Response to Dr. Matthew Israel’s response

Yesterday, I posted some comments about an op-ed in the Boston Globe about the Judge Rotenberg Center. In my commentary, I raised a number of questions, based both on my background as a researcher and as someone who taught research design and data analysis for about a decade before leaving to go into clinical practice. My questions and concerns also reflect my clinical, advocacy, and parental experiences. About an hour after my blog entry was posted, an individual reiterated some of my questions in the Comments section following the op-ed. First, and for the record: I am not that commenter. Dr. Matthew Israel of the Judge Rotenberg Center answered the commenter, and I was glad to see him responding to requests for research-based data. Unfortunately, Dr. Israel’s answers are not really satisfactory, for reasons I will outline below, and the commenter did not follow up on his answers other than to ask if the studies were peer-reviewed and double-blind. So let me respond to Dr. Israel’s response here. Read more

“Shocking Truths” shockingly simplistic

Relevant to the recent discussion elsewhere on this blog about the controversy over the Judge Rotenberg Center, an op-ed in the Boston Globe about the Judge Rotenberg Center by columnist Lawrence Harmon serves as a useful example of how naivete, emotion, and black/white thinking inevitably polarizes people on a serious issue. It is somewhat disappointing that the Boston Globe would even publish the op-ed, as their columnist has no genuine expertise or credentials in this area and seems to have nothing new or useful to say. Harmon’s op-ed merely fans the flames that have been the mainstay of most discussions of the center and its approach.

Not surprisingly, a number of people commented on his op-ed. Some are family members who are appreciative of the center, while others are disability advocates or former employees who are appalled and/or concerned by how the center treats residents.  It is pretty much the same people and same arguments that have been going on for years.

Providing the same parent and ex-student testimonials over and over again is not a substitute for controlled research and follow-up necessary for the professional community to reach an opinion on whether the treatment should be considered efficacious.     For example, JRC claims that there is no risk or harm from contingent shock.  But where are the long-term follow-up data that would look at whether those who experienced skin shock were more likely or not to have stress-related disorders as adults?  Where are the long-term follow-up data on those who have graduated from JRC that would permit us to look at the question as to whether when confronted with others’ non-cooperation, they turned to the use of force or pain to control others?   Where are the data on those who ran away or who were removed from JRC and how they fared — not just the reports that JRC wants us to know about, but a follow-up by others that gets an adequate response rate?

Rather than being upset with well-intentioned advocates, family members of those at JRC who are happy with the program should be upset with JRC itself.  After almost 40 years, it could have and should have provided the research that might have laid a lot of the controversies to rest.

Controversy continues over Judge Rotenberg Center

The Washington Post contains a report by Associated Press reporter Bob Salsberg about the Department of Justice opening a "routine investigation" (.pdf) into the Judge Rotenberg Center in Canton, Massachusetts.   The stated purpose of the investigation is to determine whether the residential center’s methods violate the  Americans with Disabilities Act.  The complaint (.doc) was filed by 31 disability organizations. The Judge Rotenberg Center (JRC) has been controversial since its inception but all attempts to shut it down have failed, in part, because parents of children and adults placed there support the use of the aversive behavioral interventions and assert that the approach has been effective in reducing severely aggressive or self-injurious behaviors that did not respond to medication or less extreme treatment approaches. In 2006, when the New York  State Education Department (NYSED) attempted to prohibit  some of the interventions used by the school by enacting regulations that prohibit the use of aversive behavioral interventions, parents filed suit in federal court.    Just this week, the court has issued its opinion (pdf).  The court found for NYSED on some of the most important issues, but affected students will still be able to receive aversive behavioral interventions at JRC because the court refused to dissolve the temporary injunction prohibiting NYSED from implementing the regulations with respect to the students named in the lawsuit , and because the regulations provide that the students can receive aversive behavioral interventions if their Individualized Educational Plan (IEP) specified such interventions as an exception to the regulations prior to June 2009 and the student’s Committee on Special Education approved the plan. Read more

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