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vermontsavant
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24 Feb 2012, 10:11 pm

@aghogday.all your arguements are what they used to say about gaebler.but no one regrets that gaebler was shut down.look up gaebler childrens center on your eternal source of links.go to madpride.org.as to whether or whether or not the therapies at JRC are waranted i dont know.it goes on a kid by kid basis.however no has anything but regret to what happened at gaebler.i suspect the same for JRC.i knew kids who were at gaebler,you know nothing of mass dept of social services other than you box of eternal links you have somewhere.look up gaebler childrens center and throw out some links on that


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25 Feb 2012, 1:27 am

vermontsavant wrote:
@aghogday.all your arguements are what they used to say about gaebler.but no one regrets that gaebler was shut down.look up gaebler childrens center on your eternal source of links.go to madpride.org.as to whether or whether or not the therapies at JRC are waranted i dont know.it goes on a kid by kid basis.however no has anything but regret to what happened at gaebler.i suspect the same for JRC.i knew kids who were at gaebler,you know nothing of mass dept of social services other than you box of eternal links you have somewhere.look up gaebler childrens center and throw out some links on that


The madpride.org links are for the most part broken, and outdated, listing their latest newsletter in 2000.

http://en.wikipedia.org/wiki/Gaebler_Children's_Center

Quote:
The Massachusetts Department of Mental Health (DMH) closed the center as it was antiquated and could no longer serve the needs of the children it housed. According to the DMH, this closure coincided with the decision to place mentally ill children in community settings instead of in institutional settings. Others felt the center was closed due to budget cuts.


The conditions reported at Gaebler, linked in the Wiki article to that institution, were common in institutions for decades across the country. Many have been shut down. Gaebler was not shut down in 1992 for abuses, it was shut down because the facility was antiquated, could no longer serve the residents it housed, and it was in coordination with efforts to move children into residential care, in communities. It was a planned effort.

These type of harsh conditions for patients continue, to a lesser degeree, wherever there are those that are disadvantaged and entrusted to others care, and there are individuals are employed that do not properly perform their duties.

Advances in modern methods of surveillence of these employees, is about the only way to ensure that abuses do not occur. However, as was seen at the JRC, administration officials can circumvent these procedures in some cases.

The mental institutions of today are in prisons or on the street. The place where those that cannot be managed in the modern day version of psychiatric hospitals and residential communities end up. Prisons have relatively low levels of expertise in mental health care and the street has none.

The children at the JRC stand a better chance of being placed than the adults, if it were to close. The adults stand a greater potential to end up back in corrections facilities or on the street.

The problem, beyond the placement of some of the severe cases at the JRC, today, in Massachusetts, is one of funding for Mental health programs.

It is clear in the link I provided, that this is a current state wide issue, in Massachussetts, that may potentially grow worse.

It is not going to make it any easier for these individuals to be placed, and it presents a difficulty for many individuals that need mental health care, across the state and not only in Massachussetts, but across the country, where similiar cuts in social programs have been made, in the course of the last several years.

The skin-shock therapies are warranted on a case by case basis by the courts in Massachussetts, as already sourced in this thread. The decision, is one that the courts make. The JRC has no control over those court decisions.

The State and the JRC are both responsible for the fact that this type of skin-shock therapy continues. It is up to state or federal officials to ban the aversives as they are currently used on existing patients.

And, it is also up to the state to find a place for these individuals to be placed if the state decides to shut the facility down at anytime in the future, just as it was when the Gaebler facility closed down. Both institutions received/receive funding from the state. Over $200,000 a year, in some cases, for the individuals who receive care at the JRC facility.

I am not making an argument for the JRC to stay open, I am making an argument for those housed there to receive appropriate care if it were to close.

However, there are no plans or even a suggestion to shut the facility down, in the State Government in Massachuseets. The only question at this point in time, is will the state legislature in Massachussetts, be sucessful in further restrictions on aversive therapies.

From the ICAA (International Coalition for Autism and all Abilities):

http://www.icaaonline.org/?p=1472#more-1472


Quote:
1.) EXECUTIVE: The [Governor] Patrick administration, which has issued new regulations that would stop JRC from initiating its “aversive” practices on any new admissions, but would still allow prior court orders for the treatment to happen. These regulations are in place but are being held up by the JRC’s lawyers.

2.) LEGISLATIVE: There are four legislative bills introduced this year to the MA Legislature’s Joint Committee on Children, Families and Persons with Disabilities. They were heard in July, but are still awaiting a vote:

1.Senate Bill #51, An Act relative to the humane treatment of disabled persons (Sponsored by Senator Brian Joyce of Milton), which calls for a total ban on all ‘aversives;’
2.House Bill #77, An Act relative to the humane treatment of disabled persons (Sponsored by Rep. Tom Sannicandro of Ashland), which is identical to the above bill;
3.Senate Bill #49, An Act relative to level IV treatment interventions (Sponsored by Senator Joyce), a “compromise” bill which calls for ‘aversive’ interventions to be allowed, but as a strictly-regulated ‘class’ of intervention; and
4.Senate Bill #50, An Act creating a special commission on behavior modification (Sponsored by Senator Joyce), which would create a special oversight commission to monitor ‘behavioral modification’ procedures.


These bills were discussed in a hearing last Summer, and still have not come to a vote. Perhaps, there will be a vote concurring with the Presidential election this November.

At this point, an e-mail to the Justice Department, that has an open investigation into potential abuses at the JRC, may be the best support, in hopes of banning the skin-shock aversives nation wide.

And at this point there would be nothing stopping the JRC from moving to another state, if legislation to ban the aversives in Massachussetts is successful, per the international disabilities organization, that I sourced earlier in the thread, that has the email link to the Justice Department.



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25 Feb 2012, 6:43 am

yes your right gaebler was shut down because of budget cuts.it was only after it was shut down that the abuses came to light.so was the same with the belchertown state school.yes there are shortages in mass but the JRC is only one school and couldnt house more than a couple hundred.that can be easily absorbed by other programs.programs like service net have many group homes and so with the united ark and many others.also the local school system can be forced to pay for private hospital in certain circumstances


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25 Feb 2012, 8:53 am

aghogday wrote:
ProfumoAffair wrote:
I don't see why Aghogday insists on defending JRC if this is the case by constantly downplaying the numbers or exaggerating the extremeness of autism in reality by appealing to the extremes.


Again, I am not defending the abuses at the JRC, and have presented facts, that are sourced. My concern is for the welfare of the children and adults in the program, and their accessibility to care in the future, if the Center closes down.


That was not the case. Why were you defending the procedures by saying that they simply weren't considered illegal in the state even though they had killed people? Also why did you make the unfounded assertion that the children were the handpicked most self-dangerous in the country? Furthermore why have you kept trying to downplay the fact that multiple children have been killed in the JRC by saying you care about the welfare of the children?



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25 Feb 2012, 9:23 am

ProfumoAffair wrote:
aghogday wrote:
ProfumoAffair wrote:
I don't see why Aghogday insists on defending JRC if this is the case by constantly downplaying the numbers or exaggerating the extremeness of autism in reality by appealing to the extremes.


Again, I am not defending the abuses at the JRC, and have presented facts, that are sourced. My concern is for the welfare of the children and adults in the program, and their accessibility to care in the future, if the Center closes down.


That was not the case. Why were you defending the procedures by saying that they simply weren't considered illegal in the state even though they had killed people? Also why did you make the unfounded assertion that the children were the handpicked most self-dangerous in the country? Furthermore why have you kept trying to downplay the fact that multiple children have been killed in the JRC by saying you care about the welfare of the children?
well said,children were murdered at gaebler too


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25 Feb 2012, 12:12 pm

aghogday wrote:
Sweetleaf wrote:
aghogday wrote:

People have been attempting to get the JRC closed down for decades now.

However, until the abuses of the regulations that allow the aversive shock therapy in behavioral modification techniques, were found, and have now resulted in the restriction of the therapy in new patients, the Center had a compelling enough argument to defend the therapy, as justified, for the state to allow the continuance of the use of the therapy.

This an outline, provided by the organization, of the state laws/regulations in Massachusetts that have allowed the organization to justify their use of the aversive shock therapy, for decades now.

And what I am saying is it disgusts and angers me that they are allowed to continue using these harmful, cruel teqniques on the already existing patients. Them being used to abuse does not make it ok to allow it to continue.

Quote:
The aversives employed at JRC are safe, effective, and professionally approved by a Peer Review Committee and Human Rights Committee under procedures outlined by the Massachusetts Department of Mental Retardation (“MA DMR”). See 115 CMR 5.14. They are used pursuant to regulations of the MA DMR and the Massachusetts Department of Early Education and Care (“MA EEC”). JRC does not use aversive techniques until a Massachusetts Probate Court approves their use on an individual basis. JRC follows the MA DMR regulations requiring these treatment techniques to be used in a safe, well-documented manner. 115 CMR 5.14. JRC creates for each student a written behavior modification plan detailing the treatment’s rationale, duration, conditions, goals, and a detailed monitoring plan. 115 CMR 5.14(4)(c). A parent must sign a detailed aversive therapy consent form before JRC will incorporate such techniques in a student’s treatment plan and the aversive treatment is included and made part of the student’s Individualized Education Plan or Individualized Service Plan.


