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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.



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26 Feb 2012, 12:01 am

aghogday wrote:
Sweetleaf wrote:


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 rational 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.


And I am saying they are full of sh*t, punishing symptoms is wrong no matter how you slice it.....I don't care how many walls of text I see about it. I understand their stupid justifications just fine I simply strongly disagree based on what I know of psychology and the fact that abusing kids with mental disabilities is wrong....abusing kids in general is wrong.

Also what research proves that Yelling, spraying with a hose, force feeding of hot chili peppers and electric shocks are appropriate ways to reduce self harming behavior? Their own biased studies? I mean that seems contrary to everything I learned in psychology before dropping out of college. Clearly the people who run the place are more concerned with making money and keeping their abuse going than the welfare of the patients there.


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aghogday
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26 Feb 2012, 2:04 am

Sweetleaf wrote:
aghogday wrote:
Sweetleaf wrote:


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 rational 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.


And I am saying they are full of sh*t, punishing symptoms is wrong no matter how you slice it.....I don't care how many walls of text I see about it. I understand their stupid justifications just fine I simply strongly disagree based on what I know of psychology and the fact that abusing kids with mental disabilities is wrong....abusing kids in general is wrong.

Also what research proves that Yelling, spraying with a hose, force feeding of hot chili peppers and electric shocks are appropriate ways to reduce self harming behavior? Their own biased studies? I mean that seems contrary to everything I learned in psychology before dropping out of college. Clearly the people who run the place are more concerned with making money and keeping their abuse going than the welfare of the patients there.


Legally, it's neither considered corporal punishment or abuse, when used under legal guidelines as provided.

This issue is determined by the courts in Massachussetts, not by the JRC.

The JRC has been caught abusing the therapy, so they have been restricted in their use of it on new patients.

The simple justification that those that support the therapies use, is that it saves lives. An alternative to serious injury and death. That is the way that the legislator from Massachussetts that had a son in the JRC, describes the benefit of the therapy.

He states it saved his son's life. And it has been an argument so far that has worked to keep the techniques used at the JRC, lawful, for existing patients, and a claim that is backed up by research as well.

Aversive therapy for dangerous self injurious behavior is not something that the JRC invented. The particular instruments and techniques used there are unique, and extremely controversial, but never the less approved behavioral therapy methods, by the disability services agency of the state government there.

As one can see in the article below from Wiki, the use of aversives were developed as a less restrictive alternative to practices prevalent in mental institutions such as shock treatment, hydrotherapy, straightjacketing, and frontal lobotomies.

And now are only evidenced to be of effective use when the aversive presents less risk than the self injurious behavior

As far as the sources of this information and research associated with aversives, it is provided by Wiki, not the JRC.

http://en.wikipedia.org/wiki/Aversives

The only way to stop this type of therapy, in the US, is to petition to have laws created that ban the therapy. This is what organizations like the disability international organization, and the ICAA organization are attempting to do. But, as of right now where it is legal, it is neither considered corporal punishment or abuse, per the laws as they exist.

Quote:
Aversives can be used as punishment during applied behavior analysis to reduce unwanted behavior, such as self-injury, that poses a risk of harm greater than that posed by application of the aversive. Aversive stimuli may also be used as negative reinforcement to increase the rate or probability of a behavior by its removal. The use of aversives was developed as a less restrictive alternative to practices prevalent in mental institutions at the time such as shock treatment, hydrotherapy, straitjacketing and frontal lobotomies.

Early iterations of the Lovaas technique incorporated aversives during therapy,[1] though the use of aversives in ABA was not without controversy.[2] Over time the use of aversives has become less and less necessary as less and less restrictive alternative treatments have been developed. Lovaas has since stated his disdain for the use of aversives.[3] Applied behavior analysis permits the use of aversives in limited cases, such as when a behavior is dangerous, especially when the reinforcing contingencies that maintain a behavior are unknown.[4]

The Behavior Analyst Certification Board (BACB) Guidelines for Responsible Conduct state that voluntariness by the client or their surrogate is a necessary component of any behavior plan, and clients or families have the right to terminate a particular intervention if they see fit, including aversive treatments.

The Behavior Analyst Certification Board issues credentials for behavior analysts nationwide, although state regulations vary as to whether or not a person can represent themselves as a behavior analyst. The use of aversive treatment is something that practitioners of applied behavior analysis take very seriously (see Professional practice of behavior analysis) due to the risks involved and the controversy surrounding their use (even among behavior analysts). Several National and International Disability Rights Groups have spoken against the use of aversive therapies, including TASH and AUTCOM.


