bed, that there weren't electrodes locked to his skin, that he wasn't about to be shocked. It was no mystery where this recurring nightmare came from—not A Clockwork Orange or 1984, but the years he spent confined in America's most controversial "behavior modification" facility.
In 1999, when Rob was 13, his parents sent him to the Judge Rotenberg Educational Center, located in Canton, Massachusetts, 20 miles outside Boston. The facility, which calls itself a "special needs school," takes in all kinds of troubled kids—severely autistic, mentally retarded, schizophrenic, bipolar, emotionally disturbed—and attempts to change their behavior with a complex system of rewards and punishments, including painful electric shocks to the torso and limbs. Of the 234 current residents, about half are wired to receive shocks, including some as young as nine or ten. Nearly 60 percent come from New York, a quarter from Massachusetts, the rest from six other states and Washington, D.C. The Rotenberg Center, which has 900 employees and annual revenues exceeding $56 million, charges $220,000 a year for each student. States and school districts pick up the tab.
The Rotenberg Center is the only facility in the country that disciplines students by shocking them, a form of punishment not inflicted on serial killers or child molesters or any of the 2.2 million inmates now incarcerated in U.S. jails and prisons. Over its 36-year history, six children have died in its care, prompting numerous lawsuits and government investigations. Last year, New York state investigators filed a blistering report that made the place sound like a high school version of Abu Ghraib. Yet the program continues to thrive—in large part because no one except desperate parents, and a few state legislators, seems to care about what happens to the hundreds of kids who pass through its gates.
In Rob Santana's case, he freely admits he was an out-of-control kid with "serious behavioral problems." At birth he was abandoned at the hospital, traces of cocaine, heroin, and alcohol in his body. A middle-class couple adopted him out of foster care when he was 11 months old, but his troubles continued. He started fires; he got kicked out of preschool for opening the back door of a moving school bus; when he was six, he cut himself with a razor. His mother took him to specialists, who diagnosed him with a slew of psychiatric problems: attention-deficit/hyperactivity disorder, post-traumatic stress disorder, bipolar disorder, and obsessive-compulsive disorder.
Rob was at the Rotenberg Center for about three and a half years. From the start, he cursed, hollered, fought with employees. Eventually the staff obtained permission from his mother and a Massachusetts probate court to use electric shock. Rob was forced to wear a backpack containing five two-pound, battery-operated devices, each connected to an electrode attached to his skin. "I felt humiliated," he says. "You have a bunch of wires coming out of your shirt and pants." Rob remained hooked up to the apparatus 24 hours a day. He wore it while jogging on the treadmill and playing basketball, though it wasn't easy to sink a jump shot with a 10-pound backpack on. When he showered, a staff member would remove his electrodes, all except the one on his arm, which he had to hold outside the shower to keep it dry. At night, Rob slept with the backpack next to him, under the gaze of a surveillance camera.
Employees shocked him for aggressive behavior, he says, but also for minor misdeeds, like yelling or cursing. Each shock lasts two seconds. "It hurts like hell," Rob says. (The school's staff claim it is no more painful than a bee sting; when I tried the shock, it felt like a horde of wasps attacking me all at once. Two seconds never felt so long.) On several occasions, Rob was tied facedown to a four-point restraint board and shocked over and over again by a person he couldn't see. The constant threat of being zapped did persuade him to act less aggressively, but at a high cost. "I thought of killing myself a few times," he says.
Rob's mother Jo-Anne deLeon had sent him to the Rotenberg Center at the suggestion of the special-ed committee at his school district in upstate New York, which, she says, told her that the program had everything Rob needed. She believed he would receive regular psychiatric counseling—though the school does not provide this.