The most commonly used “aversive” procedure at JRC is an electrical stimulation device[1] manufactured by JRC called the Graduated Electronic Decelerator (“GED”). The GED unit consists of a transmitter operated by a JRC staff member and a receiver and stimulator worn by the student. The receiver delivers a low-level surface application of electrical current to a small area of the student’s skin upon command from the transmitter, as part of a designed behavioral treatment. There are no harmful side effects and minor side effects may consist of reddening of the skin and, on rare occasions, the appearance of a small blister, both of which are temporary. For many individuals, the GED is required only during the first few months of treatment, and is no longer necessary, or is necessary to a far lesser and diminishing degree, after that period. The students receive only one application per week on average. The Supreme Judicial Court of Massachusetts has affirmed a Probate Court order authorizing the use of the GED at JRC as an appropriate intervention. See Guardianship of Brandon Sanchez, 424 Mass. 482 (1997); see also JRC v. DMR, 424 Mass. 430 (1997). Over one hundred peer-reviewed articles have been published in the professional literature supporting the safety and effectiveness of skin-shock and eight articles deal with the specific device (“SIBIS”) which is the forerunner of JRC’s GED device.


And this is their argument, that has justified the treatment as a last resort method of behavioral therapy, for the children in their treatment program that have been turned away from other programs.

Nowhere in there does it say what the purpose of this is or if it helps anything and based on that description....why does the child have to endure physical discomfort? causing the child to feel pain for behavior they are not in control of in an attempt to punish the behavior out of them hardly seems the way to go about it. I doubt the mentally ret*d children who receive this treatment even understand what the purpose is..........to them its probably 'I don't understand why these people are causing me pain.'


Quote:
JRC often acts as a treatment of last resort for children and adults with severe behavior disorders who have been resistant to all forms of drugs and other psychiatric treatment and for whom there is no other placement that can educate them and keep them safe. These students engage in behaviors such as head-banging, eye-gouging, and biting off body parts.

JRC’s policy is to use a highly consistent application of behavior modification treatment and minimal or no psychotropic medication. JRC offers intensive behavioral treatment based on peer-reviewed and accepted methods of behavioral psychology, which has been extremely effective and life-saving for students who could not be effectively treated with psychotropic medication or psychotherapy. JRC’s treatment procedures are so effective that they rapidly reduce to a zero or near zero level the major problem behaviors of students with the most difficult-to-treat behavior disorders in the country.


Again, how does causing physical discomfort in the patients in an attempt to punish the symptoms out of them solve anything? Also treating non-behavioral problems as behavioral problems is likely to cause more problems. I am curious how many kids make it out of this center and how much better do they function after having undergone this 'therapy.' I wonder how many cases of PTSD there are.

There is another side of the issue, and that is what happens to these children if the JRC can no longer use the treatment that they justify as effective for these last resort cases, and turns them away as the other facilities have done.

Picture a young adult biting their body parts off, homeless on the streets; in a corrections facility that has no idea how to deal with them; or in a state institution, if one can be found for them, heavily sedated for life.

It's a harsh potential, that has likely kept the JRC open for the last several decades. There don't appear to be many good answers for some of these patients, outside of the JRC, either.

Institutional abuse can happen in any institutional environment, and the potential increases as the level of difficulties with patients increase.

That's no justification of the abuse, but it is a reality of the human condition, both for the patient and for the individuals providing treatment, that overstep the boundries established for behavioral therapies. As, has been evidenced in the past, at the JRC, and in many other institutions.

Well it would seem JRC does not know how to deal with them either.......they seem more concerned with tormenting the patients and justifying it as the only way. Why is the abuse nessisary is what I am wondering......in another thread I mentioned other ways they could make the patient stop hurting them self. That don't involve hurting the patient to make them stop hurting them self which does not even make sense. Also since when is mental retardation or Autism for that matter a behavioral problem.....I don't think behavioral therapy is appropriate for issues that aren't behavioral

I don't like any of the potential scenarios. They are all horrifying. It is a large part of the reason, why I have tried to provide evidence for why continuing research into causes, prevention, effective therapies, and the remote possibility for a cure, is so important for the children that have these type of debilitating behavioral problems associated with some forms of Autism.


Effective therapies are a great idea, but causing physical discomfort in a patient to try and teach them a lesson......is not one of them.


Just trying to provide an answer to your question as to why this type of treatment has continued for decades. I don't condone it a good solution, however it is the only solution that the state of massachussetts, their legal experts, human rights specialists, and court appointed authority could find for this minority of children that had these severe behavioral problems.

Ok fair enough......however its not a solution at all, so I fail to see how its the only solution. They could easily quit doing abusive things to the kids that would be the start to an actual solution.


Only about 80 children in the country, have been determined to have behavioral problems bad enough to warrant this type of therapy. They are not all autistic children or young adults. I think you mentioned restraining them from biting their body parts off. This is obviously the first step anyone would do, if they found their children trying to bite their fingers off, etc. However it is not a permanent solution. The only way better solutions are going to be found is through further research.

Putting them out on the streets, is the worse possible solution. I certainly hope they will find ones better than that for the children and young adults in question.


From my understanding this center was for kids with mental disorders/disabilities such as autism and mental retardation, neither of which are behavioral problems. So treating the symptoms as 'mis-behavior' and using cruel punishments is clearly going to do a lot more harm than good. Not to mention how is that a form of therapy to begin with? and what could possibly warrant it unless these children are all Satan himself. And even then I would probably still have an issue with it because two wrongs don't make a right.

Also simply restraining them sure as hell beats the force feeding of hot peppers...whoever came up with that should have it done to them self so they can see how they like it.

And why is it they either have to be abused or have to be put on the streets? why can't they simply stop the abuse at such institutions? I mean I thought mental institutions where supposed to be safe places for people with severe mental problems not torture centers. I don't think being stuck in a place where the employees abuse you 'for your own good.' is necessarily better then being thrown on the streets both are terrible.


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25 Feb 2012, 1:04 pm

@sweatleaf.all of the children in question were shown to be very violent both autistic and other types of mental heath issues.the JRC and programs like it house all types of children who can be dangerous to themselves and others.but i would agree bed restraints would be a better alternitve than electic shocks.however bed restraint are illegal and would also require a court order in mass.its a loose loose sitiuation


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25 Feb 2012, 1:45 pm

vermontsavant wrote:
@sweatleaf.all of the children in question were shown to be very violent both autistic and other types of mental heath issues.the JRC and programs like it house all types of children who can be dangerous to themselves and others.but i would agree bed restraints would be a better alternitve than electic shocks.however bed restraint are illegal and would also require a court order in mass.its a loose loose sitiuation



All of them where very violent to begin with? even so that is no excuse for such abuse....we are talking about mentally ill kids. There is no justification for things like force feeding of hot peppers or electric shocks......how the hell does that help reduce their symptoms, calm them down or decrease their violent behavior?

My issue is not with housing these children in a place where they cannot hurt themselves or others......also I am not suggesting they just strap these kids down to beds for days but when they are being violent towards themselves or others they should be restrained in a way that does not hurt them in an attempt to help not punish.......The attitude of the mental health workers there is important as well. Also, they have no problem giving kids with ADHD adderall so why not maybe in very extreme cases use medications that could maybe reduce the violent behavior and outburts that way they would not have to constantly be restrained. Sure being on meds is not the funnest life but it beats what they are doing currently.


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25 Feb 2012, 3:33 pm

yea my last post was more or less agreeing with you.i think proper medication could reduce most of these problems.your right basicly.most of the staff at those places dont have adiquite training.they are usualy have a bachalors in psyche and are atending grad school and it is there first job with kids right out of college.


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25 Feb 2012, 5:07 pm

ProfumoAffair wrote:
aghogday wrote:
ProfumoAffair wrote:
I don't see why Aghogday insists on defending JRC if this is the case by constantly downplaying the numbers or exaggerating the extremeness of autism in reality by appealing to the extremes.


Again, I am not defending the abuses at the JRC, and have presented facts, that are sourced. My concern is for the welfare of the children and adults in the program, and their accessibility to care in the future, if the Center closes down.


That was not the case. Why were you defending the procedures by saying that they simply weren't considered illegal in the state even though they had killed people? Also why did you make the unfounded assertion that the children were the handpicked most self-dangerous in the country? Furthermore why have you kept trying to downplay the fact that multiple children have been killed in the JRC by saying you care about the welfare of the children?


Do me a favor, and quote my entire post instead of saying I asserted something that I did not assert. There is a written record here, it is fairly easy to see when someone misquotes someone else.

This is the actual full quote from my last post that you responded to.

Quote:
The court determines and approves if each child can receive the therapy. This is the only facility that provides the therapy, so these are the only children in the country that are determined to have self injurious behaviors that are serious enough where the benefits of the therapy exceed the costs of the therapy.

As I've stated many times I don't condone the abuses of the therapy, I am just reporting the facts as they exist.


I did not say the children were handpicked or the most self-dangerous children in the country. I said this is the only facility that provides the therapy, so these are the only children in the country that are determined to have self injurious behaviors that are serious enough where the benefits of the therapy exceed the costs of the therapy. The Courts in Massachussetts determines this, the JRC does not get the final decision.

