Featured picture credit: WCVB-TV
CW: abuse, child abuse, restraint, torture, suicide, shock
At this point, if you are in any way involved in the autistic community, there is no way you haven’t heard of the Judge Rotenberg Center and the #StopTheShock movement. For those of you coming to this issue for the first time, the Judge Rotenberg Center, or JRC for short, is a controversial, publicly funded school for students with disabilities who engage in severe behaviors in Canton, Massachusetts. They are typically referred there because their behaviors are a danger to themselves and/or those around them. The center is particularly famous for their use of electric shock as a method of changing behavior.
Their use of shock has never been a secret– in fact, the JRC expresses pride in its use as a method of avoiding psychoactive drugs or time-out. They consider their use of aversives the more ethical and humane way of treating dangerous behaviors, and seem to view psychoactive drugs almost as a failure for the people they are treating.
As we dig into this issue, I want to give a tremendous thanks from the bottom of my heart to the massive numbers of Autistic people who poured their emotional labor out into the world to spread information and research on this issue, including sharing their own traumatic experiences and vulnerabilities. It would be impossible to name all of them, but if you follow any autistic advocates on social media, you will see their names. They shouldn’t have had to, but they did, and they delivered. Unfortunately though, it hasn’t been enough to make change. They need the support and the privilege of the non-disabled community. Start your education with this post, follow the resources at the end, and follow #StopTheShock.
A (very) Brief History
Founded in 1971 by Matthew Israel, it was originally a small research center that rapidly expanded through the 70s and 80s into group homes and eventually the facility as we know it today. It has faced controversy pretty much since its inception, including multiple attempts to shut it down, which were thwarted by the families and practitioners for the individuals being treated. The name Judge Rotenberg Center is even in honor of a judge who helped overturn attempts by state officials to shut it down and limit their use of electric shocks.
Aversives
The most well-known tool used for modifying behavior at the JRC is the Graduated Electronic Decelerator, or GED. It was created by Matthew Israel as a replacement for previously used aversives such as as spankings, muscle squeezes, pinches, and yes, even SIBIS, another shock-delivery device which he felt was not painful enough to be effective. Restraint, sensory deprivation, and withholding food were all still utilized in addition to or in combination with the GED as consequences for behaviors targeted to reduction, such as tying a person down and delivering multiple shocks over time.
The story we’re told
The JRC is treated within the ABA community as a kind of underdog– the singular hero standing alone and statuesque against the uneducated rabble who don’t appreciate their work. They know what they are doing is necessary and good, for they are all who stand between their students and their own dangerous behaviors and evil medications. They tell the heartbreaking stories of the families who come to them with loved ones whose behaviors are disrupting their lives. It all rings reminiscent of the original Lovaas studies and interviews. The center is often described as a last resort for people with whom previous treatments have failed, or for individuals engaging in behaviors so dangerous and severe that there isn’t time to try other methods because of the risks the behaviors pose.
I remember learning about them in grad school. We were told of the behaviors seen there, such as people who have been banging their own head so hard and for so long that they have blinded themselves, or given themselves irreparable brain damage. After their treatment at the JRC, these individuals are reported to have miraculously improved lives. Their self-injurious behavior has disappeared, they are off of most if not all psychoactive drugs they had been previously prescribed, and may even be gaining new skills never thought possible for them. Perhaps most importantly, their families were thrilled.
The JRC really cares about supporting families. When faced with criticism, they really love to point out how excited families are with the results.
I hope you see what’s missing here.
Even in trying to make effective arguments against their critics, the JRC fails to ever mention any input from the actual individuals they are treating. If pushed, they may describe how the individuals are not able to provide input, but that simply isn’t true and in recent years, those individuals have been speaking, but we’ll get to that later.
The claims versus reality
It might come as no surprise that almost nothing we’ve been taught about the JRC is correct. The facts about them, all of the statements made in their defense, have become scripts parroted across the field like a religious litany. Indeed, the comparison to a religion is not used ironically. As social media amplifies criticism of ABA, the field has only become more and more closed in on itself and defensive. Of course there is a growing number learning and attempting to change the field, but there is also a frightening number banding together and clinging to these scripts like a security blanket. Their response checks off a lot of boxes on the cult behavior list, but that’s another discussion for another day.
