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Texas Observer
School of Shock: Eight states are
sending autistic, mentally retarded, and emotionally troubled kids
to a facility that punishes them with painful electric shocks. How
many times do you have to zap a child before it's torture?
June 13, 2008
By Jennifer Gonnerman
Rob Santana awoke terrified. He'd
had that dream again, the one where silver wires ran under his shirt
and into his pants, connecting to electrodes attached to his limbs
and torso. Adults armed with surveillance cameras and remote-control
activators watched his every move. One press of a button, and there
was no telling where the shock would hit—his arm or leg or, worse,
his stomach. All Rob knew was that the pain would be intense.
Every time he woke from this dream,
it took him a few moments to remember that he was in his own bed,
that there weren't electrodes locked to his skin, that he wasn't
about to be shocked. It was no mystery where this recurring
nightmare came from—not A Clockwork Orange or 1984, but the years he
spent confined in America's most controversial "behavior
modification" facility.
In 1999, when Rob was 13, his
parents sent him to the Judge Rotenberg Educational Center, located
in Canton, Massachusetts, 20 miles outside Boston. The facility,
which calls itself a "special needs school," takes in all kinds of
troubled kids—severely autistic, mentally retarded, schizophrenic,
bipolar, emotionally disturbed—and attempts to change their behavior
with a complex system of rewards and punishments, including painful
electric shocks to the torso and limbs. Of the 234 current
residents, about half are wired to receive shocks, including some as
young as nine or ten. Nearly 60 percent come from New York, a
quarter from Massachusetts, the rest from six other states and
Washington, D.C. The Rotenberg Center, which has 900 employees and
annual revenues exceeding $56 million, charges $220,000 a year for
each student. States and school districts pick up the tab.
The Rotenberg Center is the only
facility in the country that disciplines students by shocking them,
a form of punishment not inflicted on serial killers or child
molesters or any of the 2.2 million inmates now incarcerated in U.S.
jails and prisons. Over its 36-year history, six children have died
in its care, prompting numerous lawsuits and government
investigations. Last year, New York state investigators filed a
blistering report that made the place sound like a high school
version of Abu Ghraib. Yet the program continues to thrive—in large
part because no one except desperate parents, and a few state
legislators, seems to care about what happens to the hundreds of
kids who pass through its gates.
In Rob Santana's case, he freely
admits he was an out-of-control kid with "serious behavioral
problems." At birth he was abandoned at the hospital, traces of
cocaine, heroin, and alcohol in his body. A middle-class couple
adopted him out of foster care when he was 11 months old, but his
troubles continued. He started fires; he got kicked out of preschool
for opening the back door of a moving school bus; when he was six,
he cut himself with a razor. His mother took him to specialists, who
diagnosed him with a slew of psychiatric problems:
attention-deficit/hyperactivity disorder, post-traumatic stress
disorder, bipolar disorder, and obsessive-compulsive disorder.
Rob was at the Rotenberg Center for
about three and a half years. From the start, he cursed, hollered,
fought with employees. Eventually the staff obtained permission from
his mother and a Massachusetts probate court to use electric shock.
Rob was forced to wear a backpack containing five two-pound,
battery-operated devices, each connected to an electrode attached to
his skin. "I felt humiliated," he says. "You have a bunch of wires
coming out of your shirt and pants." Rob remained hooked up to the
apparatus 24 hours a day. He wore it while jogging on the treadmill
and playing basketball, though it wasn't easy to sink a jump shot
with a 10-pound backpack on. When he showered, a staff member would
remove his electrodes, all except the one on his arm, which he had
to hold outside the shower to keep it dry. At night, Rob slept with
the backpack next to him, under the gaze of a surveillance camera.
Employees shocked him for
aggressive behavior, he says, but also for minor misdeeds, like
yelling or cursing. Each shock lasts two seconds. "It hurts like
hell," Rob says. (The school's staff claim it is no more painful
than a bee sting; when I tried the shock, it felt like a horde of
wasps attacking me all at once. Two seconds never felt so long.) On
several occasions, Rob was tied facedown to a four-point restraint
board and shocked over and over again by a person he couldn't see.
The constant threat of being zapped did persuade him to act less
aggressively, but at a high cost. "I thought of killing myself a few
times," he says.
Rob's mother Jo-Anne deLeon had
sent him to the Rotenberg Center at the suggestion of the special-ed
committee at his school district in upstate New York, which, she
says, told her that the program had everything Rob needed. She
believed he would receive regular psychiatric counseling—though the
school does not provide this.
