The Shocking Truth
This is the machine.
It is a gray square of hard plastic, looks like a garage door opener but is perhaps double the size of one. Inside this square is the circuit board and all that is evil and beneficent and contentious about the machine. But the square itself couldn’t be more pedestrian. Fastened to it, by Velcro, is another casing of hard plastic, another square, which houses a 12-volt battery. Dangling from the machine’s corners are wires, and at the ends of these wires, electrodes that emit 60 volts and 15 milliamps of electricity in two-second bursts. The electrodes are attached to the arms, legs, or stomachs of roughly half of the 209 students at the Judge Rotenberg Center in Canton. The machine’s sole purpose is to shock these students. The shocks are viewed by JRC, and pretty much only JRC, as a corrective therapy.
It is a painful shock; you hear all sorts of stories about it. JRC’s lawyers used to let journalists receive it, but not anymore. They can watch, though. They can watch Ralph Antonelli, director of quality control training at JRC, a wiry man with swept-back black hair, secure an electrode to his right forearm, the machine on the table before him, and the transmitter for it, the little remote control that staffers hold at all times, sitting next to that. They can watch as Antonelli presses the button and his forearm tenses and his middle and ring fingers shoot downward toward his palm. Then they can watch his face, relaxed even as the transmitter is beeping and the electrode is bzzzing his skin. “See?” he says. “Just two seconds and it’s over.” Some liken it, as Antonelli does, to a bee sting. Others, including a student who’s received it, call it the longest two seconds of their lives. One thing is certain about the machine, known as the Graduated Electronic Decelerator: What we just witnessed isn’t it at its most powerful. There is a version that is three times stronger.
The school says that the GED needed more juice. The mentally handicapped and behaviorally impaired students who attend JRC, who are in fact its lone attendees, weren’t responding to the machine. So in the early 1990s, a couple of years after the GED was first developed, the school made a new one—upping the milliamps from 15 to 41 and the voltage to 66, and calling it the GED IV. Even at its higher capacity, the GED IV still carries less power than a stun gun, a defibrillator, or a cattle prod. But the GED IV, as well as the base model, has been found in numerous state reports and in the accounts of former JRC staffers to burn students’ skin. Some have been taken off it for a month at a time as a result. And then put back on.
These students are severely autistic, mentally retarded, or behaviorally challenged children and adults. JRC is the only school in the country to shock them—using a machine it alone manufactures, a machine it distributes to no one else. Some Massachusetts legislators who’ve filed bills this year to limit the use of the machine call it “barbaric” and the school “like Abu Ghraib.”
The legislators are only half-correct. Spend enough time around the machine and it will test everything you know about right and wrong.
This is the machine’s inventor. He is an unassuming old man, short and with a slight potbelly, rounded shoulders, half a head of curly white hair, and warm eyes. He looks as if he could be Fred Rogers’s older brother. Matthew Israel, 75, is the founder and executive director of JRC, which he incorporated under a different name in 1971. Israel responded to questions for this article only by e-mail, but while watching the school’s promotional video one notices the softness of Israel’s voice, just above a whisper and even-toned, even while describing the GED’s purpose. One notices the academic’s indifference to dress: Israel often wears suits when he’s photographed, but the tie droops a few inches below his belt line and the jacket fairly engulfs the tiny man. In Israel’s writings on the school’s website and in interviews he has given, one notices his dream, as grand as anyone’s in Hollywood but documented and executed better than most scientists’. Matthew Israel is out to save those that society discards.
He grew up in Brookline, the son of a lawyer and the younger of two brothers. Israel had loving parents; they rarely spanked him, and punishment was never emphasized. At Brookline High School he was one year ahead of Michael Dukakis. They ran cross-country together and became good friends.
Israel entered Harvard in 1950 unsure of what to do with his life. Later that freshman year he picked up Walden Two, a novel by the behavioral psychologist B. F. Skinner, who taught at Harvard. The controversial book is about a utopian society where behaviors can be modified for the benefit of all inhabitants. It is based on Skinner’s theory of operant conditioning: If an action is rewarded, it increases the likelihood that the person will perform the action again. This is, after all, how Skinner had taught pigeons to play table tennis: by rewarding the behaviors that led to their game. Israel loved Walden Two and Skinner’s theory. He wanted to start his own utopian community based on its ideals. For the next 10 years, he studied under Skinner, first as an undergrad; then as a grad student; and finally as a postdoctorate fellow, after having received his Ph.D. in psychology from Harvard in 1960.
Following his time at Harvard, Israel started a commune in 1967 in Arlington. He hoped to grow it into his utopia. The previous year Israel had founded the Association for Social Design, whose objective was to “establish a network of associated experimental communities in cities throughout the world,” writes Hilke Kuhlmann in the 2005 book Living “Walden Two”: B. F. Skinner’s Behaviorist Utopia and Experimental Communities. Israel’s Arlington commune was the first step toward something he was tentatively calling “Walden Three.”
At the commune, Israel lived next to a spoiled three-year-old named Andrea. Andrea whacked people with a broom. She screamed. She cried. She wanted always to barge into Israel’s room. He asked Andrea’s mother if he could try behavioral techniques on the girl. She agreed. Israel rewarded Andrea when she behaved well—going on walks with her and giving her treats. And one day when Andrea screamed as she sat in time-out, he flicked his finger against her cheek. The girl quieted down, and he left the room. A few minutes later, she started up again. Israel returned and once more flicked his finger. The crying stopped for good. In the days and weeks that followed, Israel could look at Andrea when she acted out and shake his head, and the girl would stop. She became a “charming individual,” Israel once told Mother Jones.