The children arrive at the facility by many different means, some parents bring them there after they have been turned away from other facilities; corrections facilities send them there by court order, and some get on the waiting list because their parents believe that it is the only facility that may be able to help them. In addition, other states send children to the facility. The JRC doesn't select people out of the population, they come there by many different means.


Sweetleaf asked why the abuse was continuing, and I reported the fact that the state is allowing it and the state's justification for it. It is not my opinion it is the facts as they exist.. I have already told you several times I don't condone the abuses of the procedures, nor am I defending them.

It is a fact that people have died in the facility; there is evidence of abuse, but there is no evidence that anyone has committed murder. That's a fact, but it doesn't mean I like the aversives that are being used and the abuses that have been committed. If there were any actual murders it would have been reported in the UN report that was provided by the agency that is trying to ban the aversives nationwide.



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25 Feb 2012, 5:56 pm

Sweetleaf wrote:
aghogday wrote:
Sweetleaf wrote:
aghogday wrote:

People have been attempting to get the JRC closed down for decades now.

However, until the abuses of the regulations that allow the aversive shock therapy in behavioral modification techniques, were found, and have now resulted in the restriction of the therapy in new patients, the Center had a compelling enough argument to defend the therapy, as justified, for the state to allow the continuance of the use of the therapy.

This an outline, provided by the organization, of the state laws/regulations in Massachusetts that have allowed the organization to justify their use of the aversive shock therapy, for decades now.

And what I am saying is it disgusts and angers me that they are allowed to continue using these harmful, cruel teqniques on the already existing patients. Them being used to abuse does not make it ok to allow it to continue.

Quote:
The aversives employed at JRC are safe, effective, and professionally approved by a Peer Review Committee and Human Rights Committee under procedures outlined by the Massachusetts Department of Mental Retardation (“MA DMR”). See 115 CMR 5.14. They are used pursuant to regulations of the MA DMR and the Massachusetts Department of Early Education and Care (“MA EEC”). JRC does not use aversive techniques until a Massachusetts Probate Court approves their use on an individual basis. JRC follows the MA DMR regulations requiring these treatment techniques to be used in a safe, well-documented manner. 115 CMR 5.14. JRC creates for each student a written behavior modification plan detailing the treatment’s rationale, duration, conditions, goals, and a detailed monitoring plan. 115 CMR 5.14(4)(c). A parent must sign a detailed aversive therapy consent form before JRC will incorporate such techniques in a student’s treatment plan and the aversive treatment is included and made part of the student’s Individualized Education Plan or Individualized Service Plan.


The most commonly used “aversive” procedure at JRC is an electrical stimulation device[1] manufactured by JRC called the Graduated Electronic Decelerator (“GED”). The GED unit consists of a transmitter operated by a JRC staff member and a receiver and stimulator worn by the student. The receiver delivers a low-level surface application of electrical current to a small area of the student’s skin upon command from the transmitter, as part of a designed behavioral treatment. There are no harmful side effects and minor side effects may consist of reddening of the skin and, on rare occasions, the appearance of a small blister, both of which are temporary. For many individuals, the GED is required only during the first few months of treatment, and is no longer necessary, or is necessary to a far lesser and diminishing degree, after that period. The students receive only one application per week on average. The Supreme Judicial Court of Massachusetts has affirmed a Probate Court order authorizing the use of the GED at JRC as an appropriate intervention. See Guardianship of Brandon Sanchez, 424 Mass. 482 (1997); see also JRC v. DMR, 424 Mass. 430 (1997). Over one hundred peer-reviewed articles have been published in the professional literature supporting the safety and effectiveness of skin-shock and eight articles deal with the specific device (“SIBIS”) which is the forerunner of JRC’s GED device.


And this is their argument, that has justified the treatment as a last resort method of behavioral therapy, for the children in their treatment program that have been turned away from other programs.

Nowhere in there does it say what the purpose of this is or if it helps anything and based on that description....why does the child have to endure physical discomfort? causing the child to feel pain for behavior they are not in control of in an attempt to punish the behavior out of them hardly seems the way to go about it. I doubt the mentally ret*d children who receive this treatment even understand what the purpose is..........to them its probably 'I don't understand why these people are causing me pain.'


Quote:
JRC often acts as a treatment of last resort for children and adults with severe behavior disorders who have been resistant to all forms of drugs and other psychiatric treatment and for whom there is no other placement that can educate them and keep them safe. These students engage in behaviors such as head-banging, eye-gouging, and biting off body parts.

JRC’s policy is to use a highly consistent application of behavior modification treatment and minimal or no psychotropic medication. JRC offers intensive behavioral treatment based on peer-reviewed and accepted methods of behavioral psychology, which has been extremely effective and life-saving for students who could not be effectively treated with psychotropic medication or psychotherapy. JRC’s treatment procedures are so effective that they rapidly reduce to a zero or near zero level the major problem behaviors of students with the most difficult-to-treat behavior disorders in the country.


Again, how does causing physical discomfort in the patients in an attempt to punish the symptoms out of them solve anything? Also treating non-behavioral problems as behavioral problems is likely to cause more problems. I am curious how many kids make it out of this center and how much better do they function after having undergone this 'therapy.' I wonder how many cases of PTSD there are.

There is another side of the issue, and that is what happens to these children if the JRC can no longer use the treatment that they justify as effective for these last resort cases, and turns them away as the other facilities have done.

Picture a young adult biting their body parts off, homeless on the streets; in a corrections facility that has no idea how to deal with them; or in a state institution, if one can be found for them, heavily sedated for life.

It's a harsh potential, that has likely kept the JRC open for the last several decades. There don't appear to be many good answers for some of these patients, outside of the JRC, either.

Institutional abuse can happen in any institutional environment, and the potential increases as the level of difficulties with patients increase.

That's no justification of the abuse, but it is a reality of the human condition, both for the patient and for the individuals providing treatment, that overstep the boundries established for behavioral therapies. As, has been evidenced in the past, at the JRC, and in many other institutions.

Well it would seem JRC does not know how to deal with them either.......they seem more concerned with tormenting the patients and justifying it as the only way. Why is the abuse nessisary is what I am wondering......in another thread I mentioned other ways they could make the patient stop hurting them self. That don't involve hurting the patient to make them stop hurting them self which does not even make sense. Also since when is mental retardation or Autism for that matter a behavioral problem.....I don't think behavioral therapy is appropriate for issues that aren't behavioral

I don't like any of the potential scenarios. They are all horrifying. It is a large part of the reason, why I have tried to provide evidence for why continuing research into causes, prevention, effective therapies, and the remote possibility for a cure, is so important for the children that have these type of debilitating behavioral problems associated with some forms of Autism.


Effective therapies are a great idea, but causing physical discomfort in a patient to try and teach them a lesson......is not one of them.


Just trying to provide an answer to your question as to why this type of treatment has continued for decades. I don't condone it a good solution, however it is the only solution that the state of massachussetts, their legal experts, human rights specialists, and court appointed authority could find for this minority of children that had these severe behavioral problems.

Ok fair enough......however its not a solution at all, so I fail to see how its the only solution. They could easily quit doing abusive things to the kids that would be the start to an actual solution.


Only about 80 children in the country, have been determined to have behavioral problems bad enough to warrant this type of therapy. They are not all autistic children or young adults. I think you mentioned restraining them from biting their body parts off. This is obviously the first step anyone would do, if they found their children trying to bite their fingers off, etc. However it is not a permanent solution. The only way better solutions are going to be found is through further research.

Putting them out on the streets, is the worse possible solution. I certainly hope they will find ones better than that for the children and young adults in question.


From my understanding this center was for kids with mental disorders/disabilities such as autism and mental retardation, neither of which are behavioral problems. So treating the symptoms as 'mis-behavior' and using cruel punishments is clearly going to do a lot more harm than good. Not to mention how is that a form of therapy to begin with? and what could possibly warrant it unless these children are all Satan himself. And even then I would probably still have an issue with it because two wrongs don't make a right.

Also simply restraining them sure as hell beats the force feeding of hot peppers...whoever came up with that should have it done to them self so they can see how they like it.

And why is it they either have to be abused or have to be put on the streets? why can't they simply stop the abuse at such institutions? I mean I thought mental institutions where supposed to be safe places for people with severe mental problems not torture centers. I don't think being stuck in a place where the employees abuse you 'for your own good.' is necessarily better then being thrown on the streets both are terrible.


The facility was specifically designed for children that have developmental disabilities with behavioral problems. Self Injurious behavior is associated with autism, moreso with those that have more severe developmental disabilities. They are more difficult to treat because of communication problems.

The Courts in Massachussetts determines the treatment as appropriate on a case by case analysis of each child in question. At this point the state does not consider the skin-shock therapy used properly as abuse. If legislation is passes to ban the aversives, this will no longer be possible.

The conversation on what would happen to the children if it were to be closed is just a what if conversation. There is not even a suggestion in the state government that there are any plans of closing the facility down.

I'm not supporting the therapy but trying to provide an understanding of why it is that the state has allowed it to continue for decades.

