Dr. John Breeding discusses the abusive policies of the Judge Rotenberg Center
More data from the New York State Department of Education review of the Judge Rotenberg Center:
JRC has a policy on modifying contingencies due to the special “pleading” of students. Part of the treatment program for students involves deliberately setting up unfair or mistaken directions or decelerative (application of a skin shock with a GED device) consequences for the students. The student is expected to handle these unfair situations successfully and not ‘plead’ or appeal to a psychologist or clinician regarding his/her treatment. In instances where the student “pleads” to the psychologist or clinician, there are consequences imposed on the student.
It was reported by a JRC staff member that one of the BRL episodes involved holding a student’s face still while staff person went for his mouth with a pen or pencil threatening to stab him in the mouth while repeatedly yelling “YOU WANT TO EAT THIS?” The goal was to aversively treat the student’s target behavior of putting sharp objects in the mouth.
It was reported that during a BRL, the student would still receive a GED for exhibiting an appropriate behavior, just less than for exhibiting a target behavior. For example, five GED applications would be given for a target behavior, such as mouthing towards the object, as opposed to one GED application for an appropriate behavior such as turning away from the object.
Students placed in the more segregated and restrictive settings (i.e., the small conference room) were not observed to receive instruction, even computer-based instruction, and a teacher is not available to provide instruction in that setting. The room is monitored by MHAs with high school diplomas and other nonteaching staff.
Students attend the school seven days per week from 9 AM to 4 PM; teachers are not present on the weekend days. Teachers interviewed by the team could not describe what the students did on the weekends at the school.
A student interviewed stated that she had entered JRC at the age of 19 with the expectation that she would receive vocational training while she resolved her emotional and behavioral problems. She had not received any vocational training and still remained in the most restrictive settings offered by JRC. This student wept as she asked the team to bring her back to New York.
Records and staff indicate that, once placed, very few students’ transition out of JRC to a less restrictive environment prior to aging-out.
A review of a student’s file indicated that the student was receiving Level III aversive interventions for “aggression”, but according to the teacher’s notes, the only aggressions exhibited by the student were in anticipation of the GED. The student was not otherwise aggressive.
There does not appear to be any measurement of, or treatment for, the possible collateral effects of punishment such as depression, anxiety, and/or social withdrawal.
Student interviews revealed reports of pervasive fears and anxieties related to the interventions used at JRC. Students verbally reported a lack of trust, fear, feeling upset/anxious and loneliness.
One student stated she felt depressed and fearful, stating very coherently her desire to leave the center. She is not permitted to initiate conversation with any member of the staff. She also expressed that she had no one to talk to about her feelings of depression and her desire to kill herself and told the interviewing team that she thought about killing herself everyday. Her greatest fear was that she would remain at JRC beyond her 21st birthday.
Mental Disability Rights International (MDRI) has filed a report and urgent appeal with the United Nations Special Rapporteur on Torture alleging that the Judge Rotenberg Center for the disabled, located in Massachusetts, violates the UN Convention against Torture.
The rights group submitted their report this week, titled “Torture not Treatment: Electric Shock and Long-Term Restraint in the United States on Children and Adults with Disabilities at the Judge Rotenberg Center,” after an in-depth investigation revealed use of restraint boards, isolation, food deprivation and electric shocks in efforts to control the behaviors of its disabled and emotionally troubled students.
Findings in the MDRI report include the center’s practice of subjecting children to electric shocks on the legs, arms, soles of feet and torso — in many cases for years — as well as some for more than a decade. Electronic shocks are administered by remote-controlled packs attached to a child’s back called a Graduated Electronic Decelerators (GEI).
The disabilities group notes that stun guns typically deliver three to four milliamps per shock. GEI packs, meanwhile, shock students with 45 milliamps — more than ten times the amperage of a typical stun gun.
A former employee of the center told an investigator, “When you start working there, they show you this video which says the shock is ‘like a bee sting’ and that it does not really hurt the kids. One kid, you could smell the flesh burning, he had so many shocks. These kids are under constant fear, 24/7. They sleep with them on, eat with them on. It made me sick and I could not sleep. I prayed to God someone would help these kids.”
More data from the NYSED report on the Judge Rotenberg Center:
The meeting minutes from one student’s CSE meeting stated the student was unable to attend the meeting because she was in restraint. This was one of the students interviewed and she stated that she needed to talk with her CSE Chairperson regarding her behavior program at JRC, but was unable to attend the last meeting. On follow up with the Chairperson, the team learned that the student was in attendance at a more recent CSE meeting in May 2006, but was unable to participate because she could not control her sobbing. According to the Chairperson, the CSE recommended at the May CSE meeting that this student be faded from the GED.
While JRC collects comprehensive data on negative targeted behaviors, there was no evidence of the collection of data on replacement or positive behaviors to document the development of replacement or enhancing skills. Documentation was difficult to find for evidence of academic progress or development of positive social skills. The program descriptions of behavioral interventions are very standardized across students and show a lack of individualization of treatment planning.
