Home to approximately 200 children with severe disabilities, the Judge Rotenberg Center (JRC) located in Canton, Massachusetts is the only educational facility of its kind in the world to use aversive shock therapy. Considered an act of torture, as defined by UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, the JRC has used aversive shock therapy to treat children for the past 40 years.1 Despite the deaths of five children and numerous lawsuits, the JRC has managed to stay open and continue to administer shock therapy to its wards.2
In 2010, Mental Disability Rights International (an international NGO based in Washington, DC) filed a report “Torture not Treatment” as an appeal to the United Nations Special Rapporteur on Torture. MDRI asked the Special Rapporteur to initiate an inquiry, noting that U.S. laws have failed to protect people with disabilities.
Since then, a U.S. Department of Justice inquiry has been launched and further lawsuits have been brought against the JRC. In November 2011, The Massachusetts Department of Developmental Services, the state agency that oversees the JRC, adopted new regulations banning the use of aversive shock therapy on new enrollees, although children and adults currently in the system will continue to receive aversive shock therapy.3
This analysis summarizes MDRI’s report that claims that aversive shock therapy is a form of torture and explores the legal protections for children and people with disabilities.
About JRC and its Behavior Modification Therapy
In its report, MDRI provided an overview of JRC’s Behavior Modification Therapy.4 JRC is classified as a school, licensed by the Massachusetts Department of Elementary & Secondary Education. State and federal agencies provide the JRC with $220,000 a year per child.5 Students are placed there voluntarily with the signature of a parent or guardian. Massachusetts Department of Developmental Services provides the JRC with Level III aversive certification and licenses its care for adults that are over 22 years old.
Attendees often have autism or severe mental retardation, accompanied by self-injuring behaviors. Some students have a diagnoses of post-traumatic stress disorder (PTSD), schizophrenia, attention deficit disorder (ADD), obsessive compulsive disorder (OCD) and bi-polar disorder, while other students are referred there through the juvenile justice system. All students, regardless of their initial diagnoses, are subject to the same behavior modification treatment.
The JRC follows the principles of Skinner’s behavior modification theory that state that positive and negative reinforcement can change a person’s behavior. Student treatment plans consists of both rewards and punishments. Rewards include the right to pick out items in a contract store, as well as basic privileges including social interactions with other patients and staff.
Punishments are given in response to self-injurious actions, such as hitting oneself, as well as to harmless behavior, such as getting out of a seat during class time, stopping work for more than ten seconds or nagging. Since the late 1990s, punishments (aversives) include electric shocks, food deprivation, and social deprivation, among others.
JRC developed the Graduated Electronic Decelerator (GED) to deliver the shock treatment as a replacement of an earlier system that was deemed not strong enough. The GED-4 (the most powerful version thus far) delivers shocks via electrodes attached to torso, arms, legs, hands and feet. The GED-4 is worn as a backpack and the shocks (45.5 milliamps) are delivered for two seconds by remote. These shocks are extremely painful. Similar shock levels delivered to animals are considered a felony account in Massachusetts.
Students do not know when they are going to be shocked and some students are shocked a dozen times a day. One student was documented receiving 350 shocks in one day (with an earlier GED model). The shock therapy can last years. Physical restraints are used in addition to shocks because students are prone to ripping off the GED backpack. Some students are strapped to a platform with 4-point mechanical restraints when they receive their shocks. Students may be restrained for hours or intermittently for days, and in some cases, for years.
Furthermore, the treatment plan includes behavioral rehearsal lesson (BRL). In BRLs, students are restrained with a GED device and provoked into carrying out a behavior that should be punished. If the student is provoked they are shocked. If the student tries to get away they are shocked with the stronger shock. The BRL only stops when the child sits motionless in the chair for ten minutes.6
Torture, International Law, and the JRC
In 1975, the UN passed the Declaration on the Protection of All Persons from Being Subjected to Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment. In 1984, the Convention Against Torture was adopted and was entered into force in 1987. The U.S. ratified the CAT and is responsible for following it.7
The UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment defines torture as:
any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person for such purposes as obtaining from him or a third person information or a confession, punishing him for an act he or a third person has committed or is suspected of having committed, or intimidating or coercing him or a third person, or for any reason based on discrimination of any kind, when such pain or suffering is inflicted by or at the instigation of or with the consent or acquiescence of a public official or other person acting in an official capacity. It does not include pain or suffering arising only from, inherent in or incidental to lawful sanctions.8
JRC’s use of aversives (shock therapy, restraints, social isolation, food deprivation) meet all four criteria in this definition: (1) the pain and suffering inflicted is severe (i.e. GED-4 shocks of45.5 milliamps) ; (2) this pain is inflicted intentionally (i.e. BRLs); (3) the infliction of pain is for a purpose that is discriminatory (given to people with disabilities); and (4) these practices are conducted with the consent or acquiescence of public officials (JRC is funded and overseen by government agencies).9
Gaps in U.S. federal and state legislation
U.S. government officials at the state and local levels are aware of the JRC and its practices, yet it has been allowed to carry out aversive therapy for 40 years. What U.S. laws are there to protect people with disabilities? What gaps exists in U.S. jurisprudence that would allow JRC to practice aversive therapy? The MDRI report tried to answers these questions.10
On the federal level, cruel and unusual punishment is prohibited by the U.S. Constitution’s 8th amendment. The U.S. Supreme court limited these protection to criminal law, thus students in schools are not protected. No federal limits exist for the use of restraints in schools or for the use of corporal punishment. Children with disabilities are protected by the Individuals with Disabilities Education Act (IDEA), although this act allows positive behavioral interventions, it does not prohibit aversives.