As the months passed, Rob's mother became increasingly unhappy. "My whole dispute with them was, 'When is he going to get psychiatric treatment?'" she says. "I think they had to get to the root of his problems—like why was he so angry? Why was he so destructive? I really think they needed to go in his head somehow and figure this out." She didn't think the shocks were helping, and in 2002 she sent a furious fax demanding that Rob's electrodes be removed before she came up for Parents' Day. She says she got a call the next day from the executive director, Matthew Israel, who told her, "You don't want to stick with our treatment plan? Pick him up." (Israel says he doesn't remember this conversation, but adds, "If a parent doesn't want the use of the skin shock and wants psychiatric treatment, this isn't the right program for them.")
Rob's mother is not the only parent angry at the Rotenberg Center. Last year, Evelyn Nicholson sued the facility after her 17-year-old son Antwone was shocked 79 times in 18 months. Nicholson says she decided to take action after Antwone called home and told her, "Mommy, you don't love me anymore because you let them hurt me so bad." Rob and Antwone don't know each other (Rob left the facility before Antwone arrived), but in some ways their stories are similar. Antwone's birth mother was a drug addict; he was burned on an electric hot plate as an infant. Evelyn took him in as a foster child and later adopted him. The lawsuit she filed against the Rotenberg Center set off a chain of events: investigations by multiple government agencies, emotional public hearings, scrutiny by the media. Legislation to restrict or ban the use of electric shocks in such facilities has been introduced in two state legislatures. Yet not much has changed.
Rob has paid little attention to the public debate over his alma mater, though he visits its website occasionally to see which of the kids he knew are still there. After he left the center he moved back in with his parents. At first glance, he seems like any other 21-year-old: baggy Rocawear jeans, black T-shirt, powder-blue Nikes. But when asked to recount his years at the Rotenberg Center, he speaks for nearly two hours in astonishing detail, recalling names and specific events from seven or eight years earlier. When he describes his recurring nightmares, he raises both arms and rubs his forehead with his palms.
Despite spending more than three years at this behavior-modification facility, Rob still has problems controlling his behavior. In 2005, he was arrested for attempted assault and sent to jail. (This year he was arrested again, for drugs and assault.) Being locked up has given him plenty of time to reflect on his childhood, and he has gained a new perspective on the Rotenberg Center. "It's worse than jail," he told me. "That place is the worst place on earth."
One Punishment Fits All
The story of the Rotenberg Center is in many ways a tale of two schools. Slightly more than half the residents are what the school calls "high functioning": kids like Rob and Antwone, who have diagnoses like attention-deficit disorder, bipolar disorder, post-traumatic stress disorder, and other emotional problems. The other group is even more troubled. Referred to as "low functioning," it includes kids with severe autism and mental retardation; most cannot speak or have very limited verbal abilities. Some have behaviors so extreme they can be life threatening: chomping on their hands and arms, running into walls, nearly blinding themselves by banging their heads on the floor again and again.
The Rotenberg Center has long been known as the school of last resort—a place that will take any kid, no matter how extreme his or her problems are. It doesn't matter if a child has been booted out of 2, 5, 10, or 20 other programs—he or she is still welcome here. For desperate parents, the Rotenberg Center can seem like a godsend. Just ask Louisa Goldberg, the mother of 25-year-old Andrew, who has severe mental retardation. Andrew's last residential school kicked him out after he kept assaulting staff members; the Rotenberg Center was the only place willing to accept him. According to Louisa, Andrew's quality of life has improved dramatically since 2000, when he was hooked up to the shock device, known as the Graduated Electronic Decelerator, or ged.
The Rotenberg Center has a policy of not giving psychiatric drugs to students—no Depakote, Paxil, Risperdal, Ritalin, or Seroquel. It's a policy that appeals to Louisa and many other parents. At Andrew's last school, she says, "he had so many medicines in him he'd take a two-hour nap in the morning, he'd take a two-hour nap in the afternoon. They'd have him in bed at eight o'clock at night. He was sleeping his life away." These days, Louisa says she is no longer afraid when her son comes home to visit. "[For him] to have an electrode on and to receive a ged is to me a much more favorable way of dealing with this," she says. "He's not sending people to the hospital."