As the months passed, Rob's mother
became increasingly unhappy. "My whole dispute with them was, 'When
is he going to get psychiatric treatment?'" she says. "I think they
had to get to the root of his problems—like why was he so angry? Why
was he so destructive? I really think they needed to go in his head
somehow and figure this out." She didn't think the shocks were
helping, and in 2002 she sent a furious fax demanding that Rob's
electrodes be removed before she came up for Parents' Day. She says
she got a call the next day from the executive director, Matthew
Israel, who told her, "You don't want to stick with our treatment
plan? Pick him up." (Israel says he doesn't remember this
conversation, but adds, "If a parent doesn't want the use of the
skin shock and wants psychiatric treatment, this isn't the right
program for them.")
Rob's mother is not the only parent
angry at the Rotenberg Center. Last year, Evelyn Nicholson sued the
facility after her 17-year-old son Antwone was shocked 79 times in
18 months. Nicholson says she decided to take action after Antwone
called home and told her, "Mommy, you don't love me anymore because
you let them hurt me so bad." Rob and Antwone don't know each other
(Rob left the facility before Antwone arrived), but in some ways
their stories are similar. Antwone's birth mother was a drug addict;
he was burned on an electric hot plate as an infant. Evelyn took him
in as a foster child and later adopted him. The lawsuit she filed
against the Rotenberg Center set off a chain of events:
investigations by multiple government agencies, emotional public
hearings, scrutiny by the media. Legislation to restrict or ban the
use of electric shocks in such facilities has been introduced in two
state legislatures. Yet not much has changed.
Rob has paid little attention to
the public debate over his alma mater, though he visits its website
occasionally to see which of the kids he knew are still there. After
he left the center he moved back in with his parents. At first
glance, he seems like any other 21-year-old: baggy Rocawear jeans,
black T-shirt, powder-blue Nikes. But when asked to recount his
years at the Rotenberg Center, he speaks for nearly two hours in
astonishing detail, recalling names and specific events from seven
or eight years earlier. When he describes his recurring nightmares,
he raises both arms and rubs his forehead with his palms.
Despite spending more than three
years at this behavior-modification facility, Rob still has problems
controlling his behavior. In 2005, he was arrested for attempted
assault and sent to jail. (This year he was arrested again, for
drugs and assault.) Being locked up has given him plenty of time to
reflect on his childhood, and he has gained a new perspective on the
Rotenberg Center. "It's worse than jail," he told me. "That place is
the worst place on earth."
One Punishment Fits All The story of
the Rotenberg Center is in many ways a tale of two schools. Slightly
more than half the residents are what the school calls "high
functioning": kids like Rob and Antwone, who have diagnoses like
attention-deficit disorder, bipolar disorder, post-traumatic stress
disorder, and other emotional problems. The other group is even more
troubled. Referred to as "low functioning," it includes kids with
severe autism and mental retardation; most cannot speak or have very
limited verbal abilities. Some have behaviors so extreme they can be
life threatening: chomping on their hands and arms, running into
walls, nearly blinding themselves by banging their heads on the
floor again and again.
The Rotenberg Center has long been
known as the school of last resort—a place that will take any kid,
no matter how extreme his or her problems are. It doesn't matter if
a child has been booted out of 2, 5, 10, or 20 other programs—he or
she is still welcome here. For desperate parents, the Rotenberg
Center can seem like a godsend. Just ask Louisa Goldberg, the mother
of 25-year-old Andrew, who has severe mental retardation. Andrew's
last residential school kicked him out after he kept assaulting
staff members; the Rotenberg Center was the only place willing to
accept him. According to Louisa, Andrew's quality of life has
improved dramatically since 2000, when he was hooked up to the shock
device, known as the Graduated Electronic Decelerator, or ged.
The Rotenberg Center has a policy
of not giving psychiatric drugs to students—no Depakote, Paxil,
Risperdal, Ritalin, or Seroquel. It's a policy that appeals to
Louisa and many other parents. At Andrew's last school, she says,
"he had so many medicines in him he'd take a two-hour nap in the
morning, he'd take a two-hour nap in the afternoon. They'd have him
in bed at eight o'clock at night. He was sleeping his life away."
These days, Louisa says she is no longer afraid when her son comes
home to visit. "[For him] to have an electrode on and to receive a
ged is to me a much more favorable way of dealing with this," she
says. "He's not sending people to the hospital."