The Americans with Disabilities Act (ADA) and the Developmental Disabilities Assistance and Bill of Rights Act (DD Act) protect children with disabilities and states that children with disabilities cannot be placed in a situation of greater risk than the general population. Though, a class action suit in a federal court resulted in a decision that the DD Act did not create any new legal rights or protections.
Since there are no federal laws limiting the use of aversives, states set their own regulations. Some states, such as California (the original home of the JRC) make it nearly impossible to use aversives. While in Massachusetts, aversives are permitted. JRC submits all high level aversives (level 3) to the court for approval. The courts have rarely denied JRC permission to use the requested aversive. While Massachusetts law limits the use of restraints, the Department of Developmental Services claims that these protections are not applied to children in an approved behavior modification plan.
Cases brought against JRC
The MDRI report highlights a number of cases brought against the JRC.11 A 1980 death in the JRC’s former location in California prompted the state to virtually ban aversive therapy and resulted in the JRC moving to Massachusetts. In 1990, a nineteen year old with severe mental retardation died as a result of severe punishments, including limiting her food intake to 300 calories per day. The Massachusetts Department of Mental Retardation conducted an exhaustive study and found that JRC could not be held accountable for her death.
From 1987 to 2009, those opposing the schools’ use of aversive therapy tried to get bills passed in the Massachusetts legislature banning or limiting the use of punishment of children with disabilities. At various point in the 1990s, the Department of Mental Retardation and the Massachusetts Office for Children (OFC) tried to shut down the JRC. The New York State Education Department conducted their own study of JRC and adopted regulations to phase out new cases where aversive treatment would be approved (New York sends the most patients to JRC). Before these new regulations could be implemented, parents and supporters of JRC brought a case to a federal court, claiming they had the right to approve aversive therapy for their children and the court granted a stay on the NY regulations.
While JRC has clearly found a way to carry out its Behavior Modification Therapy within the limits of the law, one is left wondering why parents and others agree to their approach and send their children there.
The MDRI report did not provide testimonies or information about those who support the center. This information was found in other news reports and blogs. Parents that support the JRC claim its aversive therapy improves lives and in some cases has saved their children’s lives. For example, one parent noted that before the shock therapy, her severely autistic child used to scream and bang her head on a wall, slap herself and pull out her own hair all day long. After the GED, the child became calmer and her self-abusive acts became under control. Other parents prefer the shock therapy to psychotropic drugs.12
Many parents send their children to JRC as a last resort because no other institution will allow their children to stay. One parent of a violent 17-year old noted that her child attacked her while driving and felt her daughter needed to be isolated. The mother is pleased with her daughter’s progress at the center.13 Another parent from California noted that her son’s therapy resulted in a decrease of 2,000 “health-dangerous acts” per month to an average of 30. This child’s parents briefly took their child off the shock therapy and the incidences of dangerous acts rose again.14
Does the success of the treatment of some cases justify the means? One can certainly sympathize with parents whose children are a danger to themselves and to other around them. These parents have found mainstream approaches to be ineffective and do not want to drug their children until they are non-communicative. Is torture the answer?
Update since the MDRI report
In July 2010, Manfred Nowak, the U.N.’s special rapporteur on torture, requested that the U.S. government investigate the use of shocks at the JRC and told ABC news that he considers the use of shocks to be an act of torture.15
In August 2011, the head of the JRC, Matthew Israel, faced criminal charges and was forced to step down because in 2007 his staff wrongly shocked two children dozens of times in the night hours after receiving a prank call from two students who pretended to be a supervisor. JRC vowed to change its policy of issuing shock treatment based on phone calls.16
Finally, in November 2011, the Massachusetts Department of Developmental Services adopted new regulations to limit the use of aversives. New admittances cannot be subject to shock therapy, long-term restraints and other aversives that could pose risk of long-term psychological damage. Current patients could continue to receive the shock treatment. The U.S. Department of Justice also opened an investigation of the children at the JRC. While this decision and investigation is a great step forward, the MDRI has called for a blanket ban in the U.S. on shock therapy and aversive treatment for children and adults with disabilities.17
It is horrific that this center has been allowed to stay open for the past 40 years. It is a travesty that legislators at the state and federal levels have not mandated a better solution for the most severe cases. Torture is never the answer.
1 Ahern, Laurie and Rosenthal, Eric. “Torture not Treatment.” Mental Disability Rights International. 2010.
2 Gao, Helen. “Tab for controversial school exceeds $700,000.” Rotenberg Center Blogspot. August 27, 2007.
3 “JRC Banned from Shocking New Admissions.” November 7, 2011.
4 Ahern, Laurie and Rosenthal, Eric. “Torture not Treatment.” Mental Disability Rights International. 2010.
5 Pilkington, Ed. “Shock tactics: Treatment or torture?” The Guardian. March 11, 2011.
7 UN CAT (1984) Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment.
9 Ahern, Laurie and Rosenthal, Eric. “Torture not Treatment.” Mental Disability Rights International. 2010.
12 Pilkington, Ed. “Shock tactics: Treatment or torture?” The Guardian. March 11, 2011.
13 Gotbaum, Rachel. “Lawmakers Consider Proposals Banning The Use Of Skin Shock Therapy.” July 26, 2011.
14 Gao, Helen. “Tab for controversial school exceeds $700,000.” Rotenberg Center Blogspot. August 27, 2007.
15 Reardon, Nancy. “Bill regulating controversial Judge Rotenberg shock therapy advances.” July 13, 2010.
16 Wen, Patricia and McGrory, Brian. “Rotenberg founder set to face charges.” Boston Globe. May 25, 2011.
17 “JRC Banned from Shocking New Admissions.” November 7, 2011.