Marguerite Famolare brought her son Michael to the Rotenberg Center six years ago, after he attacked her so aggressively she had to call 911 and, in a separate incident, flipped over a kitchen table onto a tutor. Michael, now 19, suffers from mental retardation and severe autism. These days, when he comes home for a visit, Marguerite carries his shock activator in her purse. All she has to do, she says, is show it to him. "He'll automatically comply to whatever my signal command may be, whether it is 'Put on your seatbelt,' or 'Hand me that apple,' or 'Sit appropriately and eat your food,'" she says. "It's made him a human being, a civilized human being."
Massachusetts officials have twice tried to shut the Rotenberg Center down—once in the 1980s and again in the 1990s. Both times parents rallied to its defense, and both times it prevailed in court. (See "Why Can't Massachusetts Shut Matthew Israel Down?" page 44.) The name of the center ensures nobody forgets these victories; it was Judge Ernest Rotenberg, now deceased, who in the mid-'80s ruled that the facility could continue using aversives—painful punishments designed to change behavior—so long as it obtained authorization from the Bristol County Probate and Family Court in each student's case. But even though the facility wasn't using electric shock when this ruling was handed down, the court rarely, if ever, bars the Rotenberg Center from adding shock to a student's treatment plan, according to lawyers and disability advocates who have tried to prevent it from doing so.
Since Evelyn Nicholson filed her lawsuit in 2006, the Rotenberg Center has faced a new wave of criticism and controversy. (See "Nagging? Zap. Swearing? Zap," page 41.) And again, the facility has relied heavily on the testimonials of parents like Louisa Goldberg and Marguerite Famolare to defend itself. Not surprisingly, the most vocal parent-supporters tend to be those with the sickest children, since they are the ones with the fewest options. But at the Rotenberg Center, the same methods of "behavior modification" are applied to all kids, no matter what is causing their behavior problems. And so, while Rob would seem to have little in common with mentally retarded students like Michael and Andrew, they all shared a similar fate once their parents placed them under the care of the same psychologist, a radical behaviorist known as Dr. Israel.
Dr. Israel's Radical Behavior
In 1950, matt israel was a Harvard freshman looking to fill his science requirement. He knew little about B.F. Skinner when he signed up for his course, Human Behavior. Soon, though, Israel became fascinated with Skinner's scientific approach to the study of behavior, and he picked up Walden Two, Skinner's controversial novel about an experimental community based on the principles of behaviorism. The book changed Israel's life. "I decided my mission was to start a utopian community," he says. Israel got a Ph.D. in psychology in 1960 from Harvard, and started two communal houses outside Boston.
One of the people Israel lived with was a three-year-old named Andrea, the daughter of a roommate. The two did not get along. "She was wild and screaming," Israel recalls. "I would retreat to my own room, and she'd be trying to pull away and get into my room, and I'd have to hold the door on one side to keep her from disturbing me." When company would come over, he says, "She would walk around with a toy broom and whack people over the head."
Through experiments with rats and pigeons, Skinner had demonstrated how animals learn from the consequences of their actions. With permission from Andrea's mother, Israel decided to try out Skinner's ideas on the three-year-old. When Andrea was well behaved, Israel took her out for walks. But when she misbehaved, he punished her by snapping his finger against her cheek. His mentor Skinner preached that positive reinforcement was vastly preferable to punishment, but Israel says his methods transformed the girl. "Instead of being an annoyance, she became a charming addition to the house."
Israel's success with Andrea convinced him to start a school. In 1971, he founded the Behavior Research Institute in Rhode Island, a facility that would later move to Massachusetts and become known as the Judge Rotenberg Center. Israel took in children nobody else wanted—severely autistic and mentally retarded kids who did dangerous things to themselves and others. To change their behavior, he developed a large repertoire of punishments: spraying kids in the face with water, shoving ammonia under their noses, pinching the soles of their feet, smacking them with a spatula, forcing them to wear a "white-noise helmet" that assaulted them with static.
