Massachusetts To Consider Restrictions on Aversive Autism Therapy

Five Massachusetts lawmakers have filed a set of bills to limit the use of aversive therapy -- which includes the use of electric shock therapy, corporal punishment, aromatic ammonia and Tabasco sauce -- on children in the state. One of the three bills also increases regulation of behavior analysts who deliver services to disabled children.

The bills come in response to reports describing the use of aversive therapies at Judge Rotenberg Center in Canton, Mass., according to State Sen. Brian A. Joyce, a Milton Democrat and a leading sponsor of the three bills filed March 1. Those reports include one from New York State education officials that raised questions about the safety and health ramifications of the treatments applied to students at the school. You can see a PDF file copy of this report via The Boston Globe's website Boston.com, by clicking here.

The bills as filed would do the following:

Restrict the origination of aversive therapy programs so that only board-certified behavior analysts (BCBAs) can develop them.

Require that BCBAs oversee the implementation of such programs through direct observation and supervision.

Create a state commission to investigate the use of aversive therapy in Massachusetts and the policies and procedures governing their use.

Establish standards for aversive therapy techniques. Joyce's announcement states: "These standards will specify the scope of techniques permissible under statute and regulations, the classification system of behavioral interventions, the format and content of behavioral plans, the policies and procedures governing the development, review, approval, implementation and monitoring of aversive interventions, and the adequacy of procedural safeguards to ensure the health, safety, privacy, dignity and human rights of individuals with behavior plans in place."

Set up a state peer-review board to oversee and approve all aversive treatment interventions.

Define associate behavior analyst as someone who has passed a certification exam, and define behavior analysis as "the design, implementation and evaluation of instructional and environmental modifications to produce socially significant improvements in human behavior through skill acquisition and the reduction of problematic behavior." And define a behavior analysis program as being "based on empirical research" which includes "the direct observation and measurement of behavior as well as a functional behavioral assessment" which uses "antecedent stimuli, positive reinforcement and other consequences to produce behavioral change."

Senator Joyce said in a statement issued March 2: "We have a duty to provide these protections to our most innocent and vulnerable populations -- autistic and mentally disabled children. I am confident that the passage of this common-sense legislation will go far in ensuring that this controversial therapy is only used by qualified individuals, while adding layers of oversight to the process."

The controversial aversive therapy, which few schools offer, has made Judge Rotenberg Center a subject of intense media attention over the past year. Reading the school's own literature (available online via www.judgerc.org) and also by reading and viewing this piece from ABC News Primetime Live, "'Shocking School' Takes on Severe Autism," it's clear that the school's educators believe that severely disabled children who are prone to violent outbursts and self-injurious behavior are better off with techniques that use with electric shock and other aversive therapies than they are taking psychotropic drugs. It's also clear that the school has a community of parents and some students who defend the practices as effective -- indeed, life-altering for the better.

However, there is a lack of research studies validating the effectiveness of aversive therapies as this extensive resource page on the issue from the Wrightslaw special education advocacy website points out. (Wrightslaw shares resources on this issue in the context of the New York State report.)

Further muddying the waters on issues involving this particular school: Judge Rotenberg Center has been the subject of Massachusetts' officials scrutiny over its alleged claims that some clinicians there were psychologists who were not in fact licensed. The state and the school last October reached a consent decree, a kind of enforced settlement by which the school agreed to stop making such claims and the school agreed to pay $43,000 to settle the matter. See information about the consent decree here. The school may have to refund an estimated $800,000 in tuition fees related to this matter, the Associated Press reported March 2. See that report here, via Boston.com.

More information and background on this issue:

From Judge Rotenberg Center:

• You can read part of a research paper, "Use of Skin-Shock As A Supplementary Aversive at The Judge Rotenberg Center," by the school's executive director, Matthew Israel.
• See a description of the program here -- see especially section on "GED" or graduated electronic decelerator.

Other resources and information

New York State Board of Regents memo, March 2006, on policy question facing state on use of aversive therapies. See here.

Massachusetts State Sen. Brian Joyce website.

Readers note: I can't find the text of the three bills cited in this article on the state's Mass.gov website, but they are listed in the Senate docket, which you can see here. The bills are called:

SD01988, An Act Creating a Special Commission on Behavior Modification

SD02033, An Act Creating and Authorizing Level IV Behavioral Treatment Interventions

SD02039, An Act Relative to Behavior Analysts

Quotes in this article come from the text of the bills and from Joyce's announcement, with information provided by the offices of Sen. Joyce and Rep. John Scibak, who is a BCBA.

One last note of interest for Massachusetts readers: One of the other sponsors, Rep. Barbara L'Italien, is the mother of a child with autism.