Marguerite Famolare brought her son
Michael to the Rotenberg Center six years ago, after he attacked her
so aggressively she had to call 911 and, in a separate incident,
flipped over a kitchen table onto a tutor. Michael, now 19, suffers
from mental retardation and severe autism. These days, when he comes
home for a visit, Marguerite carries his shock activator in her
purse. All she has to do, she says, is show it to him. "He'll
automatically comply to whatever my signal command may be, whether
it is 'Put on your seatbelt,' or 'Hand me that apple,' or 'Sit
appropriately and eat your food,'" she says. "It's made him a human
being, a civilized human being."
Massachusetts officials have twice
tried to shut the Rotenberg Center down—once in the 1980s and again
in the 1990s. Both times parents rallied to its defense, and both
times it prevailed in court. (See "Why Can't Massachusetts Shut
Matthew Israel Down?" page 44.) The name of the center ensures
nobody forgets these victories; it was Judge Ernest Rotenberg, now
deceased, who in the mid-'80s ruled that the facility could continue
using aversives—painful punishments designed to change behavior—so
long as it obtained authorization from the Bristol County Probate
and Family Court in each student's case. But even though the
facility wasn't using electric shock when this ruling was handed
down, the court rarely, if ever, bars the Rotenberg Center from
adding shock to a student's treatment plan, according to lawyers and
disability advocates who have tried to prevent it from doing so.
Since Evelyn Nicholson filed her
lawsuit in 2006, the Rotenberg Center has faced a new wave of
criticism and controversy. (See "Nagging? Zap. Swearing? Zap," page
41.) And again, the facility has relied heavily on the testimonials
of parents like Louisa Goldberg and Marguerite Famolare to defend
itself. Not surprisingly, the most vocal parent-supporters tend to
be those with the sickest children, since they are the ones with the
fewest options. But at the Rotenberg Center, the same methods of
"behavior modification" are applied to all kids, no matter what is
causing their behavior problems. And so, while Rob would seem to
have little in common with mentally retarded students like Michael
and Andrew, they all shared a similar fate once their parents placed
them under the care of the same psychologist, a radical behaviorist
known as Dr. Israel.
Dr. Israel's Radical Behavior In
1950, matt israel was a Harvard freshman looking to fill his science
requirement. He knew little about B.F. Skinner when he signed up for
his course, Human Behavior. Soon, though, Israel became fascinated
with Skinner's scientific approach to the study of behavior, and he
picked up Walden Two, Skinner's controversial novel about an
experimental community based on the principles of behaviorism. The
book changed Israel's life. "I decided my mission was to start a
utopian community," he says. Israel got a Ph.D. in psychology in
1960 from Harvard, and started two communal houses outside Boston.
One of the people Israel lived with
was a three-year-old named Andrea, the daughter of a roommate. The
two did not get along. "She was wild and screaming," Israel recalls.
"I would retreat to my own room, and she'd be trying to pull away
and get into my room, and I'd have to hold the door on one side to
keep her from disturbing me." When company would come over, he says,
"She would walk around with a toy broom and whack people over the
head."
Through experiments with rats and
pigeons, Skinner had demonstrated how animals learn from the
consequences of their actions. With permission from Andrea's mother,
Israel decided to try out Skinner's ideas on the three-year-old.
When Andrea was well behaved, Israel took her out for walks. But
when she misbehaved, he punished her by snapping his finger against
her cheek. His mentor Skinner preached that positive reinforcement
was vastly preferable to punishment, but Israel says his methods
transformed the girl. "Instead of being an annoyance, she became a
charming addition to the house."
Israel's success with Andrea
convinced him to start a school. In 1971, he founded the Behavior
Research Institute in Rhode Island, a facility that would later move
to Massachusetts and become known as the Judge Rotenberg Center.
Israel took in children nobody else wanted—severely autistic and
mentally retarded kids who did dangerous things to themselves and
others. To change their behavior, he developed a large repertoire of
punishments: spraying kids in the face with water, shoving ammonia
under their noses, pinching the soles of their feet, smacking them
with a spatula, forcing them to wear a "white-noise helmet" that
assaulted them with static.