Here is a third party source that provides information on self injurious behaviors in autistic children, that may provide a better understanding of what is going on with the children with these behaviors.

This is not my point of view, this provides an understanding of how others are looking at the situation of self injurious behavior in Autistic Children, beyond the abuses of therapies that have occured at the JRC.

http://www.autism-help.org/behavior-self-injury-intro.htm


Quote:
INTRODUCTION TO SELF-INJURIOUS BEHAVIOR
On a "good" day Bobby (not his real name) hits his head with his fist 500 times an hour. On a bad day the count may go up to 1,800 hits per hour. The short-term results of this self-abuse are absolutely sickening. The long-term results are much worse. Bobby has autism and engages in self-injurious behavior. That explains things for the professionals but how about for Mom and Dad? For a while they were even suspected of inflicting the injuries on Bobby themselves. But now that everyone knows what is going on, how do you make this self-injury behavior stop?



types of self-injury an autistic child may engage in
Children and adults with autism may engage in self-injurious behaviors, also known as self-harm. Self-injurious behaviors are actions that the child performs that result in physical injury to the child’s own body. Typical forms of self-injury behavior include:

• hitting oneself with hands or other body parts

• head-banging

• biting oneself

• picking at skin or sores

• scratching or rubbing oneself repeatedly.



The cause of self-harming behaviors remains as much a mystery as the cause of autism. It is thought that the behaviors may be caused by a chemical imbalance, sinus problems, headaches, attention-seeking, seizures, ear infection, frustration, seeking sensory stimulation/input, sound sensitivity, or to escape or avoid a task. There many different ways to treat self-injurious behaviors. The method chosen may depend upon the perceived cause of the self-injury and/or the bias of the professionals involved.



why less noticeable self-harm may be serious
Self-injurious behavior that results in bleeding and serious tissue damage is easy to notice and usually leads to frantic efforts to stop it. However, some repetitive behaviors that seem harmless (e.g., rubbing the skin, lightly tapping the forehead) can have serious, even life-threatening consequences over time. To see why, I will have to take you back to my high school physics class. I was taught that a 1,000 pound ball suspended on a chain would start to move back and forth from the steady, rhythmic motion of a ping-pong ball hitting up against it for thousands of repetitions. It is not the overwhelming force or the weight of the ping-pong ball that causes the movement but the repetitive nature of the motion. The danger of repetitive rubbing or tapping can also cause tissue damage over time and, if the head is involved, may even cause brain damage over many years. The point is, all forms of self-injurious behavior should be treated as soon as it is noticed.



assessment of self-injurious behavior
Each child or adult engaging in self-injurious behavior will require an individual assessment to try to determine the cause and motivation for the self-injurious behavior. If your child is hurting himself or herself in any way, make this an issue with the child's physician, psychologist, and/or any other professional who treats your child. If a medical problem is discovered, the medical problem can be treated. If the child is seeking sensory stimulation/input, you may be able to find a replacement behavior that will meet this need in a more socially acceptable and safe way (e.g., the child who seeks pressure from pounding his hands on the floor may prefer a vigorous hand massage).



different strategies for different causes of self-harming
If the self-injurious behavior is driven by attention, then tactical ignoring of the self-injurious behavior may extinguish the behavior. This would have to be accompanied by giving the child attention for appropriate behavior when it occurs, known as positive reinforcement. Of course, if the child is seriously hurting himself or herself, this may not be an option. Reinforcing other behavior that makes the self-injurious behavior impossible to perform may also be recommended (e.g., reinforcing the child for manipulating toys, which keeps the hands occupied and prevents face-slapping).



If the self-injurious behavior is caused by frustration, it may be that teaching the child a way to cope or communicate will prevent the self-injury. Simply giving the child constructive things to do may prevent boredom, which could lead to self-injury.



Some children are treated with medication. If the problem is a chemical imbalance, then treating the child with appropriate medications may be a perfect answer. There is a theory that children who injure themselves do so to release opiate-like chemicals in the brain. Naltrexone is a medication that inhibits the release of these opiate-like chemicals in the brain and the belief is that this will remove the reason for the self-injury. As a last resort, some parents and professionals have resurrected aversive procedures to treat the most serious self-injurious behavior. Aversives are behavior modification techniques that provide a negative stimulus to the child whenever the self-injurious behavior occurs (e.g., the child is spanked, yelled at, sprayed with water, or receives a mild electrical shock). It seems strange that a punishment would actually stop a child from harming themselves but many studies have proven the effectiveness of aversives in stopping serious self-injury.



debate over aversive strategies for self-injurious behavior
It would make sense that the seriousness of the self-injury should direct the choice of treatment. A child's whose life is in danger should receive the most aggressive treatment. The choice of treatment needs to be up to the parent, of course. In some countries or states, there may be laws that limit the type of treatment a child may receive, however. These laws may require treating self-injurious behavior with positive behavioral programs and outlaw the use of aversives, even when the self-injury is life-threatening.



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25 Feb 2012, 6:11 pm

vermontsavant wrote:
well said,children were murdered at gaebler too


Just for clarification while there are legends and opinions that children were murdered at Gaebler, there is no legal evidence of it.

And, again while there is evidence of abuse of therapy at the JRC there is no legal evidence that anyone has been murdered at the JRC, only evidence that several patients have died while under care at that facility.

There was a patient-patient murder that is well known that happened at the Metropolitan State hospital on the same grounds as the Gaebler Center.

And again, to clarify, I am not defending the practices of any institution with this information, I am just relaying facts, for clarification of information presented in the discussion.

http://en.wikipedia.org/wiki/Metropolitan_State_Hospital_(Massachusetts)

Quote:
Patient murder scandal. In 1978, Metropolitan State patient Anne Marie Davee was murdered by another patient, Melvin W. Wilson. Wilson dismembered Davee's body and kept seven of her teeth which were discovered in his possession by employees of the hospital. Despite this discovery and its obvious implications, no action was taken against Wilson until Massachusetts State Senator Sen. Jack Backman (D-Brookline) led a Senate investigation into the case along with 19 other reports of negligence by state mental health workers



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25 Feb 2012, 8:27 pm

vermontsavant wrote:
yes your right gaebler was shut down because of budget cuts.it was only after it was shut down that the abuses came to light.so was the same with the belchertown state school.yes there are shortages in mass but the JRC is only one school and couldnt house more than a couple hundred.that can be easily absorbed by other programs.programs like service net have many group homes and so with the united ark and many others.also the local school system can be forced to pay for private hospital in certain circumstances


If these were children and young adults that positive behavioral methods work well on, they would have a better chance of being placed, but the JRC was a last resort for some that were in correctional facilities.

It is possible that some would go back to correctional facilities, if other facilities that could handle their problems were not available. The JRC provides care for young adults. Per the problems in the Massachussetts mental health care system; the shortage in care facilities for adults is a much larger problem than that for children.

The reason the facility is still open and the therapy continues, even after abuses were evidenced, is that the state hasn't been able to provide better answers, than the ones that have allowed the therapy to continue.

That is still the case, or the Governor of Massachusetts could have provided a court order to eliminate the therapy for existing patients rather than continue to support it, in existing patients.

It is a very complicated issue, and not a problem that the state has been able to resolve.

The previous report on self injurious behaviors, I provided presents common ones reported in autistic children. Here is a larger report of the type of behaviors evidenced in these children before they arrived at the JRC; not all of the children or adults are autistic:


Quote:
The students who are treated at JRC have shown, prior to admission to JRC, self-abusive
behaviors such as: gouging out their eyes, causing near-blindness; smearing feces; headbanging to the point of causing detached retinas and blindness5 or even stroke6; skin
scratching to the point of fatal blood and bone infection; pulling out their own adult
teeth7; running into a street filled with moving cars; or suicidal actions such as attempting
to hang oneself, swallowing razor blades, taking a drug overdose, and jumping out of a
moving vehicle or off of a building.

Some students have shown violent aggression such as biting, hitting, kicking, punching, and head butting others. Some have pushed a parent down a flight of stairs, raped someone, tried to strangle a parent while the parent was driving, and beat a peer so severely that plastic surgery was required. Some have attempted to injure or kill others—for example, by pushing a child into oncoming traffic, smothering a sibling, stabbing a teacher, or slicing a peer’s throat. Some have attacked police and therapists. Some have set their homes on fire, lit a fire in school, and lit
themselves or family members on fire. Some have engaged in prostitution, been involved
in gangs, and assaulted others with weapons such as a machete and chainsaw.


http://www.judgerc.org/


These aren't the type of behaviors that many facilities are equipped to deal with. While it might be easier to put some of these children back in correctional facilities, the state could have a hard time finding community settings where this behavior could be delt with, even if there were not shortages in beds for mental health patients in the state of Massachussetts.

The more interesting question is, what would happen if the state outlawed the aversive skin shock therapies altogether at the JRC. Would the facility move to another state?

Many Aversives were banned in California, in 1980, which resulted in the JRC move to Massachussetts.

The only sure answer to eliminate an aversive therapy, which there continues to be a demand for, is to ban it as an illegal therapy, nationwide.

That is what the international disability rights organization, that provided the report to the UN, is hoping to do.