Treatment plans do not always vary for different types of behavioral difficulties exhibited by an individual student, even though these behaviors may serve different functions for the student.
In one classroom it was observed that a new staff member was briefly informed that his role in the room was to monitor 1:1 student S and second party verification was not required before administering the GED. The new staff person was handed the SLED (GED transmitter) and verbally given direction and instruction in when to administer the GED. As the instructing staff person was departing, she also informed the new staff that student S is deaf.
There is no evidence that JRC considers the potential negative effects, such as depression or anxiety, that may result from the use of aversive behavioral strategies with certain individual students. Several students from NYS came to JRC with diagnoses of Post Traumatic Stress Disorder (PTSD), yet their behavior programs call for skin shock. Skin shock has the potential to increase the symptoms associated with PTSD, yet there is no evidence of data measuring these possible side effects or therapies designed to treat these symptoms.
JRC is receiving federal funds to administer the National School Lunch and School Breakfast Program that are not properly payable. JRC did not have adequate documentation to support that all meals served at the school met the minimum standards established by the United States Department of Agriculture (USDA). We have notified John Magnarelli, Director of Special Nutrition Programs for USDA’s Northeast Regional Office of this finding; he informed NYS that he has instructed the MDOE to formally notify JRC and request that they comply with the federal meal pattern requirements immediately.
A student, reported to have extreme head banging behaviors, was observed not exhibiting any inappropriate behaviors while having her hair braided by an adult in the classroom. Her appropriate interactions were not rewarded and/or acknowledged by the staff. However, the following day, this student was placed in a higher demand activity (academic computer work) and exhibited several head banging attempts. These behaviors were met with the ongoing loss of her contract. Loss of contract involved returning to the academic computer work. In this case, academic work was scheduled into the contract as a punishing consequence. The teacher reported that she would simply continue to lose her contract award and if the behaviors increased in intensity, it could result in the need to restrain her. Otherwise, no other intervention strategies were being used with this student. She is currently awaiting court approval for the use of Level III aversives.
[I want to draw special attention to this one. She can function okay in low-stress environments, but head-bangs in stressful environments. The “solution” is to punish her head-banging by keeping her in the stressful environment until she needs to be physically restrained, and they’re trying to get permission to use the remote zaps on her. -ed]
X-post from John M Grohol PsyD
We’ve written previously about the incredible story of a former patient being able to get the staff at the Judge Rotenberg Educational Center (JRC) to apply electrical shock to two of its current patients. Any safeguards the Center had in place to prevent such a tragedy apparently were not operating that night. We also noted in the comments how the Center destroyed videotape evidence relating to an investigation of the incident, against the direction of the investigator.
A few days ago, The Boston Globe detailed one of the incidents that night in its article, Parent details toll taken by shocks at group home. One of the patients is still there, the other has been moved to another facility.
The details are heart-breaking:
But after that, the staff tied Dumas’s son to a board, restraining all four limbs. The teenager, resigned to his fate, said, “Let them know I’m being compliant.”
During the next hour, he received dozens of rapid-fire shocks to his abdomen and limbs, which in fact violated his treatment plan. At one point, he complained, “Mister, I can’t breathe.”
On tape, the staff recounted the reasons for different shocks, including swearing, verbal threats, and noncompliance. Of the two power levels of shock treatments used by the school, Dumas’s son received the most powerful each time, school officials have said.
Shift supervisor Michael Thompson, on the job for two months, left the room at one point, saying he wanted to “either cry or throw up,” the report said.
The father of this child tried to “keep perspective” on the incident:
The father [… blamed] poor weekend staffing for what transpired that night. He said the home had many immigrants who had difficulty giving even simple directions in English.
“On the weekends, they have a lot of people who don’t speak good English and are fearful of losing their jobs,” Dumas said.
Ahh, well, there you go. Can’t afford legitimate health care workers who speak the language? Get whoever you can, give them a few days of training, and just trust nothing will go wrong.
Findings from the NYSED review of the Judge Rotenberg Educational Center:
There was very limited social interaction between the classroom staff and students except for 1:1 prompting (jargon) to computer tasks and/or the awarding or removal of tokens.
JRC does not promote the development of social skills for any of their students and in fact requires that the students not attempt social interactions with staff or classmates as part of their behavior programs. Questions to staff about programs for social skills development were always answered by descriptions of social opportunities that included recess as well as scheduled recreational outings. The recreational outings were with groups of students and provided no opportunities for interaction with members of the general community.
Several observations were made of the outdoor recess periods and lunch breaks. The recreation area was set up with swings and a wooden structure for climbing and walking across bridges and several plastic slides. The area was very well maintained and appropriate for children under seven or eight years old. However, the students during all observations appeared to be adolescents. Staff was attentive and providing appropriate supervision to students and the interactions between staff and students were positive, supportive and respectful. However, they tended to be helping interactions rather than conversations or play. 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 to contracts. When questioned about friendships and social interactions among students, the students interviewed stated that they were unable to socialize in a natural way.
