|The Right to Effective Treatment in the Crosshairs: Massachusetts Versus Judge Rotenberg Center
|Monday, May 27, 2019
|3:00 PM–4:50 PM
|Swissôtel, Event Center Second Floor, Vevey 1/2
|Area: CBM/PCH; Domain: Translational
|Chair: W. Joseph Wyatt (Marshall University)
|Discussant: W. Joseph Wyatt (Marshall University)
|CE Instructor: W. Joseph Wyatt, Please Select...
Within a treatment/educational program that is highly positive, is there a place for use of aversives if that mode of treatment advances a client toward his or her full potential and optimizes the client’s quality of life? Is there a small population of clients for whom aversive stimulation falls within the individual’s right to effective treatment? This symposium will examine these issues as they played out in a recent legal case in Massachusetts. The presentations include a review of the research, how aversives (including relevant safeguards) fit into an otherwise highly positive program at the Judge Rotenberg Center and the role of media on public perceptions of JRC. Testimony of experts and legal tactics in the case will reviewed as well. The symposium will show how, following a 44 day trial that included dozens of witnesses and hundreds of pages of exhibits, a judge concluded that there is a place for ethical use of aversives. A parent will describe the impact of aversive programming on the dangerous behaviors, and on the life prospects, of his adult child.
|Instruction Level: Basic
|Target Audience: The target audience includes graduate students and their professors, professionals who work with clients who exhibit dangerous behaviors or who plan to do so.
|Learning Objectives: 1. Acquisition of knowledge of the pros and cons of the use of aversives.
2. Understanding of the ethical issues involved.
3. Working knowledge of the Judge Rotenberg Center's model review process for use of aversives.
The Science Informing the Standard of Care for Treating Severe Behavior Disorders
|NATHAN BLENKUSH (Judge Rotenberg Educational Center)
In 2013, the Massachusetts Department of Developmental Services (DDS) filed a motion to vacate a settlement agreement that allowed the Judge Rotenberg Center (JRC) to use a skin shock device (the Graduated Electronic Decelerator (GED)), approved by the Massachusetts Probate Court on a case-by-case basis, to treat individuals with severe problem behaviors. To support the motion, DDS initially claimed that positive behavior supports rendered punishment procedures unnecessary. Later, DDS provided expert testimony that psychotropic medications combined with positive behavior supports were sufficiently effective to treat severe problem behaviors. On the other hand, JRC argued that despite the advances in psychopharmacology and behavior analysis, some individuals continued to require treatment that included the GED. Over the course of 44 trial days, hundreds of scientific articles were offered to the court and critically examined by lawyers and experts on both sides. Here, the process of presenting and critiquing the literature pertaining to severe problem behaviors is discussed using transcripts from the trial.
“Bad Faith”: The State of Massachusetts Versus the Judge Rotenberg Center
|W. JOSEPH WYATT (Marshall University)
In a recent court case, a Massachusetts judge undertook a thorough review of the use of an aversive stimulation method (skin shock) at the Judge Rotenberg Center, the only treatment center in the U.S. to use the controversial method. This presentation will review the judge’s findings after a thorough review of the evidence, pro and con. The judge also described included numerous acts of “bad faith” by individuals within the State Department of Developmental Services in its efforts to undermine and prevent effective treatment at JRC. The presentation will address ethical issues including the likelihood of a future of institutionalization, lived out on high doses of medications that include deleterious side effects, is preferable to the thoughtful and ethical use of aversive stimulation when that treatment modality is carefully and minimally used within a treatment program that is overwhelmingly positive. Is a two-second shock, although painful, an ethical treatment if it opens the door to a life of education, community outings, employment and a quality of life that previously could not have been imagined? Ethics of the use of skin shock will be discussed and audience participation is encouraged.
The Effects of Negative Media on a Residential Treatment Center for Students With Severe Behaviors
|GLENDA CROOKES (Judge Rotenberg Educational Center)
Since the mid-1980's, the Judge Rotenberg Center has been embroiled in controversy that more often than not has been misrepresented by the media. For decades, we have been fighting for the right to effective treatment as well as parents’ rights to recommend what they feel is the most effective, least restrictive treatment for their children. Often the media have responded to outcries from well-intentioned but misguided individuals who have never worked with clients who exhibit high rates of behaviors that are dangerous to themselves and/or to others. Moreover, those who have most harshly criticized the use of aversives at JRC have refused to visit the Center even when invited to do so. Despite the progress made and the dramatic improvement in many clients’ quality of life, the media has portrayed what happens at the center in a negative light. This presentation will discuss the ramifications of the negative media, including protests, serious threats, and proposed regulatory changes.
My Child’s Experience at the Judge Rotenberg Center: His History, Behaviors, and How Aversives Changed Everything
|Glenda Crookes (Judge Rotenberg Educational Center), NICK LOWTHER (Judge Rotenberg Educational Center)
This parental presentation will trace the history of a child whose high rates of extremely dangerous behaviors had resulted in his placement in, and eventual expulsion from, a number of well-respected residential placements wherein the best efforts of professionals had failed to eliminate or significantly reduce those behaviors. Several of the behaviors were life-threatening and had resulted in extreme, though necessary, restrictions on quality of life. The earlier placements had involved long-term physical restraints as well as heavy doses of psychotropic medications that produced unhealthy side-effects. After several months at the Judge Rotenberg Center during which only positive techniques were employed, there had been little improvement in the dangerous behaviors. Ultimately, I was approached about the use of aversive stimulation, skin shock, with my child. This presentation will review the behaviors, earlier failed efforts to address them, the decision-making process regarding aversives, the treatment and the outcome relative to the dangerous behaviors along with resultant changes in my child’s quality of life and potential