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25 Feb 2012, 8:34 pm

aghogday wrote:
Sweetleaf wrote:
aghogday wrote:
Sweetleaf wrote:
aghogday wrote:

People have been attempting to get the JRC closed down for decades now.

However, until the abuses of the regulations that allow the aversive shock therapy in behavioral modification techniques, were found, and have now resulted in the restriction of the therapy in new patients, the Center had a compelling enough argument to defend the therapy, as justified, for the state to allow the continuance of the use of the therapy.

This an outline, provided by the organization, of the state laws/regulations in Massachusetts that have allowed the organization to justify their use of the aversive shock therapy, for decades now.

And what I am saying is it disgusts and angers me that they are allowed to continue using these harmful, cruel teqniques on the already existing patients. Them being used to abuse does not make it ok to allow it to continue.

Quote:
The aversives employed at JRC are safe, effective, and professionally approved by a Peer Review Committee and Human Rights Committee under procedures outlined by the Massachusetts Department of Mental Retardation (“MA DMR”). See 115 CMR 5.14. They are used pursuant to regulations of the MA DMR and the Massachusetts Department of Early Education and Care (“MA EEC”). JRC does not use aversive techniques until a Massachusetts Probate Court approves their use on an individual basis. JRC follows the MA DMR regulations requiring these treatment techniques to be used in a safe, well-documented manner. 115 CMR 5.14. JRC creates for each student a written behavior modification plan detailing the treatment’s rationale, duration, conditions, goals, and a detailed monitoring plan. 115 CMR 5.14(4)(c). A parent must sign a detailed aversive therapy consent form before JRC will incorporate such techniques in a student’s treatment plan and the aversive treatment is included and made part of the student’s Individualized Education Plan or Individualized Service Plan.


The most commonly used “aversive” procedure at JRC is an electrical stimulation device[1] manufactured by JRC called the Graduated Electronic Decelerator (“GED”). The GED unit consists of a transmitter operated by a JRC staff member and a receiver and stimulator worn by the student. The receiver delivers a low-level surface application of electrical current to a small area of the student’s skin upon command from the transmitter, as part of a designed behavioral treatment. There are no harmful side effects and minor side effects may consist of reddening of the skin and, on rare occasions, the appearance of a small blister, both of which are temporary. For many individuals, the GED is required only during the first few months of treatment, and is no longer necessary, or is necessary to a far lesser and diminishing degree, after that period. The students receive only one application per week on average. The Supreme Judicial Court of Massachusetts has affirmed a Probate Court order authorizing the use of the GED at JRC as an appropriate intervention. See Guardianship of Brandon Sanchez, 424 Mass. 482 (1997); see also JRC v. DMR, 424 Mass. 430 (1997). Over one hundred peer-reviewed articles have been published in the professional literature supporting the safety and effectiveness of skin-shock and eight articles deal with the specific device (“SIBIS”) which is the forerunner of JRC’s GED device.


And this is their argument, that has justified the treatment as a last resort method of behavioral therapy, for the children in their treatment program that have been turned away from other programs.

Nowhere in there does it say what the purpose of this is or if it helps anything and based on that description....why does the child have to endure physical discomfort? causing the child to feel pain for behavior they are not in control of in an attempt to punish the behavior out of them hardly seems the way to go about it. I doubt the mentally ret*d children who receive this treatment even understand what the purpose is..........to them its probably 'I don't understand why these people are causing me pain.'


Quote:
JRC often acts as a treatment of last resort for children and adults with severe behavior disorders who have been resistant to all forms of drugs and other psychiatric treatment and for whom there is no other placement that can educate them and keep them safe. These students engage in behaviors such as head-banging, eye-gouging, and biting off body parts.

JRC’s policy is to use a highly consistent application of behavior modification treatment and minimal or no psychotropic medication. JRC offers intensive behavioral treatment based on peer-reviewed and accepted methods of behavioral psychology, which has been extremely effective and life-saving for students who could not be effectively treated with psychotropic medication or psychotherapy. JRC’s treatment procedures are so effective that they rapidly reduce to a zero or near zero level the major problem behaviors of students with the most difficult-to-treat behavior disorders in the country.


Again, how does causing physical discomfort in the patients in an attempt to punish the symptoms out of them solve anything? Also treating non-behavioral problems as behavioral problems is likely to cause more problems. I am curious how many kids make it out of this center and how much better do they function after having undergone this 'therapy.' I wonder how many cases of PTSD there are.

There is another side of the issue, and that is what happens to these children if the JRC can no longer use the treatment that they justify as effective for these last resort cases, and turns them away as the other facilities have done.

Picture a young adult biting their body parts off, homeless on the streets; in a corrections facility that has no idea how to deal with them; or in a state institution, if one can be found for them, heavily sedated for life.

It's a harsh potential, that has likely kept the JRC open for the last several decades. There don't appear to be many good answers for some of these patients, outside of the JRC, either.

Institutional abuse can happen in any institutional environment, and the potential increases as the level of difficulties with patients increase.

That's no justification of the abuse, but it is a reality of the human condition, both for the patient and for the individuals providing treatment, that overstep the boundries established for behavioral therapies. As, has been evidenced in the past, at the JRC, and in many other institutions.

Well it would seem JRC does not know how to deal with them either.......they seem more concerned with tormenting the patients and justifying it as the only way. Why is the abuse nessisary is what I am wondering......in another thread I mentioned other ways they could make the patient stop hurting them self. That don't involve hurting the patient to make them stop hurting them self which does not even make sense. Also since when is mental retardation or Autism for that matter a behavioral problem.....I don't think behavioral therapy is appropriate for issues that aren't behavioral

I don't like any of the potential scenarios. They are all horrifying. It is a large part of the reason, why I have tried to provide evidence for why continuing research into causes, prevention, effective therapies, and the remote possibility for a cure, is so important for the children that have these type of debilitating behavioral problems associated with some forms of Autism.


Effective therapies are a great idea, but causing physical discomfort in a patient to try and teach them a lesson......is not one of them.


Just trying to provide an answer to your question as to why this type of treatment has continued for decades. I don't condone it a good solution, however it is the only solution that the state of massachussetts, their legal experts, human rights specialists, and court appointed authority could find for this minority of children that had these severe behavioral problems.

Ok fair enough......however its not a solution at all, so I fail to see how its the only solution. They could easily quit doing abusive things to the kids that would be the start to an actual solution.


Only about 80 children in the country, have been determined to have behavioral problems bad enough to warrant this type of therapy. They are not all autistic children or young adults. I think you mentioned restraining them from biting their body parts off. This is obviously the first step anyone would do, if they found their children trying to bite their fingers off, etc. However it is not a permanent solution. The only way better solutions are going to be found is through further research.

Putting them out on the streets, is the worse possible solution. I certainly hope they will find ones better than that for the children and young adults in question.


From my understanding this center was for kids with mental disorders/disabilities such as autism and mental retardation, neither of which are behavioral problems. So treating the symptoms as 'mis-behavior' and using cruel punishments is clearly going to do a lot more harm than good. Not to mention how is that a form of therapy to begin with? and what could possibly warrant it unless these children are all Satan himself. And even then I would probably still have an issue with it because two wrongs don't make a right.

Also simply restraining them sure as hell beats the force feeding of hot peppers...whoever came up with that should have it done to them self so they can see how they like it.

And why is it they either have to be abused or have to be put on the streets? why can't they simply stop the abuse at such institutions? I mean I thought mental institutions where supposed to be safe places for people with severe mental problems not torture centers. I don't think being stuck in a place where the employees abuse you 'for your own good.' is necessarily better then being thrown on the streets both are terrible.


The facility was specifically designed for children that have developmental disabilities with behavioral problems. Self Injurious behavior is associated with autism, moreso with those that have more severe developmental disabilities. They are more difficult to treat because of communication problems.

The Courts in Massachussetts determines the treatment as appropriate on a case by case analysis of each child in question. At this point the state does not consider the skin-shock therapy used properly as abuse. If legislation is passes to ban the aversives, this will no longer be possible.

The conversation on what would happen to the children if it were to be closed is just a what if conversation. There is not even a suggestion in the state government that there are any plans of closing the facility down.

I'm not supporting the therapy but trying to provide an understanding of why it is that the state has allowed it to continue for decades.

Here is a third party source that provides information on self injurious behaviors in autistic children, that may provide a better understanding of what is going on with the children with these behaviors.

This is not my point of view, this provides an understanding of how others are looking at the situation of self injurious behavior in Autistic Children, beyond the abuses of therapies that have occured at the JRC.

http://www.autism-help.org/behavior-self-injury-intro.htm


Quote:
INTRODUCTION TO SELF-INJURIOUS BEHAVIOR
On a "good" day Bobby (not his real name) hits his head with his fist 500 times an hour. On a bad day the count may go up to 1,800 hits per hour. The short-term results of this self-abuse are absolutely sickening. The long-term results are much worse. Bobby has autism and engages in self-injurious behavior. That explains things for the professionals but how about for Mom and Dad? For a while they were even suspected of inflicting the injuries on Bobby themselves. But now that everyone knows what is going on, how do you make this self-injury behavior stop?



types of self-injury an autistic child may engage in
Children and adults with autism may engage in self-injurious behaviors, also known as self-harm. Self-injurious behaviors are actions that the child performs that result in physical injury to the child’s own body. Typical forms of self-injury behavior include:

• hitting oneself with hands or other body parts

• head-banging

• biting oneself

• picking at skin or sores

• scratching or rubbing oneself repeatedly.