Opportunities to socialize with peers must be earned through compliance with behavioral contracts.
Students in classrooms were docile and compliant and did not attempt to socially engage, either verbally or with eye contact, anyone in the rooms. This was also apparent in the residences visited by the team. Staff indicated, on at least three occasions, that it was unsafe to allow students to socialize because in the past students had plotted against staff.
This is past mere child abuse. We know what happens when children are socially isolated for extended periods – the effects are well-documented in the scientific literature. With a normal, healthy child the best you can hope for is depression and some retardation of normal social development.
I want to call special attention to that last line in the quote:
Staff indicated, on at least three occasions, that it was unsafe to allow students to socialize because in the past students had plotted against staff.
I find this entirely sane and justified … on behalf of the students. This is the level of atrocity for which if nonviolent means fail to work, violence is justified in self defense and the defense of others. This is the level of atrocity for which if legal means do not work – and they have not in the past (the center is named after a judge who ruled in their favor) – extralegal means are justified. This is the level of atrocity that, if such a thing as a moral obligation exists, we are morally obligated to put an end to.
I in no way think that violent or other illegal methods are justified or likely to help. Rather, I mean that this is so beyond ordinary moral outrage that extreme methods understandable on the part of the students, who have essentially zero access to each other, let alone media and lawyers. This is already a place where self-injury and threatening to commit suicide is “normal” – the students going on hunger strike is not going to change anything — if it is even noticed.
More data from the New York State Department of Education review of the Judge Rotenberg Center:
A review of JRC’s internal IEP admission checklist states that staff ‘eliminate’ (where possible) related service recommendations, such as speech and language therapy or counseling. While JRC employs or contracts with some related service providers, documentation showed that JRC takes steps to have CSEs eliminate recommendations for related services.
Student files contained documentation that JRC consistently requests that speech and language therapy, occupational therapy (OT), and counseling be removed from a student’s IEP. A review of IEPs of NYS students showed:
- 23 students had CSE recommendations for counseling that were later eliminated based on JRC’s recommendation;
- 12 students had IEP recommendations for speech and language therapy that were later eliminated based on JRC’s recommendation;
- Seven students had IEP recommendations for OT that were later terminated based on JRC’s recommendation and one continued OT on a “one hour per month – consult” basis; and
- Four students had IEP recommendations for PT [physical therapy] that were later terminated based on JRC’s recommendation.
Twenty students’ current IEPs include recommendations for speech and language therapy. JRC records indicate that 12 students are receiving speech language therapy with most at a duration and frequency of 1×30 min/week (below the minimum NYS regulatory requirement).
At JRC, behavioral counseling is provided in a nontraditional format in which students are expected to learn how to self-manage their target behaviors. Students who request to speak with a psychologist must write a note or “business letter” requesting a session and “pay” with their tokens. (The nature of counseling is unclear). The Director of Clinical Services indicated that other types of counseling could be used, but that it is not routinely offered.
Based on classroom observations, there was no evidence that language instruction, as required by NYS regulations for students with autism, was being provided.
Out of 148 NYS students at JRC, 128 students receive no related services. The provision of related services was not observed during either visitation.
Observers did not see a structured, systematic program for teaching of generalization of skills, self-care, social/recreational or community skills in the school or the residences to assist students in post-secondary transitions or to promote transitions to less restrictive settings.
There was no evidence of social skills instruction or use of a curriculum or instruction to teach alternatives to aggressive behaviors. When asked about their social skills curriculum, JRC staff described opportunities to socialize and opportunities for recreational trips. None of the staff mentioned any of the published social skills curriculum that are in common use for the treatment of children with autism spectrum disorders or curricular for teaching prosocial and anger management strategies. For students with autism and students with diagnoses that represent social difficulties (e.g., oppositional defiant disorder; conduct disorder), there was no evidence of teaching students positive social ways to communicate or of teaching or programming for social skills during the observation periods.
The complete lack of organized, instructional social interaction periods and reinforcement for positive social interactions also prevented developing time with other children as a reinforcing activity.
This is a particularly glaring omission in programming when contemplating transition to a less restrictive school or adult settings where positive social play and interaction with other children and adults is necessary for success.
This is an outrage. Even if JRC was doing nothing else wrong, this alone would justify an immediate termination of the program and criminal prosecution of those in charge – at a bare minimum, they’re defrauding state governments and parents by claiming to offer therapy and then systematically denying therapy, and I would hope a case could be made for child abuse on just on the systematic and intentional denial of speech and physical therapy to children who need it. Ordinary, well funded schools with a halfway decent special ed program provide or help arrange for speech therapy. That JRC goes out of their way to actively be worse than mediocre is inexcusable.
And students who want to speak to a psychologist have to request it in writing and pay for it with good behaviour tokens? That is below bare minimum standards. Normal schools allow access to a counselor with nothing more than asking a teacher, and I haven’t seen one where a student in distress would be turned away from a drop-in appointment.
It gets worse. JRC found a way to do one better than denying social skills classes and speech therapy to their charges: preventing them from talking and socializing altogether.