In 1977, Israel opened a branch of his program in California's San Fernando Valley, along with Judy Weber, whose son Tobin is severely autistic. Two years later, the Los Angeles Times reported Israel had pinched the feet of Christopher Hirsch, an autistic 12-year-old, at least 24 times in 30 minutes, while the boy screamed and cried. This was a punishment for soiling his pants. ("It might have been true," Israel says. "It's true that pinches were being used as an aversive. The pinch, the spank, the muscle squeeze, water sprays, bad taste—all those procedures were being used.") Israel was in the news again in 1981, when another student, 14-year-old Danny Aswad, died while strapped facedown to his bed. In 1982, the California Department of Social Services compiled a 64-page complaint that read like a catalog of horrors, describing students with bruises, welts, and cuts. It also accused Israel of telling a staff member "to grow his fingernails longer so he could give an effective pinch."
In 1982, the facility settled with state officials and agreed to stop using physical punishments. Now called Tobinworld, and still run by Judy Weber, it is a $10-million-a-year organization operating day schools near Los Angeles and San Francisco. The Rotenberg Center considers itself a "sister school" to Tobinworld, and Israel makes frequent trips to California to visit Weber. The two were married last year.
Despite his setback in California, Israel continued to expand on the East Coast—and to generate controversy. In 1985, Vincent Milletich, an autistic 22-year-old, suffered a seizure and died after he was put in restraints and forced to wear a white-noise helmet. Five years later, 19-year-old Linda Cornelison, who had the mental capacity of a toddler, refused to eat. On the bus to school, she clutched her stomach; someone had to carry her inside, and she spent the day on a couch in a classroom. Linda could not speak, and the staff treated her actions as misbehaviors. Between 3:52 p.m. and 8 p.m., staffers punished her with 13 spatula spankings, 29 finger pinches, 14 muscle squeezes, and 5 forced inhalings of ammonia. It turned out that Linda had a perforated stomach. She died on the operating table at 1:45 a.m.
The local district attorney's office examined the circumstances of Vincent's death but declined to file any charges. In Linda's case, the Massachusetts Department of Mental Retardation investigated and found that while Linda's treatment had "violated the most basic codes and standards of decency and humane treatment," there was insufficient evidence to prove that the use of aversives had caused her death.
By the time Linda died, Israel was moving away from spatulas and toward electric shock, which, from his perspective, offered many advantages. "To give a spank or a muscle squeeze or a pinch, you had to control the student physically, and that could lead to a struggle," he says. "A lot of injuries were occurring." Since shocking only required pressing a button, Israel could eliminate the need for employees to wrestle a kid to the ground. Another benefit, he says, was increased consistency. It was hard to know if one staff member's spatula spanking was harder than another's, but it was easy to measure how many times a staff member had shocked a child.
Israel purchased a shock device then on the market known as sibis—Self-Injurious Behavior Inhibiting System—that had been invented by the parents of an autistic girl and delivered a mild shock that lasted .2 second. Between 1988 and 1990, Israel used sibis on 29 students, including one of his most challenging, Brandon, then 12, who would bite off chunks of his tongue, regurgitate entire meals, and pound himself on the head. At times Brandon was required to keep his hands on a paddle; if he removed them, he would get automatic shocks, one per second. One infamous day, Brandon received more than 5,000 shocks. "You have to realize," Israel says. "I thought his life was in the balance. I couldn't find any medical solution. He was vomiting, losing weight. He was down to 52 pounds. I knew it was risky to use the shock in large numbers, but if I persevered that day, I thought maybe it would eventually work. There was nothing else I could think of to do...but by the time it went into the 3,000 or 4,000 range, it became clear it wasn't working."