Soon after that, Israel’s commune fell apart. As did a second he started in the South End. As did, ultimately, the Association for Social Design, despite the fact that it had expanded to three other cities. In Living “Walden Two,” Kuhlmann blames Israel, suggesting he, as the commune’s patriarch, wanted his inhabitants to live lives based on altering one another’s behavior; the others in the communes and the association thought this was no life at all. Israel says the communities fell apart because the people living in them didn’t get along. Simple as that.
But he wasn’t ready to give up. He thought if he opened a school, he could provide the commune’s inhabitants with jobs. A self-sustaining economy might lead, ultimately, to utopia. Plus, he kept thinking about the success he’d had with Andrea. Skinner had experimented only with rats and pigeons, but Israel had had this little girl, a real person, whose behavior had changed as surely as Skinner’s vermin’s. Israel wanted his school to serve autistic children&mda
sh;their actions could be changed with fewer social ramifications, Kuhlmann writes—where he could implement the theories his predecessor had tested in the lab. But the pupil would differ from his teacher: He would punish the children when necessary. Skinner never advocated that.
In the beginning there were only two students, a schizophrenic and an autistic teenager. Israel had set up his day school, such as it was, in Providence, Rhode Island, in 1971, calling it the Behavior Research Institute. He opened a residential program the following year in a wing of the schizophrenic’s home in nearby Cranston. By 1975, BRI had another home in Seekonk. Two years later, Israel founded a sister branch of BRI in California. From there BRI opened residential homes in Attleboro and Rehoboth. Soon Israel had lost interest in Walden Three; he wanted to oversee his school.
They used aversive therapy at BRI. They used positive reinforcement, too: food and toys and a near-continuous stream of compliments for behaving well. But it was the aversives that drew attention. Teachers pinched students, spanked them with spatulas, stuck ammonia pellets beneath their nostrils, put them in white-noise helmets. Israel saw aversive therapy—and still sees it—as the best response to self-injurious and disruptive behavior. He almost never doped his pupils, a position he holds to this day. He believes drugs often only sate the patient; they do not solve her problems. Israel, then as now, put his trust in punishment.
It wasn’t long before people wondered if that trust was misplaced. In 1979, the state of New York issued two reports from agencies that oversaw the Behavior Research Institute. Fifteen New Yorkers at that time attended the school. (New Yorkers today still account for the highest percentage of the school’s student body.) The bright red buttocks and scrapes across the cheek; the plaintive cry of a student who said, “Take me home, I want to go home”; the weird, oft-repeated, and grammatically challenged cheers from teachers (“Good working without stopping”)—it led the authors of one report to write that the school’s “rigidly implemented” program was the “singular most depressing experience that team members have had.” That was not the worst of it, though.
On July 17, 1981, at BRI’s sister school in Northridge, California, staffers restrained 14-year-old Danny Aswad face-down on his bed. Aswad died in that position. The autopsy report concluded that he died of natural causes, but the state of California placed the school on a two-year probation anyway. In 1982, the state’s Department of Social Services filed a 63-page legal complaint alleging abuse at the school. The complaint claimed, among other things, that BRI withheld meals; showed staff how to hide students’ injuries from regulatory agencies; and, strangely, encouraged students to act out for a film crew, the footage to be used later to demonstrate how the children had behaved before BRI. Later that year the state reached a settlement with BRI in California. The school couldn’t use anything more punishing than a water spray. The state also forbade Israel—who says he’d turned over control of the campus before Aswad’s death—from stepping foot on the Northridge property. But this, too, was not the worst of it.
In 1985, Vincent Milletich died. The 22-year-old from Queens, New York, attended the school in Providence, as did, by that time, roughly 60 others. On July 23, for acting out at the BRI residential home in Seekonk, Milletich was restrained in a chair, his hands and feet tied by plastic cuffs, his face masked and his head helmeted, the earphones inside it emitting white noise. He suffocated in there, asphyxiation. Though BRI was not found to have caused Milletich’s death, a district court judge ruled it was negligent for approving the therapy and not carrying it out with sufficient supervision.
Later that year, the state’s Office for Children, which regulated the school because its residential homes were in Massachusetts, issued an order to close the Behavior Research Institute. The school appealed the closure, and countersued the Office for Children. Then a judge recommended BRI stop using aversives. Advocates for the disabled cheered the move; many of them had written to Governor Dukakis asking him to shutter BRI, but to no avail.
Without the treatment, the school said, its students seriously regressed. For Israel, this meant the therapy had been working. But others drew a different conclusion. The children “are controlled by the threat of punishment,” one of the New York reports had said. “When that threat is removed, they revert to their original behaviors.”
Hoping someone would see things his way, Israel brought one of his most terribly self-abusive students before Judge Ernest Rotenberg at a hearing at the Bristol County Probate Court in 1986. After Israel detailed the student’s history, Rotenberg ruled that she was unable to make her own treatment decisions. And if she were, she’d choose BRI. The Office for Children and BRI settled the following year, the state agreeing to pay $580,000. Rotenberg allowed BRI to use aversives, as long as each student’s treatment plan was approved by the probate court. He also appointed a mediator to hear future disputes.