Either way, it’s a lot to sift through, so I am going to break it down here to make sure everything is loud and clear.
The shocks used are mild
When being taught about shock as a treatment for behavior, I always heard it described as essentially a shock you’d receive from touching a doorknob in the winter time. It made sense. That sensation was very aversive — often in the dry winters where I live, I develop a temporary compulsion of slapping any metal device before I use it to minimize the shock I experience — but it definitely isn’t dangerous. It’s a commonplace annoyance we’ve all experienced and never heard of resulting in any injury.
The GED-4, the device used at JRC on every student, delivers a shock for 2 seconds. At its lowest setting, that shock is 45mA. At its highest, it’s 90.
That meant nothing to me either, so here’s a helpful comparison:
A doorknob gives less than 1mA in a fraction of a second.
A cattle prod uses no more than 10mA also for a fraction of a second.
Tasers use 2.5-3.4mA.
It’s a lie and they’re using this on children.
Shocks are only used for extreme behaviors
If we’re not physically in the JRC, and student records are protected by HIPAA, we kind of have to take their word on this because there’s no way to prove otherwise, right?
Of course not.
A former student at JRC has graciously shared her behavior plan with the world, including the behaviors targeted for reduction and the shocks she is to receive for engaging in them. This is an actual document from the JRC.
It’s a little hard to read, but the behaviors targeted to be shocked are as follows:
- Physical aggression including posturing, threatening to aggress, hair-pulling, biting, choking, punching, and spitting
- Aggression to property including touching, throwing or kicking objects, as well as other actions towards property such as touching outlets without permission, slamming doors, and “touching electrical items in an attempt to dismantle or defeat its use.”
- Self-injury behaviors, including cutting self, picking at fingers that cause redness or bleeding, “violent” head shakes, picking scabs, hitting self, scratching self, dropping to the floor, and verbal threats to harm oneself. These also include suicide attempts, examples of which include removing seatbelts without permission or attempting to remove restraints.
- Inappropriate urination/defecation which is simply eliminating bowels and/or bladder anywhere other than in the toilet
- Verbal aggression such as swearing, threats, and yelling
- Refusal, which includes simply saying “no” when given a direction, refusing physical prompting, and attempting to remove the GED.
Other behaviors reported from students who have gone public with their experiences include refusing to take off one’s coat. As seen in this video (HUGE trigger warning), he was placed in a 4-point restraint and shocked repeatedly for 7 hours.
Raise your hand if you’ve ever supported a person who engaged in literally any of these behaviors.
Raise your hand if it ever crossed your mind that an appropriate response to these behaviors would be to deliver a shock 9 times that of a fucking cattle prod.
Maybe I shouldn’t put this out there in public, but I pick my freaking fingers all the damn time. Yes, sometimes it results in bleeding. Is it a good habit? Of course not, but what are you going to do? Shock me for it?
It’s a lie and they’re doing this to children.
Aversives, including shocks, are only used as a last resort
Based on what we’ve just discussed– and witnessed– this is literally impossible. Aside from the unquestionable fact that some of these are totally inappropriate behaviors to target for reduction, anyone who has been in the field more than a month has likely seen that reinforcement-based techniques, sometimes with extremely low intensity punishers included, are almost always effective in creating behavior change.
JRC is also not the only organization treating severe behavior. There are plenty of other places just like it, where staff ratios are 2:1, meaning there is one staff member on either side of the individual at all times. There are places where staff have to wear protective gear, basically the equivalent to riot gear to keep themselves safe. In these places, there are positive, meaningful results with reinforcement-based techniques and without the use of electric shocks.
The JRC’s use of aversives is in line with the BACB’s Code of Ethics
I went through our Code of Ethics several times, as we all should periodically, and found a few that stood out to me on this issue.
Ethics Code 4.02: Behavior analysts involve the client in the planning of and consent for behavior-change programs.