This day was a turning point in the history of Israel's operation—that's when he decided to ratchet up the pain. The problem, he decided, was that the shock sibis emitted was not strong enough. He says he asked sibis's manufacturer, Human Technologies, to create a more powerful device, but it refused. "So we had to redesign the device ourselves," he says. He envisioned a device that would start with a low current but that could increase the voltage if needed—hence its name, Graduated Electronic Decelerator or ged—but he abandoned this idea early on. "As it turns out, that's really not a wise approach," he says. "It's sort of like operating a car and wearing out the brakes because you never really apply them strongly enough. Instead, we set it at a certain level that was more or less going to be effective for most of our students."
Thirty years earlier, O. Ivar Lovaas, a psychology professor at ucla, had pioneered the use of slaps and screams and electric jolts to try to normalize the behavior of autistic kids. Life magazine featured his work in a nine-page photo essay in 1965 with the headline, "A surprising, shocking treatment helps far-gone mental cripples." Lovaas eventually abandoned these methods, telling cbs in 1993 that shock was "only a temporary suppression" because patients become inured to the pain. "These people are so used to pain that they can adapt to almost any kind of aversive you give them," he said.
Israel encountered this same sort of adaptation in his students, but his solution was markedly different: He decided to increase the pain once again. Today, there are two shock devices in use at the Rotenberg Center: the ged and the ged-4. The devices look similar and both administer a two-second shock, but the ged-4 is nearly three times more powerful—and the pain it inflicts is that much more severe.
The Mickey Mouse Club
Ten years ago, Israel hung up a Mickey Mouse poster in the main hall, and he noticed that it made people smile—so he bought every Mickey Mouse poster he could find. He hung them in the corridors and even papered the walls of what became known as the Mickey Mouse Conference Room. Entering the Rotenberg Center is a bit like stepping into a carnival fun house, I discovered during a two-day visit last autumn. Two brushed-aluminum dogs, each nearly 5 feet tall and sporting a purple neon collar, stand guard outside. Giant silver stars dangle from the lobby ceiling; the walls and chairs in the front offices are turquoise, lime green, and lavender.
Israel, 74, still holds the title of executive director, for which he pays himself nearly $400,000 in salary and benefits. He appears utterly unimposing: short and slender with soft hands, rounded shoulders, curly white hair, paisley tie. Then he sits down beside me and, unprompted, starts talking about shocking children. "The treatment is so powerful it's hard not to use if you have seen how effective it is," he says quietly. "It's brief. It's painful. But there are no side effects. It's two seconds of discomfort." His tone is neither defensive nor apologetic; rather, it's perfectly calm, almost soothing. It's the sort of demeanor a mother might find comforting if she were about to hand over her child.
Before we set off on our tour of the facility, there's something Israel wants me to see: Before & After, a homemade movie featuring six of his most severe cases. Israel has been using some of the same grainy footage for more than two decades, showing it to parents of prospective students as well as visiting reporters. They've already mailed me a copy, but Israel wants to make sure I watch it. An assistant slips the tape into the vcr, Israel presses the remote, and we all stare at the screen:
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.
1981: Janine, also 11 years old, shrieks and slams her head against the ground, a table, the door. Bald spots testify to the severity of her troubles; she's yanked out so much hair it's half gone.
Both girls exhibit autistic behaviors, and compared with these scenes, the "After" footage looks almost unbelievable: Janine splashes in a plastic pool, while Caroline grins as she sits in a chair at a beauty salon. "Most people haven't seen these pictures," Israel says, setting down the remote. "They haven't seen children like this, so they cannot imagine. These are children for whom positive-only procedures did not work, drugs did not work. And if it wasn't for this treatment, some of these people would not be alive." The video is extremely persuasive: The girls' self-abuse is so violent and so frightening that it almost makes me want to grab a ged remote and push the button myself. Of course, this is precisely the point.
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."
Employees shock students for a wide range of behaviors, from violent actions to less serious offenses, like getting out of their seats without permission. In 2006, the New York State Education Department sent a team of investigators, including three psychologists, to the Rotenberg Center, then issued a scathing report. Among its many criticisms was that the staff shocked kids for "nagging, swearing, and failing to maintain a neat appearance." Israel only disputes the latter. As for nagging and swearing? "Sometimes a behavior looks innocuous," he says, "but if it's an antecedent for aggression, it may have to be treated with an aversive."