I as well as you don't agree that this option is a good one, and also agree that it has been a source of abuse at the JRC. However, from an objective point of view, there are two sides of the argument.

Some are of the point of view that it saves lives, and some are of the point of view that it is abuse and torture. There is objective evidence that aversive therapy can be used for both purposes, well beyond the walls of the JRC.

The decision will be made by the legal systems as to which evidence carries more weight. The evidence for the torture and abuse seems to be tilting that way for the JRC, but as far as a nationwide ban on all skin shock therapy including the SIBIS system, I have heard no complaints, specific to that system, from organizations against the JRC methods, or even understood that type of therapy was in use across the country, in the school systems, until today.

From the facts as presented by Wiki, SIBIS doesn't appear to have the same potential for abuse, though, that exists at the JRC, because the skin shocks are controlled automatically rather than by subjective discretion of a second party observer. They are not as strong of a shock, and must be voluntarily accepted by the students, as an acceptable means to control their self-injurious behaviors.

Do you think that the students should be allowed to use the SIBIS system, if they have determined it as effective means to control their self-injurious behavior?

It presents a new dimension to the issue, because if all skin shock behavioral therapy, was outlawed in the US, as some organizations are lobbying for, these students in the school systems would no longer have the right to use a system they find effective in helping control the self-injurious behavior of head banging that could result in life long disability, or even possibly death.



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26 Feb 2012, 6:23 am

@aghogday.your facts are correct and as usual you have done your research well.all my arguements were based on knowing all those facts in the first place and i dont see exactly how those facts prove that shuting down the JRC would make mass amounts of children homeless.im not sure what or who funds the JRC but budget cuts and all there are still plenty of recources.they used to say the same thing when there was the proposition 2 and 1\2 override in the eighties.in the mass closing of state hospitals in the early 90's group homes took in the over flow


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26 Feb 2012, 10:36 am

vermontsavant wrote:
@aghogday.your facts are correct and as usual you have done your research well.all my arguements were based on knowing all those facts in the first place and i dont see exactly how those facts prove that shuting down the JRC would make mass amounts of children homeless.im not sure what or who funds the JRC but budget cuts and all there are still plenty of recources.they used to say the same thing when there was the proposition 2 and 1\2 override in the eighties.in the mass closing of state hospitals in the early 90's group homes took in the over flow
maybe the solution is for the state to confiscate the JRCs property and funds and use them to build better hospitals.



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26 Feb 2012, 11:32 am

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


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 rational 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.


And I am saying they are full of sh*t, punishing symptoms is wrong no matter how you slice it.....I don't care how many walls of text I see about it. I understand their stupid justifications just fine I simply strongly disagree based on what I know of psychology and the fact that abusing kids with mental disabilities is wrong....abusing kids in general is wrong.

Also what research proves that Yelling, spraying with a hose, force feeding of hot chili peppers and electric shocks are appropriate ways to reduce self harming behavior? Their own biased studies? I mean that seems contrary to everything I learned in psychology before dropping out of college. Clearly the people who run the place are more concerned with making money and keeping their abuse going than the welfare of the patients there.


Legally, it's neither considered corporal punishment or abuse, when used under legal guidelines as provided.

This issue is determined by the courts in Massachussetts, not by the JRC.

The JRC has been caught abusing the therapy, so they have been restricted in their use of it on new patients.

Sometimes the law is wrong, this is a good example.......also what about the patients they still are allowed to abuse? Just barring it from happening to new patients is simply not good enough.

The simple justification that those that support the therapies use, is that it saves lives. An alternative to serious injury and death. That is the way that the legislator from Massachussetts that had a son in the JRC, describes the benefit of the therapy.

He states it saved his son's life. And it has been an argument so far that has worked to keep the techniques used at the JRC, lawful, for existing patients, and a claim that is backed up by research as well.

Aversive therapy for dangerous self injurious behavior is not something that the JRC invented. The particular instruments and techniques used there are unique, and extremely controversial, but never the less approved behavioral therapy methods, by the disability services agency of the state government there.