But the Milletich affair, too, was not the last of the school’s troubles. In 1990, BRI student Linda Cornelison died. She was mentally retarded, could not talk, and one day began clutching her stomach on the bus to school. Once there, she lay on a couch, but a nurse thought her illness was an act, according to a report later filed by the Massachusetts Department of Mental Retardation. After school, Cornelison returned to her BRI-run home in Attleboro, where staff gave her 13 spatula spankings, 29 finger pinches, and 14 muscle squeezes, and five times forced her to inhale ammonia. She died in the hospital early the next morning from complications related to a gastric perforation. Her mother said Cornelison had never had gastrointestinal problems before, according to a medical report. Though the department’s report said the school “violated the most basic codes and standards of decency,” it found that neither the dereliction of care nor the administration of aversives had killed her.
Some time after Cornelison’s death, Israel eschewed the punishment he’d favored for two decades. He would instead use something more uniform, and far more painful.
This is the machine that led to the machine. It’s called the Self-Injurious Behavior Inhibiting System (SIBIS). There are two models, the simpler consisting of an electrode and a radio transmitter wrapped by Velcro around the arm or leg. The administrator holds the control and, when necessary, presses the shock button. It feels like the hard slap of a rubber band, and lasts nearly as long: 0.2 seconds. In an academic paper on SIBIS that appeared in 1990, the authors said its shock produced an “almost complete elimination of the self-injurious behavior.”
Israel’s school was one of the first to use SIBIS. What Israel liked was the same thing the study’s authors liked. The aversive was consistent: It delivered the same shock, with the same power, for the same duration, every time—unlike, say, a spatula spank, whose parameters were not nearly as defined. Its intent was clear: There was no chance the student would confuse the aversive with some other action. And it was discreet: The shock didn’t cause the distraction, or require the manpower, of restraining someone, which meant it could be delivered in a classroom setting while other students went about their work.
The Behavior Research Institute tested the device on 29 students over 14 months. One of them was Brandon Sanchez, the autistic nephew of state Representative Jeff Sanchez. Brandon banged his head until he cracked it open. He once
chewed off part of his tongue. He was a ruminator, too: He would vomit, chew the vomit, swallow it, and vomit again. The acidity was burning his esophagus; the vomiting was causing him to lose weight. Israel thought SIBIS might be the only way to save this 12-year-old’s life. Brandon was down to 52 pounds.
Israel and his staff started in with the treatments. Fifty shocks became 100; 100 became 500; 500 became 1,000, and still they shocked more. Brandon wasn’t responding. So, 2,000 shocks. And then 3,000, 4,000. After roughly 5,000 shocks in one day, Israel told his staff to stop.
The shocks weren’t strong enough, Israel thought. He asked SIBIS’s developers to increase the voltage. They refused. And that’s when Israel made his own machine.
The Graduated Electronic Decelerator was roughly three times stronger than SIBIS when Israel and engineer David Marsh finished it in December 1990. Its shock lasted two seconds, not two-tenths of one.
But the human body is a curious thing. It can adapt to almost anything, including 60 volts and 15 milliamps of electricity. So in 1992, with 52 students already on the GED, the school developed the GED IV. Israel himself has called its shocks “very painful.”
It’s probably best to provide some context here, in order to give a better understanding of what was about to happen. Behavior analysis is an evolving field. In the years before the GED’s invention, clinicians and academics published studies concluding that positive reinforcement, with no aversives, could work on students as difficult as Israel’s. If you did “functional analyses”—monitor patients day and night, figure out what was making them angry, sad, or frustrated, and then redirect those feelings to something positive—you could stop their behaviors. Hundreds of articles and entire books on this so-called positive-behavior support followed. Clinics and schools across the country, including some of the best in New England, began to implement (and continue to implement) its findings.
BRI came under intense pressure because of this burgeoning research. Undercutting the claims Israel made were those of O. Ivar Lovaas, a psychologist at UCLA. Like Israel, Lovaas once espoused the benefits of electric shocks. In the early 1970s, Lovaas even used cattle prods on children. But in 1987 he published a study finding that through 40-hour weeks of one-to-one therapy, autistic preschoolers could attain “normal functioning.” In 1993, Lovaas condemned his former self, saying that shock therapy was a short-term solution that produced no long-term gains.
Into this milieu now stepped Philip Campbell, who in 1991 became commissioner of the Massachusetts Department of Mental Retardation, the agency regulating BRI. He had previously been the executive director of the Massachusetts Association for Retarded Citizens, a nemesis of BRI and Israel. Campbell knew the literature. He despised the new GED, and wasted no time in going after its creator.
It was a nasty fight. Campbell was eventually found to have leaked erroneous reports about BRI to the press, to have hired a team with a known bias against the school to investigate it. BRI said the Department of Mental Retardation was in violation of the state’s 1987 agreement with the school. In 1994, to show its fortitude and to honor the judge who had overseen that agreement, the Behavior Research Institute renamed itself the Judge Rotenberg Center.
The brawl would go on for three more years. But then in 1997 the Massachusetts Supreme Judicial Court affirmed a previous decision finding Campbell and his department in contempt of court for various things, including lying under oath. Campbell, who was never prosecuted for perjury, resigned. The state was ordered to pay JRC more than $1 million in court costs.
The court placed the department in receivership, leaving JRC to gain licensure and certification through an independent attorney appointed by the probate court. The move meant, effectively, that efforts to regulate the school would be difficult to carry out.