The cause of self-harming behaviors remains as much a mystery as the cause of autism. It is thought that the behaviors may be caused by a chemical imbalance, sinus problems, headaches, attention-seeking, seizures, ear infection, frustration, seeking sensory stimulation/input, sound sensitivity, or to escape or avoid a task. There many different ways to treat self-injurious behaviors. The method chosen may depend upon the perceived cause of the self-injury and/or the bias of the professionals involved.



why less noticeable self-harm may be serious
Self-injurious behavior that results in bleeding and serious tissue damage is easy to notice and usually leads to frantic efforts to stop it. However, some repetitive behaviors that seem harmless (e.g., rubbing the skin, lightly tapping the forehead) can have serious, even life-threatening consequences over time. To see why, I will have to take you back to my high school physics class. I was taught that a 1,000 pound ball suspended on a chain would start to move back and forth from the steady, rhythmic motion of a ping-pong ball hitting up against it for thousands of repetitions. It is not the overwhelming force or the weight of the ping-pong ball that causes the movement but the repetitive nature of the motion. The danger of repetitive rubbing or tapping can also cause tissue damage over time and, if the head is involved, may even cause brain damage over many years. The point is, all forms of self-injurious behavior should be treated as soon as it is noticed.



assessment of self-injurious behavior
Each child or adult engaging in self-injurious behavior will require an individual assessment to try to determine the cause and motivation for the self-injurious behavior. If your child is hurting himself or herself in any way, make this an issue with the child's physician, psychologist, and/or any other professional who treats your child. If a medical problem is discovered, the medical problem can be treated. If the child is seeking sensory stimulation/input, you may be able to find a replacement behavior that will meet this need in a more socially acceptable and safe way (e.g., the child who seeks pressure from pounding his hands on the floor may prefer a vigorous hand massage).



different strategies for different causes of self-harming
If the self-injurious behavior is driven by attention, then tactical ignoring of the self-injurious behavior may extinguish the behavior. This would have to be accompanied by giving the child attention for appropriate behavior when it occurs, known as positive reinforcement. Of course, if the child is seriously hurting himself or herself, this may not be an option. Reinforcing other behavior that makes the self-injurious behavior impossible to perform may also be recommended (e.g., reinforcing the child for manipulating toys, which keeps the hands occupied and prevents face-slapping).



If the self-injurious behavior is caused by frustration, it may be that teaching the child a way to cope or communicate will prevent the self-injury. Simply giving the child constructive things to do may prevent boredom, which could lead to self-injury.



Some children are treated with medication. If the problem is a chemical imbalance, then treating the child with appropriate medications may be a perfect answer. There is a theory that children who injure themselves do so to release opiate-like chemicals in the brain. Naltrexone is a medication that inhibits the release of these opiate-like chemicals in the brain and the belief is that this will remove the reason for the self-injury. As a last resort, some parents and professionals have resurrected aversive procedures to treat the most serious self-injurious behavior. are behavior modification techniques that provide a negative stimulus to the child whenever the self-injurious behavior occurs (e.g., the child is spanked, yelled at, sprayed with water, or receives a mild electrical shock). It seems strange that a punishment would actually stop a child from harming themselves but many studies have proven the effectiveness of aversives in stopping serious self-injury.



debate over aversive strategies for self-injurious behavior
It would make sense that the seriousness of the self-injury should direct the choice of treatment. A child's whose life is in danger should receive the most aggressive treatment. The choice of treatment needs to be up to the parent, of course. In some countries or states, there may be laws that limit the type of treatment a child may receive, however. These laws may require treating self-injurious behavior with positive behavioral programs and outlaw the use of aversives, even when the self-injury is life-threatening.



Well that was kind of a wall of text, but I guess what I am really wondering how hurting a child for hurting them self is going to teach them not to hurt them self especially if they have a mental disability in which such behavior is more common. I still see no justification whatsoever.


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25 Feb 2012, 8:53 pm

Sweetleaf wrote:
aghogday wrote:
Sweetleaf wrote:
aghogday wrote:
Sweetleaf wrote:
aghogday wrote:

People have been attempting to get the JRC closed down for decades now.

However, until the abuses of the regulations that allow the aversive shock therapy in behavioral modification techniques, were found, and have now resulted in the restriction of the therapy in new patients, the Center had a compelling enough argument to defend the therapy, as justified, for the state to allow the continuance of the use of the therapy.

This an outline, provided by the organization, of the state laws/regulations in Massachusetts that have allowed the organization to justify their use of the aversive shock therapy, for decades now.

And what I am saying is it disgusts and angers me that they are allowed to continue using these harmful, cruel teqniques on the already existing patients. Them being used to abuse does not make it ok to allow it to continue.

Quote:
The aversives employed at JRC are safe, effective, and professionally approved by a Peer Review Committee and Human Rights Committee under procedures outlined by the Massachusetts Department of Mental Retardation (“MA DMR”). See 115 CMR 5.14. They are used pursuant to regulations of the MA DMR and the Massachusetts Department of Early Education and Care (“MA EEC”). JRC does not use aversive techniques until a Massachusetts Probate Court approves their use on an individual basis. JRC follows the MA DMR regulations requiring these treatment techniques to be used in a safe, well-documented manner. 115 CMR 5.14. JRC creates for each student a written behavior modification plan detailing the treatment’s rationale, duration, conditions, goals, and a detailed monitoring plan. 115 CMR 5.14(4)(c). A parent must sign a detailed aversive therapy consent form before JRC will incorporate such techniques in a student’s treatment plan and the aversive treatment is included and made part of the student’s Individualized Education Plan or Individualized Service Plan.


The most commonly used “aversive” procedure at JRC is an electrical stimulation device[1] manufactured by JRC called the Graduated Electronic Decelerator (“GED”). The GED unit consists of a transmitter operated by a JRC staff member and a receiver and stimulator worn by the student. The receiver delivers a low-level surface application of electrical current to a small area of the student’s skin upon command from the transmitter, as part of a designed behavioral treatment. There are no harmful side effects and minor side effects may consist of reddening of the skin and, on rare occasions, the appearance of a small blister, both of which are temporary. For many individuals, the GED is required only during the first few months of treatment, and is no longer necessary, or is necessary to a far lesser and diminishing degree, after that period. The students receive only one application per week on average. The Supreme Judicial Court of Massachusetts has affirmed a Probate Court order authorizing the use of the GED at JRC as an appropriate intervention. See Guardianship of Brandon Sanchez, 424 Mass. 482 (1997); see also JRC v. DMR, 424 Mass. 430 (1997). Over one hundred peer-reviewed articles have been published in the professional literature supporting the safety and effectiveness of skin-shock and eight articles deal with the specific device (“SIBIS”) which is the forerunner of JRC’s GED device.


And this is their argument, that has justified the treatment as a last resort method of behavioral therapy, for the children in their treatment program that have been turned away from other programs.

Nowhere in there does it say what the purpose of this is or if it helps anything and based on that description....why does the child have to endure physical discomfort? causing the child to feel pain for behavior they are not in control of in an attempt to punish the behavior out of them hardly seems the way to go about it. I doubt the mentally ret*d children who receive this treatment even understand what the purpose is..........to them its probably 'I don't understand why these people are causing me pain.'


Quote:
JRC often acts as a treatment of last resort for children and adults with severe behavior disorders who have been resistant to all forms of drugs and other psychiatric treatment and for whom there is no other placement that can educate them and keep them safe. These students engage in behaviors such as head-banging, eye-gouging, and biting off body parts.

JRC’s policy is to use a highly consistent application of behavior modification treatment and minimal or no psychotropic medication. JRC offers intensive behavioral treatment based on peer-reviewed and accepted methods of behavioral psychology, which has been extremely effective and life-saving for students who could not be effectively treated with psychotropic medication or psychotherapy. JRC’s treatment procedures are so effective that they rapidly reduce to a zero or near zero level the major problem behaviors of students with the most difficult-to-treat behavior disorders in the country.


Again, how does causing physical discomfort in the patients in an attempt to punish the symptoms out of them solve anything? Also treating non-behavioral problems as behavioral problems is likely to cause more problems. I am curious how many kids make it out of this center and how much better do they function after having undergone this 'therapy.' I wonder how many cases of PTSD there are.

There is another side of the issue, and that is what happens to these children if the JRC can no longer use the treatment that they justify as effective for these last resort cases, and turns them away as the other facilities have done.

Picture a young adult biting their body parts off, homeless on the streets; in a corrections facility that has no idea how to deal with them; or in a state institution, if one can be found for them, heavily sedated for life.

It's a harsh potential, that has likely kept the JRC open for the last several decades. There don't appear to be many good answers for some of these patients, outside of the JRC, either.

Institutional abuse can happen in any institutional environment, and the potential increases as the level of difficulties with patients increase.

