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The seeming elegance of Skinner's approach moved Israel to dedicate his life to applying it. After leaving Harvard with a Ph.D. in 1960, Israel started a company to manufacture so-called "teaching machines," one of the technologies Skinner advocated to properly condition young learners. By the late '60s, Israel had started two communes that applied behavioral techniques. But the teaching-machine business was never successful enough to support the communes. So Israel instead launched a school that applied "Skinnerian" techniques to students with severe behavioral problems. The Behavioral Research Institute began in Providence, Rhode Island, in 1971. In the mid 1970s it opened branches in Massachusetts. Israel later changed the school's name to honor a Massachusetts judge, Ernest Rotenberg, who had sided with Israel in a battle against Bay State regulators in the mid 1980s over his use of painful aversive stimuli.
Aversive therapy first emerged in experiments with animals. Then in the 1960s, around the time Skinner's behavioral analysis was dominating psychology, some scientists used aversion to try to "cure" homosexuals. But Skinner was never a major advocate for aversive stimuli. His work concentrated mainly on the use of rewards to encourage good behavior, not punishments to discourage bad conduct. In the world he envisioned in Walden II, Skinner foresaw little punishment. But Israel says Skinner acknowledged that places like JRC were not utopias. JRC does employ a comprehensive program of positive reinforcement, consisting of those prizes and privileges that students can earn for the simplest tasks. But for Israel, punishments are just the flip side of rewards.
That view is not universal. The American Association for Mental Retardation calls aversive therapies "inhumane" and wants them eliminated. The New York Civil Liberties Union seeks a total ban in New York, dubbing aversive therapies "outmoded and ineffective." But while there's not an abundance of research on the effectiveness of skin shocks because of the ethical issues involved with shocking human subjects, many psychologists believe that in a very few, very serious instances of dangerous behavioral problems, skin shocks might be a legitimate therapy option. "Only in your most extreme cases where there's a threat of harm would you use it," says Kathryn Potoczak, a professed Skinnerian psychologist at Shippensburg University, a public college in Pennsylvania. She, like many psychologists, believes the choice in those cases is between shocking patients and allowing them to hurt themselves so severely they might die.
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Matthew Israel, a disciple of pioneering behaviorist B.F. Skinner, started two communes before he launched the Rotenberg Center. He believes the painful punishments that his staff administers have saved students' lives.
photo: David Yellen
The Rotenberg Centerâwith an annual tuition of $214,000âhas been positioned as the program of last resort: It doesn't automatically reject anyone except for sex offenders and those with very serious medical conditions. Many of its students were thrown out or refused by other schools.
That's what happened to Samantha, a 13-year-old with autism from Roslyn Heights who has been at the school since March 2005. "We had her in four different schools and they tried all kinds of therapy, all kinds of positive behavioral therapy, and we had various therapists coming all over the house and it basically didn't work," says her father, Dr. Mitchell Shear, an internist who practices in the Bronx. "She became more aggressive. She would bite and scratch people. She was basically constantly crying." She also smacked herself in the head so hard she detached both retinas. The Anderson School in Purchase, where she'd been staying, said they couldn't handle Samantha anymore. A person at Anderson recommended Rotenberg to the Shear family.
The Shears' desperation resembles that of Bronx resident Lorraine Slaff 18 years ago. Slaff's autistic son Matthew had troubles early; she recalls having to pad his crib because he kept ramming his head into the sides. As he grew up, he began banging his head on sharp points like the corner of a table, bashing deep holes into his scalp. When he was home, Slaff didn't sleep for fear that she'd miss the sound of her son trying to do himself harm. When other facilities told Slaff that they couldn't handle her then 17-year-old boy, Rotenberg offered itself as a willing alternative. The catch: Slaff would have to consent to her child being subjected to physical pain. Shear faced the same choice. Neither parent blinked. "It didn't bother me because I thought he was going to die," recalls Slaff. "There was nothing else." Matthew's twin, Stewart, is also autistic, but exhibited symptoms later than his brother, and now Slaff believes Stewart would benefit from aversive therapy. But she cannot obtain that treatment for him in New Yorkâbecause adult facilities here don't use aversivesâor get him into the Rotenberg Center. While some children remain at the center after they reach adulthood, the state does not place adults there.