Again the state government is clearly wrong.....of course they did not invent that sort of horrendous therapy, but this sort of hourrendous treatment of mental health patients is so 18th century meaning it should have been banned by now, everywhere. The argument 'it saves lives.' can be used for anything one could argue sending sucidal people to prison will save lives........but obviously the life quality is not going to be all that great. So it might save lives but at what cost to the psychological and physical well-being? Same with spraying mentally disabled kids with hoses, force feeding them hot peppers, screaming at them or shocking them with electricity.......it might make them so afraid to express themselves in any way they they live in a constant state of fear of being hurt if they can't express their frustration correctly do to their mental condition and thus 'behave' better..........but it probably does not actually improve their mental health and is likely to be detrimental. Not to mention force feeding hot peppers could cause mouth and throat problems so I would like to see specifically how their the state can possibly veiw this as an appropriate therapy.

As one can see in the article below from Wiki, the use of aversives were developed as a less restrictive alternative to practices prevalent in mental institutions such as shock treatment, hydrotherapy, straightjacketing, and frontal lobotomies.

And now are only evidenced to be of effective use when the aversive presents less risk than the self injurious behavior

As far as the sources of this information and research associated with aversives, it is provided by Wiki, not the JRC.

http://en.wikipedia.org/wiki/Aversives

The only way to stop this type of therapy, in the US, is to petition to have laws created that ban the therapy. This is what organizations like the disability international organization, and the ICAA organization are attempting to do. But, as of right now where it is legal, it is neither considered corporal punishment or abuse, per the laws as they exist.


Also I was already aware of what you got from wikipedia.....and that in psychology I learned the mental health field has been moving away from such damaging ways of handling mentally ill/disabled people. And that such techniques are looked down on by most educated mental health professionals. So I still do not see an value in it.

And I am aware of the law having to be changed.....and by the definition of abuse it is abuse I don't care what their state law says, abuse is abuse.....its just not a very friendly word so of course the law is not going to consider it abuse because that would make the state government look bad if they admitted to allowing abuse.


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26 Feb 2012, 11:52 am

@sweatleaf.yes at this point all handling and restraints are today viewed a draconian by the educated levels of the mental health profession.that is why i was so shocked and at first didnt believe the accusations against JRC because mass is so progresive usualy. @aspie48.they wont do that,the grounds of gaebler,westboro and northamton state hospitals remain in a undeveloped state of decay.aghogday is right about there being money problems for state care facilities.there are still places that could handle the overflow


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26 Feb 2012, 11:57 am

vermontsavant wrote:
@sweatleaf.yes at this point all handling and restraints are today viewed a draconian by the educated levels of the mental health profession.that is why i was so shocked and at first didnt believe the accusations against JRC because mass is so progresive usualy. @aspie48.they wont do that,the grounds of gaebler,westboro and northamton state hospitals remain in a undeveloped state of decay.aghogday is right about there being money problems for state care facilities.there are still places that could handle the overflow


I don't see how it would be more expensive to stop spraying the patients with hoses, screaming at them, shocking them with electricity or force feeding them hot peppers. I am sure there are better ways to prevent these kids from hurting themselves without hurting them. But yeah this sort of thing just pisses me off


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26 Feb 2012, 12:06 pm

when i mentioned budget cuts i was refering to aspie48 sugestion of building a new hospital on the ground of JRC if it were shut down.stopping electric shocks and restraints would if anything save the state money.if the state could sell some of the old state hospitals to private corporations and use the money to build a new facility that would work.very few businesses want to buy those facilities(maybe superstition).a lot of like goth type teenagers go to the ground of these places and think there getting intouch with spirits and things.the stigma may make these places undesireable to comerce


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26 Feb 2012, 12:10 pm

vermontsavant wrote:
when i mentioned budget cuts i was refering to aspie48 sugestion of building a new hospital on the ground of JRC if it were shut down.stopping electric shocks and restraints would if anything save the state money.if the state could sell some of the old state hospitals to private corporations and use the money to build a new facility that would work.very few businesses want to buy those facilities(maybe superstition).a lot of like goth type teenagers go to the ground of these places and think there getting intouch with spirits and things.the stigma may make these places undesireable to comerce


Well restraints might be nessisary in very extreme cases, but certainly not as a long term treatment strictly to restrain a patient if they are likely to cause a lot of harm to themself or others until they are more calm...but even that should be a very last resort the other things should not even take place as they serve no therapeutic or helpful purpose other than providing a way for the employees to take out their frustration on the patients which is not the purpose of a mental hospital.