This is the machine as big business.
Protected by the court orders, JRC expanded quickly, its enrollment going from 110 in 2000, to 145 in 2002, to 228 last year. As enrollment increased, so did funding, because school districts and state governments pay to send their kids there. JRC’s budget went from $18 million in 2000 to $56 million in 2006. What were once a few residences for the students grew to 33 homes spread across the southern suburbs of Boston, from Stoughton to Norfolk. JRC employs about 900 people: psychologists and teachers and night staff and orderlies and everyone it takes to care for a population that today comes from 10 different states. As of the last public filing, Matthew Israel made $321,000 a year.
Part of the increase in enrollment is due to the students JRC now serves. They are no longer a largely autistic and mentally retarded clientele. Today, roughly half of the students are considered to be “high-functioning,” their impairment behaviorally based, such as kids with ADHD who’ve been in trouble with the law. Indeed, some of JRC’s students come from jail.
Handling a population like that is tough. One former staff psychologist says around 2001, the school’s policy switched from educating and treating to simply keeping students in line. “Israel couldn’t stand them not behaving in a perfectly controlled way,” the psychologist says.
JRC has always believed in punishing not only the negative behavior, but also the actions that presage it: A face-slapper could be shocked for simply raising his hand. This is called “treating the antecedent.” A lot of things can be antecedents at JRC: yelling, refusing a teacher’s order, talking out of turn. Another psychologist, who left in 2002, says these aren’t precursors to violence so much as ordinary classroom disturbances.
JRC has video monitors in every room of the school, in every residence—has had them since 1975. Certain staffers, called quality control, sit in a control room day and night, a wall of television monitors and computer screens before them, watching everyone, and, because the rooms are miked, hearing everything. The control room is ostensibly to ensure that students are shocked for the inappropriate behaviors that an employee might miss; when that happens, quality control phones the staffer in the room, who then applies the shock. But the people who sit in the control room serve another purpose: They’re watching their own. If, say, a teacher in a classroom refuses to shock a kid, he or she is written up. The write-ups carry the Orwellian title “Performance Improvement Opportunities.” Anyone can tattle on anyone else, regardless of station. The school has staffers whose job is to read and track these forms. Get enough of them, and you’re gone.
“Oh my God, I hated that place,” says Jessica Croteau, a teacher at JRC who started in August 2005 and quit seven months later. “I stood there for eight hours a day and basically watched their behaviors and marked it in their behavior logs.” Susan Wilson taught science for six years at JRC. “There’s a lack of dedication to education. And it’s across the board,” Wilson says. What bothered both women, too, was the constant surveillance. Croteau became so paranoid that she and a fellow teacher ate lunch in that teacher’s Jeep. They vented until it was time to go back inside.
This is the imprint of the machine.
Greg Miller was a teacher’s assistant at JRC from 2003 to 2006. He was one of the people who administered the shocks. He recalls stories about them frantically, as if he’s on break and still not able to speak freely. At JRC, he wore a modified carpenter’s belt. Dangling from it was a series of buttons, each affixed with a student’s name and photograph.
Miller says the worst part was shocking everyday behaviors. He would later testify about this on Beacon Hill.
One student was shocked for stopping work for more than 20 seconds. A second, a girl with cerebral palsy, was shocked for moaning and reaching out to hold a staffer’s hand. A third was shocked for closing his eyes for more than five seconds. A fourth was shocked for urinating in her pants; Miller says she’d asked for over two hours to go to the bathroom. A fifth was shocked because he yelled when he saw another student about to be shocked.
Miller says this last scenario played out all the time. He remembers a staffer warning him to always announce to the class when he planned to reach for something in his pocket. The one time he didn’t, the four kids he was walking to the bathroom screamed. “All of these behaviors had to be consequated with a GED electric shock,” Miller says. “There were no exceptions—a scream was a scream, a grab was a grab, and we had to follow court-approved orders.” And if they didn’t: “Staff would get evaluated, and might even lose their jobs.”
What pained Miller, made him physically ill, was the anxiety on a student’s face the moment before it happened. One with the initials C.L. gave out a high-pitched “No, no, no” and then tried to keep his mouth closed to avoid subsequent punishment. J.G.’s voice escalated to a squeak while speaking quickly in Spanish. A.T., by contrast, was strangely emotionless during the shock, but shortly thereafter would moan, quietly, to himself.
One day, Miller claims, a student he knew well was shocked for attempting to go to the bathroom without permission, then for refusing a teacher’s order, then for trying to take the GED off his arm. While shocking the boy for the third action, Miller nearly collapsed, one of his legs giving out “just like spaghetti.” He resigned after that.
In 2006, the New York State Education Department released a report saying the Judge Rotenberg Center was shocking even students “without a clear history of self-injurious behaviors.” Just as in 1979, one told investigators she wanted desperately to leave the school; she thought daily of killing herself. Her worst fear was a future in which she remained at JRC indefinitely.
Evelyn Nicholson, the mother of a JRC student from New York, sued the Judge Rotenberg Center in 2006, claiming it had mistreated her adopted son Antwone while he was on the GED. Antwone Nicholson has since left the school—and is doing much better—but his attorney says he spent the first days after his departure in a psychiatric ward. Antwone still thought cameras followed his movements and he might be shocked for misbehaving.
This is a confidential report about the machine.
