THE DIVERSITY OF MY THOUGHTS

School of Shock (Part 2)

In Cerebral Palsy, Education, Health, Medical, Unique on October 8, 2008 at 11:30 am

The students at the Rotenberg Center are mainly divided into two major groups. 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 High-functioning students


The Low-functioning students

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 kicked 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 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.”


The transmitter

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. The Rotenberg Center has faced a new wave of criticism and controversy; however, 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.

Below are some conditions that trigger the controversy among officials:

  • Staff shock kids for “nagging, swearing, and failing to maintain a neat appearance” and once threatened to shock a girl who sneezed and then asked for a tissue.
  • Some students must “earn” meals by not displaying certain behaviors. Otherwise they are “made to throw a predetermined caloric portion of their food into the garbage.”
  • When students enter and leave the school each day, “almost all” are wearing some type of restraints, such as handcuffs or leg shackles.
  • “Students may be restrained”—on a four-point restraint board or chair—”for extensive periods of time (e.g. hours or intermittently for days).”
  • Some students are shocked while strapped to the restraint board.
  • A “majority” of employees “serving as classroom teachers” are “not certified teachers.”
  • Rotenberg’s marketing reps bestow presents on prospective families—”e.g. a gift bag for the family, basketball for the student.”
  • Although the center has described its shock device as “approved” by the fda in its promotional materials, it “has not been approved.”
  • The facility collects “comprehensive data” on behaviors it seeks to eliminate, but “there was no evidence of the collection of data on replacement or positive behaviors.”
  • The facility makes no assessment of the “possible collateral effects of punishment such as depression, anxiety, and/or social withdrawal.”

Dr. Israel’s Radical Behavior

In 1950, Matt Israel was a Harvard freshman looking to fill his science requirement. He knew little about Dr. 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.

Through experiments with rats and pigeons, Skinner had demonstrated how animals learn from the consequences of their actions. One of Israel’s roommates had a troubled daughter, Angela, who was a student at the communal. 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 beginning to adopt 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.

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  1. The use of GEDs is violating one’s right. I hate such authority that includes torture

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