In 1977, Israel opened a branch of
his program in California's San Fernando Valley, along with Judy
Weber, whose son Tobin is severely autistic. Two years later, the
Los Angeles Times reported Israel had pinched the feet of
Christopher Hirsch, an autistic 12-year-old, at least 24 times in 30
minutes, while the boy screamed and cried. This was a punishment for
soiling his pants. ("It might have been true," Israel says. "It's
true that pinches were being used as an aversive. The pinch, the
spank, the muscle squeeze, water sprays, bad taste—all those
procedures were being used.") Israel was in the news again in 1981,
when another student, 14-year-old Danny Aswad, died while strapped
facedown to his bed. In 1982, the California Department of Social
Services compiled a 64-page complaint that read like a catalog of
horrors, describing students with bruises, welts, and cuts. It also
accused Israel of telling a staff member "to grow his fingernails
longer so he could give an effective pinch."
In 1982, the facility settled with
state officials and agreed to stop using physical punishments. Now
called Tobinworld, and still run by Judy Weber, it is a
$10-million-a-year organization operating day schools near Los
Angeles and San Francisco. The Rotenberg Center considers itself a
"sister school" to Tobinworld, and Israel makes frequent trips to
California to visit Weber. The two were married last year.
Despite his setback in California,
Israel continued to expand on the East Coast—and to generate
controversy. In 1985, Vincent Milletich, an autistic 22-year-old,
suffered a seizure and died after he was put in restraints and
forced to wear a white-noise helmet. Five years later, 19-year-old
Linda Cornelison, who had the mental capacity of a toddler, refused
to eat. On the bus to school, she clutched her stomach; someone had
to carry her inside, and she spent the day on a couch in a
classroom. Linda could not speak, and the staff treated her actions
as misbehaviors. Between 3:52 p.m. and 8 p.m., staffers punished her
with 13 spatula spankings, 29 finger pinches, 14 muscle squeezes,
and 5 forced inhalings of ammonia. It turned out that Linda had a
perforated stomach. She died on the operating table at 1:45 a.m.
The local district attorney's
office examined the circumstances of Vincent's death but declined to
file any charges. In Linda's case, the Massachusetts Department of
Mental Retardation investigated and found that while Linda's
treatment had "violated the most basic codes and standards of
decency and humane treatment," there was insufficient evidence to
prove that the use of aversives had caused her death.
By the time Linda died, Israel was
moving away from spatulas and toward electric shock, which, from his
perspective, offered many advantages. "To give a spank or a muscle
squeeze or a pinch, you had to control the student physically, and
that could lead to a struggle," he says. "A lot of injuries were
occurring." Since shocking only required pressing a button, Israel
could eliminate the need for employees to wrestle a kid to the
ground. Another benefit, he says, was increased consistency. It was
hard to know if one staff member's spatula spanking was harder than
another's, but it was easy to measure how many times a staff member
had shocked a child.
Israel purchased a shock device
then on the market known as sibis—Self-Injurious Behavior Inhibiting
System—that had been invented by the parents of an autistic girl and
delivered a mild shock that lasted .2 second. Between 1988 and 1990,
Israel used sibis on 29 students, including one of his most
challenging, Brandon, then 12, who would bite off chunks of his
tongue, regurgitate entire meals, and pound himself on the head. At
times Brandon was required to keep his hands on a paddle; if he
removed them, he would get automatic shocks, one per second. One
infamous day, Brandon received more than 5,000 shocks. "You have to
realize," Israel says. "I thought his life was in the balance. I
couldn't find any medical solution. He was vomiting, losing weight.
He was down to 52 pounds. I knew it was risky to use the shock in
large numbers, but if I persevered that day, I thought maybe it
would eventually work. There was nothing else I could think of to
do...but by the time it went into the 3,000 or 4,000 range, it
became clear it wasn't working."
This day was a turning point in the
history of Israel's operation—that's when he decided to ratchet up
the pain. The problem, he decided, was that the shock sibis emitted
was not strong enough. He says he asked sibis's manufacturer, Human
Technologies, to create a more powerful device, but it refused. "So
we had to redesign the device ourselves," he says. He envisioned a
device that would start with a low current but that could increase
the voltage if needed—hence its name, Graduated Electronic
Decelerator or ged—but he abandoned this idea early on. "As it turns
out, that's really not a wise approach," he says. "It's sort of like
operating a car and wearing out the brakes because you never really
apply them strongly enough. Instead, we set it at a certain level
that was more or less going to be effective for most of our
students."