It’s from the Massachusetts Disabled Persons Protection Commission, one of the many government agencies that investigate allegations of abuse against schools like the Judge Rotenberg Center. Some of it has been redacted or, where not redacted, the names changed to letters and numbers. “Events of 8/26/07” begins on page 20.
“At approximately 2:00 a.m., a call was placed to the Stoughton residence. According to AL AB1 [the first staffer], he answered the phone as AL AB3 [the second staffer] was taking a short break. [The first staffer] stated that the male caller identified himself as ‘Arthur’ from ‘DVR'”—”DVR” being slang for the control room, where live feeds from every camera at the Judge Rotenberg Center are recorded. In other words, Arthur purported to be from quality control, the people who look at the wall of televisions. In actuality Arthur was a student who’d gone missing from JRC two weeks earlier, according to a different state report.
“[The first staffer] said that the caller told him that there had been behaviors before the overnight shift that needed consequences.” That staffer seemed to know something was amiss; you weren’t supposed to give a student a shock for a behavior occurring more than two hours earlier. So the first staffer handed the phone to the second, the most senior staffer working that night. Problem was, he had been at JRC for only two months.
JRC is always looking for applicants. Greg Miller claims that three months after the school brought on his class of 52 trainees, only one person besides him remained employed there. (Israel admits the school has a high turnover, but does not recall this example.) Its psychologists are not immune from the high turnover, either, which may account for why the Massachusetts Division of Licensure found in 2006 that 14 of the school’s 17 psychologists, including then director of psychology Robert von Heyn, lacked proper licenses. Because the state reimburses JRC for the services rendered by its doctors, and because licensed psychologists can command a higher rate, this meant JRC was potentially overcharging the state. That’s what the Massachusetts Inspector General’s Office found in 2007: JRC may have overbilled the state by nearly $800,000. It fell to the Department of Mental Retardation to collect the money. But it didn’t. Or hasn’t yet—a spokeswoman for the department says the investigation is ongoing, while a spokesman for the inspector general says no action has been taken in months.
According to the report, the second staffer handed the phone back to the first, as if he wanted nothing to do with the call. Then the first staffer walked to the bedroom of the student in question and “delivered GED consequences to AL V [the student] while he was in bed.” It was later found that Arthur had instructed the staff to use the more potent GED IV. And so they did for the rest of the night. “[The student] says that he ‘got three GEDs for nothing’…. [The student] further tells the [second staffer] that he had ‘better talk to ’em’ because ‘this man'”—meaning the employee doing the shocking—”is ‘doing the wrong thing.'”
But the staffers didn’t stop. Still on the phone with Arthur, the first continued to shock the student. Moments later, the staffer went to find a GED to shock the boy’s stomach, since the battery powering the leg electrode didn’t seem to be working. “[The student] is seen speaking to [the second staffer], saying ‘get on the phone and find out what is going on…they have to call my clinician.'” By this point four other staffers were awake. They questioned Arthur’s motives, but none dared tell Arthur as much. The staffers were later interviewed by the Disabled Persons Protection Commission; one of them said they “needed jobs” and so did nothing more than what they were told.
The student put up a fight, grabbing batteries for a GED. He said, “Y’all can give me some when you get these out of my cold, dead fingers.” The confrontation lasted for nearly half an hour before staffers put him, as Arthur demanded, on a four-point restraining board. By now the boy was no longer resisting. He told the staffer holding the phone, “Let them know I’m being compliant.”
According to the school’s protocol, employees are to tell a student why he is receiving a shock. The state report refers to this as a “pinpoint.” “The first of the rec room GEDs is given, without a pinpoint for the behavior…. [The student] was given a 2nd GED with a pinpoint for physical aggression. [The student] then is heard asking, ‘Let them rotate me.'” Every hour, staffers must rotate the electrodes so they don’t burn the skin. (Though the school denies the GED injures students, Greg Miller says burns happened often enough that JRC staff had a name for a student going off the machine so his skin could heal: a “GED holiday.”)
Six more shocks were given, bringing the rec room total to eight, and still Arthur wanted more. “A 9th GED was given, and on the audio of the DVR footage an audible sob is heard, but it does not appear
to be from [the student].” At this point the second staffer left the room. “He left because he thought he would ‘either cry or throw up’ if he stayed.”
“18 was given for swearing, 19 was given with the accompanying pinpoint ‘no refusing to follow staff directions.’ [The student] responded to this with ‘yes, sir.’ 20 was given with no pinpoint. 21 again for refusing to follow direction.” After 30 shocks in a single day, staffers were to get approval from a psychologist to shock more. A staffer at one point tried to call someone in upper management from the bathroom—you weren’t supposed to use your cell phone on duty, and the bathroom was the only place that didn’t have a camera—but he had no reception.
“The 37th was given for attempting to remove device, as were the 38th and 39th…GEDs 50, 51, 52, and 53 were given for ‘verbal threats to destroy.'” The state investigator watching the tape had soon tallied 58 shocks, and noted that the staffers seemed to have miscounted: They were only at 47. Arthur had told the first staffer that 60 shocks were to be given, “and the [student] is heard saying ‘thirteen left.'” In the end, he got 12 more: 10 for yelling, the last two for no reason. Including the shocks in his bedroom, the machine had punished the student at least 70 times and as many as 77.
Describing the student afterward, the first staffer said, “He was done. There was no more to him.” His skin was “very red.” The student complained later that night of a racing heart, a dry mouth; he couldn’t breathe, he said; he felt as if he were “about to have a stroke.” The report says “no staff took action” to help him. The student remains at JRC but is off the machine.
