School of Shock

Inside a school where mentally disturbed students are jolted into good behavior

In the early days of his work with aversive stimuli, Israel and his staff used spanking, pinches, muscle squeezes, water sprays, aromatic ammonia, and unpleasant tastes to punish problematic behavior. They still withhold food from some students as an aversive, but shocks are their main treatment. The school began using electric shock in 1989, but the device they first used, called SIBIS, was so weak that many students grew accustomed to it, eroding its effectiveness. So Israel developed the GED, which he registered with the Food and Drug Administration in 1995. (The GED was classified in such a way that it only required FDA registration, not approval.) When students grew innured to that, Israel brought forth the GED-4, three times as powerful as the original GED. That version is not registered with the FDA, which now says the Rotenberg Center is exempt because it's only using the machines in-house. The skin shocks at Rotenberg aren't a form of "electroshock therapy," which involves far more powerful shocks traveling through the brain. The GED-4 sends 45 milliamperes into the surface of the skin, the kind of current that a fairly weak recharger can send to your laptop battery. It's enough to hurt, delivering a rapid, vibrating pain. Some compare the sensation to a strong pinch, a bee sting, or a tattoo needle's bite. "Painful shock, muscular control is lost" is one federal- government shorthand for the experience.

Aside from a momentary tingling, the faint whiff of singed hair, and a couple small pinpoint marks on the skin, a single shock administered to a visitor at Rotenberg didn't produce any lasting physical effects. Five of the kids under Israel's care have died in the 35 years he's run the school, but none of those deaths were linked to aversive therapy. Israel insists the GED is better than the alternatives for his students—debilitating drugs or physical restraints.

**There are around 150 New Yorkers at the Center; 100 or so are from New York City. About half the students at JRC, and half the New Yorkers as well, get skin shocks. The JRC obtains local court approval and an independent psychologist's review before it can physically punish a student. And, Israel says, he always obtains a parent's permission (Parents can even log on to a special website to see how often their kid gets shocked.)

A resident at the Rotenberg Center for 18 years, Matthew Slaff, 35, has autism.
photo: David Yellen
A resident at the Rotenberg Center for 18 years, Matthew Slaff, 35, has autism.

Students usually start by wearing three GED devices so they won't know where the next shock will hit, and won't be able to pull off all the devices at once. A person might wear up to five, but only one operates at a time. Every hour in each classroom, a computerized voice tells the teachers to rotate the GEDs so students don't get zapped repeatedly in the same area. Most students wear GEDs in which the electrodes are right next to each other. But some wear a different version that arrays the electrodes several inches apart, so that the current runs from the palm to the tip of a finger or from the ankle to the ball of the foot, and hurts more—or as the staff puts it, is "more aversive." Students wear the GEDs 24 hours a day. If a student's behavior improves, the GEDs are removed one at a time. Then the student goes GED-free for an hour, then two, and so on, until he or she is completely off the machine. They can always be hooked up again, however, if they lapse.

The goal of the GED, explains Israel, is to deliver punishment immediately so that even a student with a low IQ or a severe psychiatric disorder might be made to understand that whatever he just did was unacceptable. Even kids who hurt themselves, he says, react differently to pain outside their control. Each student has a sheet listing the types of behaviors that prompt a staff member to administer a shock. When one of the target behaviors occurs, the staffer is supposed to confirm with a colleague that a shock is warranted.

While psychologists write the aversive treatment plans for JRC students, it's the school's "mental-health aides"—required only to have a high school diploma, complete a two-week course, and attend regular in-service training—who monitor the classes and do the shocking. With confirmation in hand, the staff member zaps the student and then explains to him why he's being punished.

Sometimes the explanation to the student—and to outside observers—is simple and obvious: no tearing out your hair, no hitting yourself, stop scratching. But sometimes, the reasons are more obscure. Don't raise your hands, no swearing, stay in your seat. In the school's point of view, dangerous behaviors are sometimes preceded by seemingly benign ones. When the school detects a pattern, it might punish the prelude in order to prevent the harmful act. If a student typically slaps the arms of his chair, swears, and stands up before he attacks a teacher, a staffer might shock him when he stands up, when he swears, or perhaps when he slaps the arms of his chair. This approach is valid, say psychologists who defend Israel's approach—as long as whoever is administering the shock is sure that the minor behavior he's punishing is actually a predictor of something serious.

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