Thirty years earlier, O. Ivar
Lovaas, a psychology professor at ucla, had pioneered the use of
slaps and screams and electric jolts to try to normalize the
behavior of autistic kids. Life magazine featured his work in a
nine-page photo essay in 1965 with the headline, "A surprising,
shocking treatment helps far-gone mental cripples." Lovaas
eventually abandoned these methods, telling cbs in 1993 that shock
was "only a temporary suppression" because patients become inured to
the pain. "These people are so used to pain that they can adapt to
almost any kind of aversive you give them," he said.
Israel encountered this same sort
of adaptation in his students, but his solution was markedly
different: He decided to increase the pain once again. Today, there
are two shock devices in use at the Rotenberg Center: the ged and
the ged-4. The devices look similar and both administer a two-second
shock, but the ged-4 is nearly three times more powerful—and the
pain it inflicts is that much more severe.
The Mickey Mouse Club Ten years ago,
Israel hung up a Mickey Mouse poster in the main hall, and he
noticed that it made people smile—so he bought every Mickey Mouse
poster he could find. He hung them in the corridors and even papered
the walls of what became known as the Mickey Mouse Conference Room.
Entering the Rotenberg Center is a bit like stepping into a carnival
fun house, I discovered during a two-day visit last autumn. Two
brushed-aluminum dogs, each nearly 5 feet tall and sporting a purple
neon collar, stand guard outside. Giant silver stars dangle from the
lobby ceiling; the walls and chairs in the front offices are
turquoise, lime green, and lavender.
Israel, 74, still holds the title
of executive director, for which he pays himself nearly $400,000 in
salary and benefits. He appears utterly unimposing: short and
slender with soft hands, rounded shoulders, curly white hair,
paisley tie. Then he sits down beside me and, unprompted, starts
talking about shocking children. "The treatment is so powerful it's
hard not to use if you have seen how effective it is," he says
quietly. "It's brief. It's painful. But there are no side effects.
It's two seconds of discomfort." His tone is neither defensive nor
apologetic; rather, it's perfectly calm, almost soothing. It's the
sort of demeanor a mother might find comforting if she were about to
hand over her child.
Before we set off on our tour of
the facility, there's something Israel wants me to see: Before &
After, a homemade movie featuring six of his most severe cases.
Israel has been using some of the same grainy footage for more than
two decades, showing it to parents of prospective students as well
as visiting reporters. They've already mailed me a copy, but Israel
wants to make sure I watch it. An assistant slips the tape into the
vcr, Israel presses the remote, and we all stare at the screen:
1977: An 11-year-old girl named
Caroline arrives at the school strapped down onto a stretcher, her
head encased in a helmet. In the next shot, free from restraints,
she crouches down and tries to smash her helmeted head against the
floor.
1981: Janine, also 11 years old,
shrieks and slams her head against the ground, a table, the door.
Bald spots testify to the severity of her troubles; she's yanked out
so much hair it's half gone.
Both girls exhibit autistic
behaviors, and compared with these scenes, the "After" footage looks
almost unbelievable: Janine splashes in a plastic pool, while
Caroline grins as she sits in a chair at a beauty salon. "Most
people haven't seen these pictures," Israel says, setting down the
remote. "They haven't seen children like this, so they cannot
imagine. These are children for whom positive-only procedures did
not work, drugs did not work. And if it wasn't for this treatment,
some of these people would not be alive." The video is extremely
persuasive: The girls' self-abuse is so violent and so frightening
that it almost makes me want to grab a ged remote and push the
button myself. Of course, this is precisely the point.
Considering how compelling the
"After" footage is, I am surprised to learn that five of the six
children featured in it are still here. "This is Caroline," one of
my escorts says an hour or two later as we walk down a corridor.
Without an introduction, I would not have known. Caroline, 39,
slumps forward in a wheelchair, her fists balled up, head covered by
a red helmet. "Blow me a kiss, Caroline," Israel says. She doesn't
respond.
A few minutes later, I meet
36-year-old Janine, who appears in much better shape. She's not
wearing a helmet and has a full head of black hair. She's also got a
backpack on her shoulders and canvas straps hanging from her legs,
the telltale sign that electrodes are attached to both calves. For
16 years—nearly half her life—Janine has been hooked up to Israel's
shock device. A couple years ago, when the shocks began to lose
their effect, the staff switched the devices inside her backpack to
the much more painful ged-4.