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26 Feb 2012, 5:54 pm

Sweetleaf wrote:
vermontsavant wrote:
@sweatleaf.yes at this point all handling and restraints are today viewed a draconian by the educated levels of the mental health profession.that is why i was so shocked and at first didnt believe the accusations against JRC because mass is so progresive usualy. @aspie48.they wont do that,the grounds of gaebler,westboro and northamton state hospitals remain in a undeveloped state of decay.aghogday is right about there being money problems for state care facilities.there are still places that could handle the overflow


I don't see how it would be more expensive to stop spraying the patients with hoses, screaming at them, shocking them with electricity or force feeding them hot peppers. I am sure there are better ways to prevent these kids from hurting themselves without hurting them. But yeah this sort of thing just pisses me off


Just for clarification on the facts, the quote from the early part of this thread about hot peppers, spraying the children with water, pinching, spanking, ammonia, were aversives used at the school before 1991. Those aversives were replaced by the skin shock method, along with food deprivation, and temporary restraints.

The report provided earlier on from the international disability rights organization that was presented to the UN describes the history of aversives used at the facility and current methods used in complete detail, that are presented as meeting the UN definition of torture.



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26 Feb 2012, 6:22 pm

aghogday wrote:
Sweetleaf wrote:
vermontsavant wrote:
@sweatleaf.yes at this point all handling and restraints are today viewed a draconian by the educated levels of the mental health profession.that is why i was so shocked and at first didnt believe the accusations against JRC because mass is so progresive usualy. @aspie48.they wont do that,the grounds of gaebler,westboro and northamton state hospitals remain in a undeveloped state of decay.aghogday is right about there being money problems for state care facilities.there are still places that could handle the overflow


I don't see how it would be more expensive to stop spraying the patients with hoses, screaming at them, shocking them with electricity or force feeding them hot peppers. I am sure there are better ways to prevent these kids from hurting themselves without hurting them. But yeah this sort of thing just pisses me off


Just for clarification on the facts, the quote from the early part of this thread about hot peppers, spraying the children with water, pinching, spanking, ammonia, were aversives used at the school before 1991. Those aversives were replaced by the skin shock method, along with food deprivation, and temporary restraints.

The report provided earlier on from the international disability rights organization that was presented to the UN describes the history of aversives used at the facility and current methods used in complete detail, that are presented as meeting the UN definition of torture.


Food deprivation? For f*cks sake are they insane?


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26 Feb 2012, 9:11 pm

Sweetleaf wrote:
aghogday wrote:
Sweetleaf wrote:
vermontsavant wrote:
@sweatleaf.yes at this point all handling and restraints are today viewed a draconian by the educated levels of the mental health profession.that is why i was so shocked and at first didnt believe the accusations against JRC because mass is so progresive usualy. @aspie48.they wont do that,the grounds of gaebler,westboro and northamton state hospitals remain in a undeveloped state of decay.aghogday is right about there being money problems for state care facilities.there are still places that could handle the overflow


I don't see how it would be more expensive to stop spraying the patients with hoses, screaming at them, shocking them with electricity or force feeding them hot peppers. I am sure there are better ways to prevent these kids from hurting themselves without hurting them. But yeah this sort of thing just pisses me off


Just for clarification on the facts, the quote from the early part of this thread about hot peppers, spraying the children with water, pinching, spanking, ammonia, were aversives used at the school before 1991. Those aversives were replaced by the skin shock method, along with food deprivation, and temporary restraints.

The report provided earlier on from the international disability rights organization that was presented to the UN describes the history of aversives used at the facility and current methods used in complete detail, that are presented as meeting the UN definition of torture.


Food deprivation? For f*cks sake are they insane?


Not likely anymore insane than the state legislators and courts that have approved the therapy for decades.

Ethical options that work for these individuals, are what should be required, and no one has provided an answer for them, so far, in the state of Massachussetts, or in other treatment facilities that have not been able to find one for them.

Drugging the individuals into oblivion, is the only legal option of treatment, currently available for some of these individuals, beyond the therapies being used at the JRC. That is no more of a sane option than using a therapy that restricts caloric intake.

One inhibits all function, and one attempts to improve function, through procedures that many consider unethical, that meet the UN standards of abuse, and torture.