New York officials disagreed, and in January 2007 issued regulations that would prohibit shocking New York students for minor infractions. But a group of New York parents filed a federal lawsuit to stop the state from enforcing these regulations. They prevailed, winning a temporary restraining order against the state, one that permits the Rotenberg Center staffers to continue using shock. The parents' case is expected to go to trial in 2008.
When they talk about why they use the shock device, Israel and his employees like to use the word "treatment," but it might be more accurate to use words like "convenience" or "control." "The ged—it's two seconds and it's done," says Patricia Rivera, a psychologist who serves as assistant director of clinical services. "Then it's right back to work." By contrast, it can take 8 or 10 employees half an hour or longer to restrain a strong male student: to pin him to the floor, wait for him to stop struggling, then move his body onto a restraint board and tie down each limb. Restraining five or eight kids in a single day—or the same student again and again—can be incredibly time-consuming and sometimes dangerous.
Even with the ged, the stories both students and employees tell make the place sound at times like a war zone: A teenage boy sliced the gym teacher across the face with a cd. A girl stabbed a staffer in the stomach with a pencil. While staff have been contending with injuries ever since Israel opened his facility, the recent influx of high-functioning students, some with criminal backgrounds, has brought a new fear: that students will join forces and riot. Perhaps tellingly, among high-functioning kids most of the violence is directed at the staff, not each other.
"Our Students Have a Tendency to Lie"
Rotenberg staff place the more troubled (or troublesome) residents on 1:1 status, meaning that an aide monitors them everywhere they go. For extremely violent students, the ratio is 2:1. Soon after I arrived, right before I set off on my tour, a small crowd gathered—it seemed that almost the entire hierarchy of the Rotenberg Center was going to follow me around. That's when I realized I'd been put on 5:1. As I began to roam around the school with my escorts, my every move monitored by surveillance cameras, I realized it would be impossible to have a private conversation with any student. The best I could hope for would be a few unscripted moments.
Ten years ago, a reporter visiting Israel's center would have been unable to talk to most students; back then few of them could speak. These days, there are more than 100 high-functioning kids fully capable of voicing their views, and Israel has enlisted a few in his campaign to promote the ged. "If we had only [severely] autistic students, they couldn't talk to you and say, 'Gee, this is really helping me,'" Israel says. "Now for the first time we have students like Katie who can tell you it helped them."
In the world of the Rotenberg Center, Katie Spartichino is a star. She left the facility in the spring of 2006 and now attends community college in Boston. Around noon, a staff member brings her back to the facility to talk to me. We sit at an outdoor picnic table away from the surveillance cameras but there's no privacy: Israel and Karen LaChance, the assistant to the executive director for admissions, sit with us.
Katie, 19, tells me she overdosed on pills at 9, spent her early adolescence in and out of psych wards, was hooked up to the ged at 16, and stayed on the device for two years. "This is a great place," she says. "It took me off all my medicine. I was close to 200 pounds and I'm 160 now." She admits her outlook was less rosy when she first had to wear the electrodes. "I cried," she says. "I kind of felt like I was walking on eggshells; I had to watch everything I said. Sometimes a curse word would just come out of my mouth automatically. So being on the geds and knowing that swearing was a targeted behavior where I would receive a [GED] application, it really got me to think twice before I said something disrespectful or something just plain-out rude."
As Katie speaks, LaChance runs her fingers through Katie's hair again and again. The gesture is so deliberate it draws my attention. I wonder if it's just an expression of affection—or something more, like a reward.
"Do you swear anymore?" I ask.
"Oh, God, all the time," Katie says. She pauses. "Well, I have learned to control it, but I'm not going to lie. When I'm on the phone, curse words come out."
The hair stroking stops. LaChance turns to Katie. "I hope you're not going to tell me you're aggressive."