Again and again, the JRC and its defenders state that clients are involved in treatment planning and agree to the methods. Indeed, families have jumped to defend the JRC and fight litigation against them because of the miraculous results they see for their loved ones. They even let families feel the shocks for themselves (once, at the lowest setting, with warning).
Who is the client, again? Isn’t that Ethics 101? The family is not the only one whose opinion should matter, yet that is becoming increasingly the norm. The learners themselves are not even being considered, as if they don’t even have thoughts to offer. Deficits in communication are the favorite excuse given, but it’s a piss-poor one. Assent is a thing, even for learners with very limited effective communication, and their assent, or lack thereof, is clear in those videos.
For those out there though who refuse to try to understand what assent or any communication looks like outside of that most similar to neurotypical communication, there are plenty of learners who can accommodate them. Jennifer Msumba, for example, has been bravely telling her story as a former student at JRC.
… and Leilaripsthesystem, who took to instagram to share her experiences with similar programs
Either way, it’s not on them to communicate in a way the neurotypical world prefers or else accept being ignored or dismissed. It’s on us to shut up and listen.
Ethics Code: 4.08c: Before implementing punishment-based procedures, behavior analysts ensure that appropriate steps have been taken to implement reinforcement-based procedures unless the severity or dangerousness of the behavior necessitates immediate use of aversive procedures.
Looking at JRC’s own materials as well as personal anecdotes, there is no evidence whatsoever that this code is being followed. Sure, there are point systems in place with which students can earn prizes, but that’s hardly exhausting all reinforcement-based techniques. There are also several behaviors listed in the behavior plan above that in no way present the level of “severity or dangerousness” this code is referring to. It would be naive to think that that example was a fluke. If it was, why would the JRC be so quiet about their current practices? Why would they not openly denounce examples like these and be able to provide a solid plan to avoid it happening again in the future?
Because it’s still happening, that’s why.
Ethics Code: 4.09: Behavior analysts review and appraise the restrictiveness of procedures and always recommend the least restrictive procedures likely to be effective.
This code is specific to the use of aversives and is often cited when ABA is criticized for its use of punishment. As we know, punishment is simply any consequence that, when following a behavior, results in that behavior being less likely to occur again in the future. Being told “no,” response costs like losing points, or missing a play date, are all familiar examples of things that have made behavior, even our own, less likely to occur in the future.
Shock is often listed as one of the most restrictive measures even available for consideration. How many such cases are likely to appear in anyone’s career if we are only implementing the least restrictive effective procedures? If these rules were being followed correctly, it seems unlikely that 55 examples would appear in anyone’s career, much less all gathered in a single school that makes over $90 million a year. They seem to be experiencing a very unique and localized population.
Furthermore, we as a field love to throw the technical definition in the face of anyone criticizing us for using severe punishments, as if it completely discredits all of it. Critics talk about torture and injury resulting from punishments being used for harmless behaviors, and all we have to say is
“um actually, punishment is just any consequence that results in a behavior being less likely to occur in the future.”
– Pretentious BCBA on the internet
WE. ARE. SHOCKING. CHILDREN.
Is this really the most important argument you need to be having right now?
Ethics Code 7.01: Behavior analysts promote an ethical culture in their work environments and make others aware of this code.
Let’s just begin with the totally inappropriate behavior plan up there, complete with behaviors that don’t need to be targeted for reduction and the absolute overkill of the response prescribed to them. Staff are required to implement these plans to the letter (I would assume), and thus, are being taught and encouraged to use unethical practices.
There’s another side of it though. See, shocks are delivered via remote control. They’d have to be, because impact-based shock-delivery systems such as SIBIS don’t help much when you are targeting things like “hesitating before walking through a doorway.”
It reminded me of the Stanford Prison Study in 1971, in which 2 groups of participants were assigned roles as prisoners and prison guards. The differences in power dynamic resulted in such severe abuses from the prison guards and such extreme distress on the part of the prisoners, that it turned violent and the study had to be stopped after less than a week.