While the abscence of most functionality through heavy sedation, may not be considered physical torture or abuse, it is chemical restraint, that can take away one's conscious awareness of the world. And, potentially any possibilities for freedoms in life.

From the perspective of some, the life of a zombie, is not a good option either.

If a young adult could not stop banging their head on the wall, through conventional therapies, what would be a better restriction for them, restriction of caloric intake as a therapy, or the life of a zombie through chemical restraint by drugs?

Perhaps, they would choose a third controversial treatment through the SIBIS skin-shock method. Is that better than living the effective life of a zombie through drugs that result in chemical restraint, or being deprived of caloric intake, in a controversial technique in a program to modify their behavior?

It might be the choice some individuals legally choose for themselves in states where it is a legal method of controlling the head banging behavior. And it may be a choice that some in the JRC, would prefer over chemical restraint, through drugs. Some of those students have testified it has saved their lives, when not abused as has recently been evidenced at the JRC.

If it works for them, and saves their health and lives, would it be fair to outlaw it nationwide, because organizations feel the only way to control the abuses of the skin-shock therapy, at the JRC, are to completely ban it nationwide?

While food deprivation, or skin shock behavioral therapy might seem like an insane solution to a problem; when the only alternative legal treatment results in the life of a zombie, is that a less insane solution?

This is a question that the state of Massachussetts has wrestled with for decades. So, far they have determined that the zombie option is not the best option. Does that make them insane, or does it mean they have chosen what they have determined as the lesser of two evils?

There obviously are no good options in any of this, but objectively, because of that reality, it has not made the decision making process on restrictions of the options that are available an easy one for the Massachussetts state legislature.

The abuses of the legal use of the therapy at the JRC, appears to be what could potentially lead to the outlawing of all skin-shock therapy in the US.

Whether one considers skin-shock aversive therapy a good thing or a bad thing, outlawing it nationwide will also result in the legal involuntary treatment of heavy sedation for some of these individuals whom present harm to themselves; whom no longer would have access to these controversial therapies, such as the SIBIS method, currently used across the country.

Options that work better than the zombie choice, and the controversial methods at the JRC, should be developed and made available, before some of these individuals are potentially sentenced to the life of a zombie, because of the possibility of changes in the laws of the nation. And, right now, it appears that no one has an answer for that.



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26 Feb 2012, 10:32 pm

Why can't they just medicate enough to reduce symptoms enough to reduce violent behavior and add positive therapy to that? And I can't help but not be more glad than sad they won't have access to skin shock therapy or any other painful things that don't truly help with the underlying issues.


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27 Feb 2012, 12:37 am

Sweetleaf wrote:
Why can't they just medicate enough to reduce symptoms enough to reduce violent behavior and add positive therapy to that? And I can't help but not be more glad than sad they won't have access to skin shock therapy or any other painful things that don't truly help with the underlying issues.


In the cases of some of these individuals, functional assessments have been done at other facilities, temporary restraints have been used, positive cognitive and behavioral intervention methods have been used, and every drug available has been tried to help them, to no avail.

This type of hopeless scenario is why electro-convulsive therapy is still used in rare cases in hospitals across the US; it is still a last resort method of treatment for severe mental illness when nothing else works. It is a much more severe method than skin-shock therapy, but for some there is simply no other alternative, but suffering and/or death.

Transcranial Magnetic Stimulation (TMS) is now being used in the place of electro-convulsive therapy, in some cases of intractable depression, and is also being studied for treatment of autism as well.

It is definitely a more positive solution than electro-convulsive therapy. Unfortunately it is not known to help with these severe cases of self-injurious behavior.

A nation wide legal ban on skin-shock therapy would certainly reduce the potential for abuse in the clinical setting, but it would also be the elimination of a controversial therapy that has been shown to prevent self injurious behavior, that can and does lead to permanent disability, and death.

Hopefully, further research will provide another answer for these individuals that display serious self-injurious behaviors, as TMS has provided for cases of intractable depression.

Most insurance companies still won't cover TMS, whereas medicare covers Electro-convulsive therapy.



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27 Feb 2012, 7:45 am

1.im not that liberal and i can be willing to suport some corporal punishment,but electicuting people is indefensable.
2.when i was young i saw many kids who were so violent bed restraint,medication and body bags were justifiable restraints,but NEVER electricuting people.
3.if this was realy a therapy a way to not just protect people but change people than why is it not used everywhere


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