“If we tried to apply this brutal device to a prisoner in Guantanamo or someone in Abu Ghraib, there would be worldwide outrage,” says state Senator Brian A. Joyce, whose district includes the school’s Canton site. “In fact, it’s against the Eighth Amendment in our country, right? Cruel and unusual punishment. But we allow it for these innocent children. It’s just not right.”
Part II
You don’t know. You don’t know what it’s like to be the parent of a student at the Judge Rotenberg Center. You don’t know what it takes to hear all this and still come out in favor of the school, and you don’t know because you don’t have a kid who pulls out her hair in bloody clumps, who seems to enjoy that, okay, a kid whose scalp resembles that of a frontier settler worked over by a furious native. And then to see her today: happy, smiling, a brunette like any other brunette. And all thanks to JRC. Her life saved by the machine. Saved. And that’s just one kid. Just one story. You see, there’s another side.
For over 20 years state legislators have authored bills attempting to ban JRC’s use of skin shocks. For over 20 years the bills have failed to pass. Attribute it, if you must, to the usual suspects: the lobbyists JRC employs, Brian S. Hickey Associates, among the most powerful on Beacon Hill and to whom JRC paid $120,000 in 2007, more than any other Hickey client. Or to state Representative Jeff Sanchez, Brandon’s uncle, who gives JRC an entrenched and influential ally in the chamber. But those aren’t the real reasons the bills fail. The real reason is because the parents want them to. Out of desperation the parents find JRC, and then out of a fierce loyalty they defend it.
So it went this year. Senator Joyce, who says reining in the school “would be among the most meaningful things I’ve ever been involved with,” wrote legislation with state Representative John Scibak to limit the Judge Rotenberg Center’s use of aversives. The thinking was, if they couldn’t beat the school, they could maybe at least inhibit its “torture” (Joyce’s word). But at a public hearing in January, 15 parents, one grandmother, and one sister spoke about the school, many of them coming from out of state, all of them pleading with legislators not to inhibit the school’s practices. Several others who couldn’t do so in person did so in writing. The letters from parents of JRC students stacked 6 inches high.
And so, for the 21st year, despite the news in the confidential report that a another student was shocked at least 28 times at Arthur’s behest, leading to first-degree burns, the bill did not make it out of committee. In May, Joyce sneaked his anti-JRC measure into the state budget as an amendment, a last-ditch attempt with uncertain prospects. And advocates for the disabled have no one to blame for JRC’s survival but the parents of its students.
Here are some other things you don’t know.
Out on Turnpike Street in Canton, there is a rise in the road, and just after that a low-slung building with big bay windows from end to end. The Judge Rotenberg Center is not the dreary place you might imagine but a well-lit, almost antiseptically clean school whose classrooms are painted in bright colors—this one blue, that one red—and outfitted with sofas and big-screen televisions for kids who’ve behaved properly. In one such room, on a purple couch, is P. J. Biscardi. He is 41 years old, but looks no older than 16, with his tousled hair, thin mustache, and slight frame. You go to JRC and people surround you: No fewer than eight staffers and parents are on this trip surveying the grounds. One of them is P.J.’s father, Peter, a short, auburn-haired man, thick in the waist, who smiles when he sees his son. He walks over. “Have you been a good boy?” Peter asks. P.J. at first is unresponsive, but then whispers his affirmation. It goes like this for a few more moments, before Peter says, “Give me a kiss,” and P.J. smacks a big one on his father’s cheek.
At age three, P.J. was diagnosed with autism. One summer, while Peter drove the family to Cape Cod, P.J. grabbed his father’s hair and pulled it out, blood smearing the upholstery. Peter and his wife, Maureen, had to lock everything in their house in Burlington—drawers, file cabinets, anything that could be opened—so P.J., then maybe all of 10, wouldn’t destroy the place. Or kill himself. But it didn’t matter: P.J. was violent. P.J. was violent, and P.J. was curious. One year, at a holiday meal with the extended family, P.J. sneaked into the bathroom and sipped Drano. Drano. Maureen had never yelled louder in her life. They rushed him to the hospital, where doctors announced, mercifully, that P.J. had only suffered chemical burns. Another time, P.J. took one of Peter’s razor blades to his arms. “Hurt, hurt,” he said, when Maureen saw the blood-soaked towel. P.J. was known to ram his body into the walls; you’ve never see a linebacker hit a wall with such force, Peter says. He tipped out dresser drawers, knocked over shelves of books. P.J. bit himself so much that a giant callus formed on the skin between his thumb and wrist, growing larger every time he drew fresh blood. The Biscardis’ other children, an older sister and younger brother, never wanted their friends over. Peter and Maureen both blamed themselves for P.J.’s behaviors. Were it not for that, well, they knew a lot of parents of autistic children who had divorced.
The school district didn’t want P.J. The Biscardis couldn’t keep him at home. So they tried four treatment centers. At the last place, the drugs temporarily stunted P.J.’s growth. He was 12. Peter wasn’t comfortable with the level of medication, especially since the drugs didn’t seem to do much to keep the kid calm. The school’s doctor told Peter, “If you don’t increase the dose, we’re not going to keep him here.”