I also recall some of my own experiences, particularly in group homes for adults who engaged in severe behaviors. As much as we trained and trained on proper uses of restrictive responses, it was constantly used inappropriately. Even when I, as a supervisor, was present, I had to intervene on staff attempting to use restraint for behaviors that weren’t dangerous multiple times. Often, the decision to use them had nothing to do with evaluating the danger in the situation and more to do with the staff’s current mood and annoyance with the resident in question at the time.
This blog has discussed before that there is a power dynamic in all of our services whether we like it or not. It’s something we need to be hyper aware of at all times because of the constant risk of exploitation and abuse. We cannot ever be 100% sure that the contingencies we want to set up in an environment are in fact, the exact and only contingencies we do set up, or that they will teach only what we want them to teach.
After combining research and anecdotal reports, it should be clear: Humans cannot be trusted with the power to cause pain to another individual. Thus, when they are given such power, it is fostering an unethical work environment.
Ethics code 7.02b: If a client’s legal rights are being violated, or if there is potential or harm, behavior analysts must take necessary action to protect the client, including but not limited to, contacting relevant authorities, following organizational policies, and consulting with appropriate professionals, and documenting their efforts to address this matter.
In my introduction, you may have noticed I offered my thanks specifically to the autistic community for their information and action in this issue. I have no thanks for the ABA community, because I can count on 1 hand the number of BCBAs who have made any effort to fight this, and one of them is myself.
Not only has the field been relatively silent about the abuses at the JRC, they continue to spout the same scripted lies and nonsense to defend it. Furthermore, ABA International unapologetically supports it, and even had them speak at their 2021 annual convention. It also included a panel discussion that same year to specifically speak out against the FDA’s recent ban on their use of electric shock. The words “challenging the FDA’s ban” were literally in the title. So much for objective measurement.
Yes, that’s right, the FDA banned the use of the GED. It’s considered a torture device by the United Nations and is illegal in multiple countries. That ban was overturned in July 2021 though, due to the outcries from families and practitioners. Hence, #StopTheShock is (re)born.
Not only is there a mountain of evidence that the JRC violates clients’ rights on a daily basis, but there is little to no evidence for any of the justifications given for its methods. We’ve already discussed how most of those justifications are lies, yet nearly all of the people standing up for those clients’ rights are disabled people outside of the field of ABA. Practitioners, and the non-disabled community as a whole, has been deafeningly silent, and their silence is in direct violation of their own, beloved ethics code.
Do no harm
It’s not a formal Ethics Code with a fancy decimal number, it’s the main rule for the entire human services field, with ABA as no exception. No behavior, no matter how severe or dangerous, justifies doing harm or risking a person’s life simply to make it stop. It’s well established that the methods at JRC cause harm– from physical injuries such as burns to psychological injuries such as stress disorders and trauma. The very presence of the GED is trauma-inducing. It’s a device that remains attached to a person at all times, including while showering or sleeping, that can be triggered by another person to cause pain at any moment without warning. It doesn’t take a doctorate in clinical psychology to see what’s wrong with that.
Forcing a person to suffer in a reserved way instead of a loud, disruptive way is not a justification for these methods. ABA’s tendency to focus only on public events is one of the main flaws in our system, and it is literally killing people.
Yes, killing people. 6 residents have died at the JRC from preventable causes since its inception, and those statistics don’t include the number of suicides that could be linked back to experiences there. Those would be difficult to track down, but given the incredibly high suicide rate among disabled people, it would be naive to assume that the JRC doesn’t contribute.
Other problematic facts
The demographics at the center raise some serious concerns as well.
What we see here is a residential facility using unethical and dangerous procedures on a student body, the overwhelming majority of whom are people of color. That is a problem and raises serious questions. If the center was only targeting the most severe behaviors with the least-restrictive measures using only the most ethical methods, why would there be such a discrepancy? After all, disabilities such as autism affect all ethnic and racial groups and dangerous behaviors are seen just as widely distributed across these populations. The city of Canton, Massachusetts, where the center resides, is 81.6% white, so it certainly isn’t due to the location. Yes, it’s true students do attend there from other states, but the U.S. is 60% white, so it still doesn’t add up no matter how you try to spin the numbers.
