The US Food and Drug Administration (FDA) announced today a proposal to ban "electrical stimulation devices" that are used for aggressive or self-injurious behavior. The devices, which deliver an electric shock as a presumed deterrent to these behaviors, "present an unreasonable and substantial risk to public health that cannot be corrected or eliminated through changes to the labeling," according to a news release from the agency.
At this time, only one place in the United States uses these devices: The notorious Judge Rotenberg Center. I've written about this center and their use of shocks before, when the United Nation's special rapporteur on torture called the center out for using these shocks to 'treat' people with various conditions, including autism. In his report, the rapporteur urged federal action to end the use of these aversive treatments nationally. Now it looks like the feds are finally moving to do just that.
Without this move, the center seems likely to have continued its use of these shocks on children and teens. The FDA warned the Judge Rotenberg Center in 2012 about these devices, saying that they violate FDA regulations. It was the third time the FDA had contacted the center. In 2011 and earlier in 2012, the agency informed the center that because of changes made to the device, the Judge Rotenberg Center would need to file a new approval application. The Center is the only manufacturer of the device, which shocks patients who are forced to wear a backpack with wires to various regions of their bodies for zapping. The changes in question involved increasing the voltage since the 1994 approval of the zapper, putting the device out of compliance.
For a look at how the Judge Rotenberg Center has used these devices, this story in the Boston Globe details the experience of one girl with cerebral palsy.
The background on the modern-era use of electric shocks as 'aversives' for certain behaviors started in a box, the Skinner Box, which Harvard's B.F. Skinner developed to shock rats through an electrified floor (Skinner describes using this technique to apply the "Sidman procedure" here and for further work here and here; he details it epically here; see more about this "positive punishment" approach here in this beginning psychology textbook by Charles Stangor, professor and associate chair of psychology within the Social, Decisional, and Organizational Sciences Specialty Area at the University of Maryland). From rats on floors to children zapped with cattle prods wasn't a huge leap for some behaviorists, most notably pioneered by the father of applied behavioral analysis, Ivar Lovaas. For a look at how his controversial and rigid technique was born and how other brutal, sadistic approaches were used on autistic children, this site includes narrative and images from a 1965 story in Life entitled, "Screams, Slaps & Love: A surprising, shocking treatment helps far-gone mental cripples." Shocking and slaps, yes. Love, not so much.
It's straightforward to trace the dots from Skinner and Lovaas, whom Skinner is described as mentoring straight to a fellow named Matthew Israel, who is reported to have taken a course with Skinner and taken inspiration from Skinner's utopian fiction. One of Lovaas's advisors was Sidney Bijou, a behavior analyst who also studied under Skinner. Mother Jones interviewed Israel in 2007, in which he describes other aversive tactics he'd tried, including spraying water in the face, spanking and pinching his "patients." In the interview, he also describes why he turned to using electric shocks and a reference to the cattle prod, which Lovaas favored:
You do find a lot of these in the literature of the ’60s and ’70s and ’80s—more so then, because it has become so politically incorrect. What you’ll also find is the skin shock. They would use a cattle prod. My consulting psychiatrist would say, “Why don’t you use the skin shock? It’s so much cleaner.”
Because we wouldn't want a mess, now would we?
Israel, who has faced criminal charges, went on to develop the shock device that the Judge Rotenberg Center produces and uses but was later forced out of his position there. Last year, he was discovered working as a behavior analyst--two words that should start pinging radars--at a couple of schools in Antioch, CA, that his wife runs. The schools are Tobinworld II and Tobinworld III, and at least four area school districts have been sending children to them. At Tobinworld, Israel's work has apparently involved designing BIPs, or behavioral intervention plans.
The school, according to a 2105 EdSource article, is an offshoot of an earlier iteration that Israel founded, the Behavior Research Institute of California, which was associated with another Israel school in Rhode Island. According to EdSource:
In 1982, an investigation of the Behavior Research Institute of California by then-California Attorney General George Deukmejian found that teenagers and adults with autism were handcuffed to chairs, sprayed with a garden hose, refused access to a bathroom and denied food. Residents were pinched to the point of screaming and forced to take part in “behavior rehearsal lessons” where they were told to destroy property and then were squirted with water as punishment for their actions, according to the investigation. In 1981, a 14-year-old boy died while being restrained in bed.
Israel eventually moved the Rhode Island institute to Massachusetts, where it became the Judge Rotenberg Center.
Whatever he called it and wherever it was located, electric shocks were never far behind. Perhaps now, the slow-moving hand of regulation will pull the plug once and for all.