"Oh, no, that's gone," Katie says. "No, no, no. The worst thing I do sometimes is me and my mom get into little arguments."
For Israel, of course, one drawback of having so many high-functioning students is that he cannot control everything they say. One afternoon, when I walk into a classroom of teenagers, a 15-year-old girl catches my eye, smiles, and holds up a sheet of paper with a message written in pink marker: HELP US. She puts it back down and shuffles it into her stack of papers before anyone else sees. When I move closer, she tells me her name is Raquel, she is from the Bronx, and she wants to go home.
My escorts allow me to interview Raquel while two of them sit nearby. Raquel is not hooked up to the ged, but she has many complaints, including that she has just witnessed one of her housemates get shocked. "She was screaming," Raquel says. "They told her to step up to be searched; she didn't want to step up to be searched, so they gave her one." After 20 minutes, my escorts cut us off. "Raquel, you did a great job—thank you for taking the time," says Patricia Rivera, the psychologist.
Once Raquel is out of earshot, Rivera adds, "Some of the things she said are not true, some of them are. Our students obviously have a tendency to lie about things." She explains that a staff member searches Raquel's housemate every hour because she's the one who recently stabbed an employee with a pencil.
The Rotenberg Center does not have a rule about how old a child must be before he or she can be hooked up to the ged. One of the program's youngest students is a nine-year-old named Rodrigo. When I see him, he is seated outside at a picnic table with his aide. Rodrigo's backpack looks enormous on his tiny frame; canvas straps dangle from both legs.
"He was horrible when he first came in," Rivera says. "It would take five staff to restrain him because he's so wiry." What was he like? "A lot of aggression. A lot of disruptive behavior. Whenever he was asked to do a task that he didn't feel like doing, he would scream, yell, swear. The stuff that would come out of his mouth you wouldn't believe—very sexually inappropriate."
"Rodrigo, come here," one of my escorts says.
Rodrigo walks over, his straps slapping the ground. He wears a white dress shirt and tie—the standard uniform for male students—but because he is so small, maybe 4 feet tall, his tie nearly reaches his thighs. "What's that?" he asks.
"That's a tape recorder," I say. "Do you want to say something?"
"Yeah."
Unfazed by the presence of Israel, Rivera, and my other escorts, Rodrigo lifts a small hand and pulls the recorder down toward his lips. "I want to move to another school," he says.
The Employee-Modification System
To understand how the Rotenberg Center works, it helps to know that it runs not just one behavior-modification program, but two—one for the residents, and one for the staff. Employees have no autonomy. If a staffer believes it's okay to shock a kid who is smashing his head against a wall, but it's not okay to shock someone for getting out of his chair without permission, that could spell trouble. "There's pressure on you to do it," a former teacher told me. "They punish you if you don't."
I met this former teacher at a restaurant, and our meeting stretched on for six hours. At times it felt less like an interview than a confession. "The first time you give someone a ged is the worst one," the teacher said. "You don't want to hurt somebody; you want to help. You're thinking, 'This has got to be okay. This has got to be legal, or they wouldn't be doing this.'" At the Rotenberg Center, it's virtually impossible to discuss such concerns with coworkers because there are cameras everywhere, even in the staff break room. Staff members who want to talk to each other without being overheard may meet up in the parking lot or scribble notes to each other. But it's hard to know whom to trust, since Israel encourages employees to file anonymous reports about their coworkers' lapses.
In addition, staff members are prohibited from having casual conversations with each other. They cannot, for example, say to a coworker, "Hey, did you see the Red Sox game last night?" "We don't want them discussing their social life or the ball games in front of the students or while they're on duty," Israel says. "So we'll sometimes actually have one staffer deliberately start a social conversation with another and we'll see whether the other—as he or she should—will say, 'I don't want to discuss that now.'" Monitors watch these setups on the surveillance cameras and punish staffers who take the bait.