That's no justification of the abuse, but it is a reality of the human condition, both for the patient and for the individuals providing treatment, that overstep the boundries established for behavioral therapies. As, has been evidenced in the past, at the JRC, and in many other institutions.

Well it would seem JRC does not know how to deal with them either.......they seem more concerned with tormenting the patients and justifying it as the only way. Why is the abuse nessisary is what I am wondering......in another thread I mentioned other ways they could make the patient stop hurting them self. That don't involve hurting the patient to make them stop hurting them self which does not even make sense. Also since when is mental retardation or Autism for that matter a behavioral problem.....I don't think behavioral therapy is appropriate for issues that aren't behavioral

I don't like any of the potential scenarios. They are all horrifying. It is a large part of the reason, why I have tried to provide evidence for why continuing research into causes, prevention, effective therapies, and the remote possibility for a cure, is so important for the children that have these type of debilitating behavioral problems associated with some forms of Autism.


Effective therapies are a great idea, but causing physical discomfort in a patient to try and teach them a lesson......is not one of them.


Just trying to provide an answer to your question as to why this type of treatment has continued for decades. I don't condone it a good solution, however it is the only solution that the state of massachussetts, their legal experts, human rights specialists, and court appointed authority could find for this minority of children that had these severe behavioral problems.

Ok fair enough......however its not a solution at all, so I fail to see how its the only solution. They could easily quit doing abusive things to the kids that would be the start to an actual solution.


Only about 80 children in the country, have been determined to have behavioral problems bad enough to warrant this type of therapy. They are not all autistic children or young adults. I think you mentioned restraining them from biting their body parts off. This is obviously the first step anyone would do, if they found their children trying to bite their fingers off, etc. However it is not a permanent solution. The only way better solutions are going to be found is through further research.

Putting them out on the streets, is the worse possible solution. I certainly hope they will find ones better than that for the children and young adults in question.


From my understanding this center was for kids with mental disorders/disabilities such as autism and mental retardation, neither of which are behavioral problems. So treating the symptoms as 'mis-behavior' and using cruel punishments is clearly going to do a lot more harm than good. Not to mention how is that a form of therapy to begin with? and what could possibly warrant it unless these children are all Satan himself. And even then I would probably still have an issue with it because two wrongs don't make a right.

Also simply restraining them sure as hell beats the force feeding of hot peppers...whoever came up with that should have it done to them self so they can see how they like it.

And why is it they either have to be abused or have to be put on the streets? why can't they simply stop the abuse at such institutions? I mean I thought mental institutions where supposed to be safe places for people with severe mental problems not torture centers. I don't think being stuck in a place where the employees abuse you 'for your own good.' is necessarily better then being thrown on the streets both are terrible.


The facility was specifically designed for children that have developmental disabilities with behavioral problems. Self Injurious behavior is associated with autism, moreso with those that have more severe developmental disabilities. They are more difficult to treat because of communication problems.

The Courts in Massachussetts determines the treatment as appropriate on a case by case analysis of each child in question. At this point the state does not consider the skin-shock therapy used properly as abuse. If legislation is passes to ban the aversives, this will no longer be possible.

The conversation on what would happen to the children if it were to be closed is just a what if conversation. There is not even a suggestion in the state government that there are any plans of closing the facility down.

I'm not supporting the therapy but trying to provide an understanding of why it is that the state has allowed it to continue for decades.

Here is a third party source that provides information on self injurious behaviors in autistic children, that may provide a better understanding of what is going on with the children with these behaviors.

This is not my point of view, this provides an understanding of how others are looking at the situation of self injurious behavior in Autistic Children, beyond the abuses of therapies that have occured at the JRC.

http://www.autism-help.org/behavior-self-injury-intro.htm


Quote:
INTRODUCTION TO SELF-INJURIOUS BEHAVIOR
On a "good" day Bobby (not his real name) hits his head with his fist 500 times an hour. On a bad day the count may go up to 1,800 hits per hour. The short-term results of this self-abuse are absolutely sickening. The long-term results are much worse. Bobby has autism and engages in self-injurious behavior. That explains things for the professionals but how about for Mom and Dad? For a while they were even suspected of inflicting the injuries on Bobby themselves. But now that everyone knows what is going on, how do you make this self-injury behavior stop?



types of self-injury an autistic child may engage in
Children and adults with autism may engage in self-injurious behaviors, also known as self-harm. Self-injurious behaviors are actions that the child performs that result in physical injury to the child’s own body. Typical forms of self-injury behavior include:

• hitting oneself with hands or other body parts

• head-banging

• biting oneself

• picking at skin or sores

• scratching or rubbing oneself repeatedly.



The cause of self-harming behaviors remains as much a mystery as the cause of autism. It is thought that the behaviors may be caused by a chemical imbalance, sinus problems, headaches, attention-seeking, seizures, ear infection, frustration, seeking sensory stimulation/input, sound sensitivity, or to escape or avoid a task. There many different ways to treat self-injurious behaviors. The method chosen may depend upon the perceived cause of the self-injury and/or the bias of the professionals involved.



why less noticeable self-harm may be serious
Self-injurious behavior that results in bleeding and serious tissue damage is easy to notice and usually leads to frantic efforts to stop it. However, some repetitive behaviors that seem harmless (e.g., rubbing the skin, lightly tapping the forehead) can have serious, even life-threatening consequences over time. To see why, I will have to take you back to my high school physics class. I was taught that a 1,000 pound ball suspended on a chain would start to move back and forth from the steady, rhythmic motion of a ping-pong ball hitting up against it for thousands of repetitions. It is not the overwhelming force or the weight of the ping-pong ball that causes the movement but the repetitive nature of the motion. The danger of repetitive rubbing or tapping can also cause tissue damage over time and, if the head is involved, may even cause brain damage over many years. The point is, all forms of self-injurious behavior should be treated as soon as it is noticed.



assessment of self-injurious behavior
Each child or adult engaging in self-injurious behavior will require an individual assessment to try to determine the cause and motivation for the self-injurious behavior. If your child is hurting himself or herself in any way, make this an issue with the child's physician, psychologist, and/or any other professional who treats your child. If a medical problem is discovered, the medical problem can be treated. If the child is seeking sensory stimulation/input, you may be able to find a replacement behavior that will meet this need in a more socially acceptable and safe way (e.g., the child who seeks pressure from pounding his hands on the floor may prefer a vigorous hand massage).



different strategies for different causes of self-harming
If the self-injurious behavior is driven by attention, then tactical ignoring of the self-injurious behavior may extinguish the behavior. This would have to be accompanied by giving the child attention for appropriate behavior when it occurs, known as positive reinforcement. Of course, if the child is seriously hurting himself or herself, this may not be an option. Reinforcing other behavior that makes the self-injurious behavior impossible to perform may also be recommended (e.g., reinforcing the child for manipulating toys, which keeps the hands occupied and prevents face-slapping).



If the self-injurious behavior is caused by frustration, it may be that teaching the child a way to cope or communicate will prevent the self-injury. Simply giving the child constructive things to do may prevent boredom, which could lead to self-injury.



Some children are treated with medication. If the problem is a chemical imbalance, then treating the child with appropriate medications may be a perfect answer. There is a theory that children who injure themselves do so to release opiate-like chemicals in the brain. Naltrexone is a medication that inhibits the release of these opiate-like chemicals in the brain and the belief is that this will remove the reason for the self-injury. As a last resort, some parents and professionals have resurrected aversive procedures to treat the most serious self-injurious behavior. are behavior modification techniques that provide a negative stimulus to the child whenever the self-injurious behavior occurs (e.g., the child is spanked, yelled at, sprayed with water, or receives a mild electrical shock). It seems strange that a punishment would actually stop a child from harming themselves but many studies have proven the effectiveness of aversives in stopping serious self-injury.



debate over aversive strategies for self-injurious behavior
It would make sense that the seriousness of the self-injury should direct the choice of treatment. A child's whose life is in danger should receive the most aggressive treatment. The choice of treatment needs to be up to the parent, of course. In some countries or states, there may be laws that limit the type of treatment a child may receive, however. These laws may require treating self-injurious behavior with positive behavioral programs and outlaw the use of aversives, even when the self-injury is life-threatening.



Well that was kind of a wall of text, but I guess what I am really wondering how hurting a child for hurting them self is going to teach them not to hurt them self especially if they have a mental disability in which such behavior is more common. I still see no justification whatsoever.
i'd tend to agree. fancy arguments can't disprove a fundamentally wrong idea.



aghogday
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25 Feb 2012, 11:57 pm

Sweetleaf wrote:
aghogday wrote:
Here is a third party source that provides information on self injurious behaviors in autistic children, that may provide a better understanding of what is going on with the children with these behaviors.