The Biscardis heard about Israel’s center, then still called the Behavior Research Institute, through a parents’ group for autistic children. Israel showed the Biscardis the success he’d had with his Skinnerian positive reinforcement. With the most troublesome kids, each small positive action earned a reward, and each reward became subsequently harder to attain. This is known at Israel’s school as “contracts.” Israel also told them about the aversives, the muscle pinches and spanks used in the years before the GED.
Three decades later, P.J. is still at JRC. The callus on his hand smoothed over long ago. After P.J. makes a visit home to Woburn, where they now live, the house is in the same shape it was when he arrived. And no locked cabinets.
When the Biscardis first sent their son to JRC, they liked the paper trail the school created: every action and contract recorded, charted, mailed to them by the stack. “You’re talking about chopping down some trees to generate this paper,” Peter says. None of P.J.’s earlier schools gave this level of detail. The school also catalogs, on disks, stored footage of P.J. from the omniscient cameras. Some former JRC staffers may not like being monitored, but for Maureen and Peter Biscardi no other school is as transparent. They can view every restraint, every shock, whenever they’d like. And they’ve asked to do that.
P.J. is on the GED, but he seldom acts out. Maureen had reservations about a stranger’s shocking her son—still has them. “I hate the thought of my son getting shocked,” she says. “It bothers me terribly. But if you asked me whether I would rather him be shocked for a short period of time or beat himself up or bite himself severely or slice himself up with a razor blade, the answer is simple.”
She continues, “We want what’s best for our son. Not what’s best for JRC.” They are not above finding another home for P.J. But no home has been better.
Something else you don’t know about what the parents go through: You don’t know what passes for treatment, for established science, at other schools. And you don’t know that because few people in the behavior world will discuss it.
The documented success of positive-behavior support is, of course, the main argument against JRC. Yet that success is open to interpretation. Start with the patriarch of the movement, O. Ivar Lovaas, the one who used cattle prods on children before publishing a study in 1987 saying there was a better way. Lovaas’s therapy, even then, worked only half the time. You’ll find the same lackluster results in the definitive study of positive-behavior support, published in 1999 by the American Association on Mental Retardation. It found that only 68 percent of the subjects showed a dramatic decrease in problematic actions. Moreover, a 2004 book edited by academics at Ohio State, Penn State Harrisburg, and the Sage Colleges Center for Applied Behavior Analysis shows that positive-behavior support practitioners generally don’t attempt to treat the most difficult cases. Presented with such children, they find another school for them.
JRC gets these kids. That’s really what no one talks about. On average, its students have been to five other treatment centers. JRC will let you look at some of the redacted transfer forms from positive-behavior support schools along the Atlantic seaboard. Schools like these have sent at least 10 of their students to JRC within the past eight years. One of the schools, the prestigious New England Center for Children in Southborough, acknowledges in its report that the child it transferred to the Judge Rotenberg Center might need aversives. Even more surprising: JRC beats the positive-behavior schools at their own game. Another student in the placement files, a highly violent child from the May Institute in Arlington, has not needed the GED in JRC’s care.
You’d think the state’s Department of Mental Retardation would acknowledge such accomplishments. Louisa Goldberg of Newton says after a New Hampshire school told her it would no longer take her son Andrew—staffers were afraid of him—she looked for more than two months at roughly 40 schools from a roster provided by the state. None wanted Andrew. And JRC was not on the list. “That happens with loads of Massachusetts parents,” she says.
Such are the politics of mental health. Politics that allows the state of New York to author that scathing 2006 report about the school when, seven months earlier, in November 2005, it had issued another report finding little wrong. What changed between the dates was the media attention brought by Evelyn Nicholson’s lawsuit, the mother of Antwone. Her attorney, Ken Mollins, made sure the case received maximum exposure: on WNBC Channel 4 in New York, Newsday, CNN. What the media failed to report, however, is that Nicholson and Mollins had done this before—specifically in 2005, when Mollins complained to New York’s Department of Education about the small size of the time-out room at Nicholson’s younger son’s school.
Given the popular conception of JRC, “you’d think I’m a monster,” says Kate VanOrden. But you’d be wrong. VanOrden is the sort of mother who, long before she had kids, or even a husband, interviewed teachers and principals in the various towns of suburban Syracuse, eventually settling in Fayetteville, 15 minutes to the east, solely for its school district. A short-haired, big-bifocaled Jewish woman, VanOrden has five adopted children, all of them black, and, because she never found that husband, a sixth child, a daughter now 17 years old, through artificial insemination. What makes VanOrden’s vantage point unique is that she’s an Ivy League–educated psychiatrist. She has worked in a violent inpatient ward at a state psychiatric hospital. And she sought out JRC.
The trouble for VanOrden’s oldest child began in kindergarten. Carino stood out—and not just because he was a young black kid in the suburbs of Syracuse. Carino couldn’t color within the lines; he couldn’t cut and paste where he wanted to. He lacked fine motor skills.
He was otherwise smart; he read voraciously, in the years to come inhaled history. But his impediment kept him from excelling in math, and that led him to despise school, which only worsened his grades, which only further hurt his self-confidence, until Carino found that misbehaving in class was an effective and sometimes fun way to vent his frustrations.