Former employees describe a workplace permeated with fear—fear of being attacked by students and fear of losing their job. There are so many rules—and so many cameras—it's not easy to stay out of trouble. Employees quit or are fired so often that two-thirds of the direct-care employees remain on the job for less than a year.
New employees must sign a confidentiality agreement promising not to talk about the Rotenberg Center—even after they no longer work there. Of the eight ex-employees I interviewed, most did not want to be identified by name for fear of Israel suing them; all were critical of how the ged is used. Maybe, says one, the use of shocks was justified in a few extreme self-injurious cases, but that's all. "Say you had a hospital that was the only hospital in the nation that had chemotherapy, and they were treating people who had the common cold with it," she says. "I think the extreme to which they abuse their power has outweighed what good they do."
The Hard Lessons of Connie Chung
Matthew Israel has been fielding questions from journalists since the 1970s, but few have examined his operation as thoroughly—and critically—as the producers at Eye to Eye with Connie Chung did. In 1993, they spent six months investigating the facility. They even found an employee willing to go inside with a hidden camera. But Israel ended up getting the last laugh. As he recounts the story for me, he can barely contain his glee. "We refused to meet with her unless the parents could be in the same room," he says, grinning. "She talked to the parents, and they really gave it to her." This is no exaggeration: When Chung tried to ask him tough questions, his parent-supporters shouted her down.
Throughout this raucous meeting, Israel had his own camera rolling, too, which turned out to be a brilliant move. Before cbs got its 40-minute story on the air, Israel launched a national campaign to discredit both Chung and her report. He accused her of being "biased" and "hostile," and to prove it, he distributed edited videotapes of her interview to media critics and cbs affiliates. It worked. A New York Times television critic savaged cbs, accusing it of using "shabby tricks of the trade." Suddenly the story was not about whether the school had abused students—but whether cbs had abused the school.
"I don't think it was a positive thing for her career," says Israel, still smiling. It's late in the day, right near the end of my visit, and I'm starting to wonder why he's brought up this topic.
By now I've spent 22 hours with Israel and his staff—wandering around the facility, meeting parents they've brought in for me to interview. But before I depart, there's one more place I want to see, the room where they repair the geds. Israel and Glenda Crookes, an assistant executive director, agree to take me there. It is just past 7 p.m. and drizzling as we climb into Israel's Lexus for a short drive to the maintenance building.
There, Crookes and Israel lead me down a hall, past storerooms filled with red helmets, ged sleds, batteries and their chargers. The room at the end of the hall looks like it could be a repair shop for any sort of electronics equipment: scissors, screwdrivers, industrial-grade glue, a Black & Decker Pivot Driver. On one desk, I spot a form called a ged Trouble Report. The report explains that someone dropped off Duane's shock device because it was "making rattling noises." Crookes explains, "Anytime a screw is loose or anything is wrong with the device, it's automatically sent back here."
A Trouble Report on another desk suggests a more serious problem: "Jamie Z was getting his battery changed, Luigi received a shock." "What does this mean?" I ask. Crookes picks up the paper, reads it, then hands it to Israel and walks away. Her gesture seems to say, I cannot believe we just spent two days with this reporter and now this is the last thing she sees.
Israel stares at the report, then reaches into his pocket and pulls out a pair of reading glasses. Nobody says anything. Outside, one car after another races by, the tail end of the evening commute.
After a minute or two, Israel says, "Well, I don't understand the whole of it." He is still staring at the paper in his hand. "But there was apparently a spontaneous activation." The ged, in other words, delivered a shock without anyone pressing its remote.
This moment reminds me of something Israel told me earlier about the premise of Skinner's Walden Two, that by changing people's behaviors you can help them have a better life. But, Israel was careful to add, "The notion was that you needed to have the whole environment under control. With a school like this, we have an awful lot. Not the whole environment, but an awful lot."
He was right; he controls nearly every aspect of his facility. But all of his surveillance cameras and microphones and paperwork and protocols had failed to protect Luigi, a mentally retarded resident who had done nothing wrong.
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