This is not my point of view, this provides an understanding of how others are looking at the situation of self injurious behavior in Autistic Children, beyond the abuses of therapies that have occured at the JRC.

http://www.autism-help.org/behavior-self-injury-intro.htm


Quote:
INTRODUCTION TO SELF-INJURIOUS BEHAVIOR
On a "good" day Bobby (not his real name) hits his head with his fist 500 times an hour. On a bad day the count may go up to 1,800 hits per hour. The short-term results of this self-abuse are absolutely sickening. The long-term results are much worse. Bobby has autism and engages in self-injurious behavior. That explains things for the professionals but how about for Mom and Dad? For a while they were even suspected of inflicting the injuries on Bobby themselves. But now that everyone knows what is going on, how do you make this self-injury behavior stop?



types of self-injury an autistic child may engage in
Children and adults with autism may engage in self-injurious behaviors, also known as self-harm. Self-injurious behaviors are actions that the child performs that result in physical injury to the child’s own body. Typical forms of self-injury behavior include:

• hitting oneself with hands or other body parts

• head-banging

• biting oneself

• picking at skin or sores

• scratching or rubbing oneself repeatedly.



The cause of self-harming behaviors remains as much a mystery as the cause of autism. It is thought that the behaviors may be caused by a chemical imbalance, sinus problems, headaches, attention-seeking, seizures, ear infection, frustration, seeking sensory stimulation/input, sound sensitivity, or to escape or avoid a task. There many different ways to treat self-injurious behaviors. The method chosen may depend upon the perceived cause of the self-injury and/or the bias of the professionals involved.



why less noticeable self-harm may be serious
Self-injurious behavior that results in bleeding and serious tissue damage is easy to notice and usually leads to frantic efforts to stop it. However, some repetitive behaviors that seem harmless (e.g., rubbing the skin, lightly tapping the forehead) can have serious, even life-threatening consequences over time. To see why, I will have to take you back to my high school physics class. I was taught that a 1,000 pound ball suspended on a chain would start to move back and forth from the steady, rhythmic motion of a ping-pong ball hitting up against it for thousands of repetitions. It is not the overwhelming force or the weight of the ping-pong ball that causes the movement but the repetitive nature of the motion. The danger of repetitive rubbing or tapping can also cause tissue damage over time and, if the head is involved, may even cause brain damage over many years. The point is, all forms of self-injurious behavior should be treated as soon as it is noticed.



assessment of self-injurious behavior
Each child or adult engaging in self-injurious behavior will require an individual assessment to try to determine the cause and motivation for the self-injurious behavior. If your child is hurting himself or herself in any way, make this an issue with the child's physician, psychologist, and/or any other professional who treats your child. If a medical problem is discovered, the medical problem can be treated. If the child is seeking sensory stimulation/input, you may be able to find a replacement behavior that will meet this need in a more socially acceptable and safe way (e.g., the child who seeks pressure from pounding his hands on the floor may prefer a vigorous hand massage).



different strategies for different causes of self-harming
If the self-injurious behavior is driven by attention, then tactical ignoring of the self-injurious behavior may extinguish the behavior. This would have to be accompanied by giving the child attention for appropriate behavior when it occurs, known as positive reinforcement. Of course, if the child is seriously hurting himself or herself, this may not be an option. Reinforcing other behavior that makes the self-injurious behavior impossible to perform may also be recommended (e.g., reinforcing the child for manipulating toys, which keeps the hands occupied and prevents face-slapping).



If the self-injurious behavior is caused by frustration, it may be that teaching the child a way to cope or communicate will prevent the self-injury. Simply giving the child constructive things to do may prevent boredom, which could lead to self-injury.



Some children are treated with medication. If the problem is a chemical imbalance, then treating the child with appropriate medications may be a perfect answer. There is a theory that children who injure themselves do so to release opiate-like chemicals in the brain. Naltrexone is a medication that inhibits the release of these opiate-like chemicals in the brain and the belief is that this will remove the reason for the self-injury. As a last resort, some parents and professionals have resurrected aversive procedures to treat the most serious self-injurious behavior. are behavior modification techniques that provide a negative stimulus to the child whenever the self-injurious behavior occurs (e.g., the child is spanked, yelled at, sprayed with water, or receives a mild electrical shock). It seems strange that a punishment would actually stop a child from harming themselves but many studies have proven the effectiveness of aversives in stopping serious self-injury.



debate over aversive strategies for self-injurious behavior
It would make sense that the seriousness of the self-injury should direct the choice of treatment. A child's whose life is in danger should receive the most aggressive treatment. The choice of treatment needs to be up to the parent, of course. In some countries or states, there may be laws that limit the type of treatment a child may receive, however. These laws may require treating self-injurious behavior with positive behavioral programs and outlaw the use of aversives, even when the self-injury is life-threatening.



Well that was kind of a wall of text, but I guess what I am really wondering how hurting a child for hurting them self is going to teach them not to hurt them self especially if they have a mental disability in which such behavior is more common. I still see no justification whatsoever.


I don't have personal justification for it, but the state of massachussetts does, and has supported it to date, based on evidence that it is an effective treatment, for these serious examples of self injury where no other therapy has been evidenced as effective.

The skin-shock therapy is one of the most severe type of aversives that have been studied. The rationale for those in the medical/legal/human rights fields is that the benefits of the evidenced effectiveness of the therapy outweigh the costs of the harm that the therapy may inflict upon the patient.

The problem identified with the therapy in Massachussetts, is that it has been abused, therefore restrictions were imposed, on new admissions, because the costs were determined to be higher than the benefits, because of those abuses.

In actually trying to understand why aversives are effective in extinguishing undesirable behavior, one could read an analysis of studies of which therapies are proven effective to modify undesirable behaviors.

http://www.effectivehealthcare.ahrq.gov/ehc/products/106/656/CER26_Autism_Report_04-14-2011.pdf

A government supported study through the Health and Human Services Department recently did a meta-analysis on research into which therapies were actually evidenced to help improve symptoms associated with autism, and the widely accepted benefits of ABA therapy, which no longer uses aversives in it's mainstream approach, was found to be effective in a minority of the cases of autism, however it was not determined through a meta-analysis of current research as an effective treatment for self-injurious behaviors.

Drugs were also studied, in controlling self harming behavior, but the side effects were extensive enough were they were considered as not having a net positive benefit.

Aversives are no longer a mainstream part of ABA, so they were not included in this study.

Studies that have focused on Aversives have found them to be effective for dangerous cases of self-injurious behaviors.

A less severe form of skin-shock therapy, SIBIS, is currently used in the school system, in Michigan to prevent the self-injurious behavior of head banging. With this system the shock is automatically administered after the children iniate head banging behavior.

http://en.wikipedia.org/wiki/Self-Injurious_Behavior_Inhibiting_System

Quote:
Though the American Psychological Association and the National Association of School Psychologists have attempted to direct school psychologists in the administration of behavioral treatment, the use of SIBIS has proven to be a very controversial topic in the public school system.[5] Those that oppose the SIBIS device as a form of treatment in a school setting claim the shock delivered to the subject qualifies as corporal punishment. However, researchers claim that aversive therapy adheres to a systematic treatment plan that is carefully constructed to diminish the dangerous, and sometimes even life-threatening, actions exhibited by children with self-injurious behavior.[5] Corporal punishment, unlike an aversive stimulus treatment plan, uses the administration of pain as a disciplinary action in order to punish an unwanted behavior.

Schools in some states, such as Michigan, have found SIBIS to be lawful and have allowed its use within the classroom setting.[5] Three stipulations are met, however:

1.The participant must be fully aware as to what he or she is consenting and the implications it may incur.
2.The participant must be competent and capable of making decisions regarding his or her health.
3.The participant must voluntarily consent to the treatment method without coercion or intimidation.



Research backs up the claim that it reduces the self injurious behavior of head banging. The children are willing to voluntarly undergo the procedure, because the results of the head banging are much more dangerous and painful than the shocks that the SIBS system deliver.

Skin shock therapy, particularly the severe type used at the JRC, is obviously not a good option, but one that has been determined to be an option of last resort, in the state of Massachussetts, and one that is used in less severe forms, in other states, on a voluntary basis, in the school system.

This is the importance of research. To find better options that work.

I think it's pretty likely that the skin-shock aversives may be voted on and banned by the general public, in Massachussetts if it comes to a vote this November.

However, the children/young adults with these severe self-injurious behaviors, are still going to need a solution for success in modifying those dangerous behaviors.

As of right now there doesn't appear to be any effective ones, as evidenced in some of these children/young adult's treatment histories, and per research that has been conducted on other currently available methods of treatment.

Skin-shock therapy is one of the most severe type of aversives, it's why it currently takes a court approved order to use the therapy, in Massachussetts; it is only used when the dangers of the self-injurious behavior exceed the negative effects of the skin-shock therapy. Which becomes a matter of judgement for the Massachussetts courts, based on the facts that are available, in regard to each individual.

An issue with the state legislature in Massachussetts, is that one of the members of the legislature has a son who was in the therapy at the JRC, whom he credits as saving the boy's life, and is also doing quite well in life now. This appears to have been part of the decision making process for years now in the legislative process.

This member of the legislature is taken very seriously, in comparison to what the testimony of anonymous parents might bring to the table, who are also very adament that the therapy has saved their children's lives, present at every legislative hearing that has taken place now for decades on this issue.

Again, I am not providing a personal opinion of defense of the treatment, just the facts as they exist, in attempting to understand why this therapy has been practiced for decades, and continues to be allowed, through the restrictions that exist, in Massachussetts.

And surprising too, to find out that skin shock therapy is used in behavioral therapy in schools across the country, in a less severe form. I was under the impression that it was only used at the JRC.