The JRC’s board also does not currently include a single person with a disability. Two people who are on the board however, are Richard Malott and Ron Van Houten, BCBAs who make frequent significant financial contributions to ABA International. ABAI, if you remember, continuously provides a voice to the JRC at their annual conference, and consistently defends their practices, including with the aforementioned “facts” we have just shown to be false. ABAI even gave a humanitarian award for “the right to effective treatment” to Robert Sherman, the lawyer who represented the parents who successfully sued the State of Massachusetts for ordering the JRC to stop using extreme aversives.
The JRC also employs an aggressively gendered dress code based entirely on genders assigned at birth, further contributing to ABA’s problematic relationship with the LGBTQ community. The risk for trauma is even more elevated with this policy when you consider that the majority of autistic people are gender, sexual, and/or romantic minorities. The policies regarding behaviors targeted for reduction also suggest that conversion therapy techniques are likely employed on an unofficial basis. Students are shocked for refusing to take off their coats. Why should we assume students aren’t also shocked for attempting to dress in ways that are more in line with their own gender identities as opposed to what the JRC demands? This is an assumption, but it’s a valid concern, and one that the JRC should have to address transparently.
And now, something all practitioners need to hear
The facts are laid out and are readily available. The BCBA Code of Ethics provides a clear stance on their practices, and our field has been nothing if not incredibly proud of our Code of Ethics. It’s a favorite defense in favor of ABA’s infallibility.
Yet, you have been silent.
Not only have you been silent, many of you have had the absolute gall to scream that ABA is “under attack.” You say that criticism of ABA is all “misinformation” or “a big lie.” We’ve gone so far as to state as much to the National Council for Independent Living (NCIL) who recently decided to ban ABA. One of our major organizations even condescendingly offered to help “educate” the NCIL by introducing them to some disabled people. The NCIL– a disabled-run organization. There were almost no attempts to touch base with the NCIL in a mature way, only to explain to them that they were clearly wrong and that ABA flawless.
I don’t care if people are publishing books saying BCBAs sacrifice children on altars to Ivar Lovaas. There are children receiving 3rd degree burns for stimming. You don’t get to cry about anything until that shit is solved.
All of us– yes even those of you outside of the autism world– have a responsibility to stand up against the Judge Rotenberg Center, against ABAI for supporting it, against the BACB for refusing to take action against it, and against any fellow BCBA for staying silent. If you carry an ABA credential, this is your problem. There are atrocities being committed in our field, and as long as we are participating in the field, we are culpable.
The defenses they tell us are lies– lies so blatant that they don’t even try to cover them up. It’s almost insulting. They’re right there, publicly available information. At this point, if you still believe that the JRC has nothing to answer for, it’s because you choose to blindly support them and to stick your head in the sand so you don’t have to deal with the discomfort.
If you want to continue believing the JRC’s actions are justifiable, you are part of the problem. You are the reason ABA has the reputation it does, and as such, you have even less of a right to complain about that reputation. As long as you are defending them, those criticisms are correct. Some of you are actually claiming you have never caused harm to a disabled person receiving your services, only to then get on the internet and threaten, invalidate, and verbally assault autistic people who describe their experiences with ABA. Now who’s the misrepresentation?
There you are, out there in the open, putting your behavior in writing, and acting like a bunch of Nazi sympathizers.
I said what I said.
Get your shit together. Follow your own ethics codes, and deal with your own fragile egos quietly where the rest of us don’t have to hear it. Right now, we are the Karens of the human services world, whining and screaming about how unfairly we are being treated while simultaneously proving every single point made against us.
When you can show us you’re ready to work by using nice words, and keeping a calm voice and body, go to the resources below and take action.
Take Action
Google Doc with lists and instructions of various ways to fight back
Resources
Judge Rotenberg Center Wikipedia page
Autistic Hoya’s Living Archive of the Judge Rotenberg Center