VanOrden saw where this was heading. A problematic black kid with an aggressive streak and academic difficulties? These were some of her patients. The Fayetteville school district ultimately wanted nothing to do with Carino. Neither did a day school more than an hour away, where Carino, then 13, ate his way through his unhappiness until he weighed 260 pounds. He spent the majority of each day in a 4-by-6-foot padded cell, throwing himself against its oak door, an even larger man on the other side, pinning him in there. The aggravation at school became anger at home, and the anger violence, and the violence one awful night in the bathroom, during which Carino tore from the wall a plastic towel hook, taking its broken end and putting it to his mother’s neck.
She yelled to the other kids to stay in the bedroom, lock the door, and call 9-1-1. VanOrden knew all the proper restraints and takedowns. So even though Carino had her in a bear hug of sorts, still holding that towel hook, “saying he’s going to shove it in my bleep, bleep, bleep,” it wasn’t long before VanOrden backed him into a corner from which he could do no damage. They struggled like that until police came.
It killed her, but she put him in juvenile detention. When he got out there was only one place she wanted him to go.
VanOrden might never have found JRC had a social worker she’d known from another mental hospital, whose son was there, not raved about the place. True to form, VanOrden had called before there was a nee
d to. “Remember how I told you I interviewed before my children were born? Well, when I saw any hint of the freight train coming, I talked with JRC—about two years before I thought he might actually go.” When she called the school, officials there insisted they meet. VanOrden said she didn’t know when she could get off work. No, the school said, we’re coming to you.
They spoke for more than four hours in VanOrden’s office. “Two guys with this great big PowerPoint thing and their papers and portfolios and all that stuff,” she says. “I’ll never, never forget it. They had a thoughtful, coherent, fully developed answer to every legal, psychiatric, medical, worst-case scenario. They had the whole thing.” Carino’s school district finally approved his placement with JRC in 2004.
This month will mark Carino’s fourth year at JRC. He is 19. He is learning at his own pace and is scheduled to receive his high school diploma before he turns 21. He isn’t on the GED; the school’s reward system was enough to decrease his outbursts. But he’s wanted to be on it. “My son begged for it for two years,” VanOrden says. “He said that it was like going into the Marines. If he had the GED, he knew that he would stop behaving badly.”
The kids who come to JRC often arrive heavily medicated. This is its own form of torture. Many of their parents write to politicians saying as much.
Joseph Assan’s daughter, Amanda, of Queens, New York, was so snowed on psychotropic drugs—all of them prescribed by doctors at her treatment center—that she had to go to detox at 16. Once she returned to school, and was put on new meds, she ballooned to nearly 300 pounds. At JRC she’s back to her normal weight and is off medication.
Roger and Barbara Forbes’s son David was in a mental hospital before JRC. Upon his discharge, a pharmacist paused when asked to fill the prescription: He thought Roger had altered it. But sure enough, David was supposed to take 900 milligrams of Thorazine—a drug that was once seen as a viable alternative to a lobotomy—per day. The Forbeses say JRC saved David’s life.
The letters go on. New York resident Charles Bryant says staffers at his son’s previous school woke him up just to take more medication. Today Bryant calls Israel a “guardian angel.”
Doris and Robert Hobbs of Northborough agree. Before JRC, their nephew, Marc, took the drugs prescribed to him until they induced a coma in 2004. He didn’t wake up for nine days. He’s now medication-free.
He’s lucky, because drugs can do more harm than that. Attention deficit hyperactivity disorder is one of the diagnoses for which kids are admitted to the Judge Rotenberg Center. A leading prescription for ADHD, Ritalin, has been linked to 30 childhood deaths this past decade, says the American Heart Association. Another illness for which kids are admitted to JRC is bipolar disorder. A 2007 study funded in part by the National Institute of Mental Health showed a fortyfold increase over the last 10 years in diagnoses among young people. But the Food and Drug Administration has approved no antidepressants to treat bipolar disorder in children, and only one antipsychotic. Children are instead given medications approved for adults—”off-label” prescriptions, they’re called in the business—the side effects unknown. Well, not entirely. Rebecca Riley, a four-year-old from Hull, died in 2006 from an overdose of the medications prescribed to treat her bipolar disorder. In that same year, Massachusetts had 8,343 kids on off-label bipolar drugs, according to MassHealth.
Medications’ side effects have always been apparent to those who send their kids to Israel’s school. After Vincent Milletich died in 1985, some parents staged a press conference to counter the uproar. One father, Garrett Lamanna, of Newark, Delaware, thought it ironic that Milletich’s death had drawn such attention, and yet every year children die from overmedication and the public barely notices.
Ultimately, you must make a choice. Drug-induced stupor or a two-second skin shock. Medication without end, and often without benefit, or the once-a-week skin shock the typical JRC student receives.
There’s a reason Evelyn Nicholson is the only parent suing the school, and it’s the same reason the legal guardian of the student shocked 70-some times said in the Disabled Persons Protection Commission report that, before that August night, he had been “totally happy” with JRC and the boy had shown the “most improvement” while there. It’s why Eddie Sanchez, brother of Representative Jeff Sanchez, took his son Brandon off the machine at the state hearing in January. Jeff Sanchez let Brandon slap himself in front of all his fellow legislators, the slaps echoing through the room, alarming bystanders and twisting Brandon’s neck hard against his right shoulder. It’s the same reason why Eddie testified moments later, “If it were not for this program, my son would be dead. And if it weren’t for that, I would blow his freakin’ brains out. That’s what I would do for my son.”
This is love. It is so strong that the parents of the Judge Rotenberg Center would rather shock their children than see them hurt any more, so strong that they would rather kill their own than have them face life without the machine.