Rogue Science In 1994, matthew
israel had just 64 students. Today he has 234. This astonishing rate
of growth is largely the result of a dramatic change in the types of
students he takes in. Until recently, nearly all were "low
functioning," autistic and mentally retarded people. But today
slightly more than 50 percent are "high functioning," with diagnoses
like add, adhd, and bipolar disorder. New York state supplies the
majority of these students, many of whom grew up in the poorest
parts of New York City. Yet despite this change in his population,
Israel's methods have remained essentially the same.
Israel has long faced criticism
that he has not published research about his use of electric shocks
in peer-reviewed journals, where experts could scrutinize it. To
defend his methods, he points to a bibliography of 110 research
articles that he's posted on the Rotenberg Center website. This
catalog seems impressive at first. Studied more closely, however, it
is not nearly so convincing. Three-quarters of the articles were
published more than 20 years ago. Eight were written or cowritten by
Lovaas, the ucla-affiliated behaviorist. One of America's leading
autism experts, Lovaas long ago stopped endorsing painful aversives.
And Lovaas' old studies focus primarily on children with autism who
engage in extreme self-injury—not on troubled teens who have been
diagnosed with adhd or add.
But then, it would be hard for
Israel to find contemporary research supporting his program, because
the practice of treating self-abusive kids with pain has been
largely abandoned. According to Dr. Saul Axelrod, a professor at
Temple University and an expert on behavior modification, "the field
has moved away from painful stimuli because of public outcry and
because we've devised better techniques," including determining the
cause of an individual's self-abuse.
Another expert Israel cites several
times is Dr. Brian A. Iwata, a consultant on the development of
sibis, the device Israel modified to create his ged. Now a professor
of psychology and psychiatry at the University of Florida, he's a
nationally recognized authority on treating severe self-abuse among
children with developmental disabilities. Iwata has visited the
Rotenberg Center and describes its approach as dangerously
simplistic: "There appears to be a mission of that program to use
shock for problem behaviors. It doesn't matter what that behavior
is." Iwata has consulted for 25 states and says there is little
relationship between what goes on at Israel's program and what goes
on at other facilities. "He may have gotten his Ph.D. at Harvard,
but he didn't learn what he's doing at Harvard. Whatever he's doing,
he decided to do on his own."
Paul Touchette, who also studied
with B.F. Skinner, has known Israel since the 1960s when they were
both in Cambridge. Like Israel, Touchette went on to treat children
with autism who exhibit extreme self-abuse, but he isn't a fan of
Israel's approach either. "Punishment doesn't get at the cause,"
says Touchette, who is on the faculty of the University of
California-Irvine School of Medicine. "It just scares the hell out
of patients."
Over the decades, Touchette has
followed Israel's career and bumped into him at professional
conferences. "He's a very smart man, but he's an embarrassment to
his profession," Touchette says. "I've never been able to figure out
if Matt is a little off-kilter and actually believes all this stuff,
or whether he's just a clever businessman."
Big Reward Store At the rotenberg
center, an elaborate system of rewards and punishments governs all
interactions. Well-behaved kids can watch TV, go for pizza, play
basketball. Students who've earned points for good behavior visit a
store stocked with dvd players, cds, cologne, PlayStation 2, Essence
magazine, knockoff Prada purses—anything the staff thinks students
might want. But even more prized is a visit to the "Big Reward
Store," an arcade full of pinball machines, video games, a pool
table, and the most popular feature, a row of 42-inch flat-screen
TVs hooked up to Xbox 360s.
Students like the "brs" for another
reason—it's the only place many can socialize freely. At the
Rotenberg Center, students have to earn the right to talk to each
other. "We had to wait until we were in brs to communicate with
others," says Isabel Cedeño, a 16-year-old who ran away from
Rotenberg in 2006 after her boyfriend, a former student, came and
got her. "That was the only time you really laughed, had fun, hung
around with your friends. Because usually, you can't talk to them.
It was basically like we had to have enemies. They didn't want us to
be friendly with nobody."
Students live grouped together in
homes and apartments scattered in nearby towns and are bused to the
facility's headquarters every morning. They spend their days in
classrooms, staring at a computer screen, their backs to the
teacher. They are supposed to teach themselves, using
self-instruction programs that include lessons in math, reading, and
typing. Even with breaks for gym and lunch, the days can be
incredibly dull. "On paper, it does look like they're being
educated, because we have lesson plans," says former teacher Jessica
Croteau, who oversaw a classroom of high-functioning teens for six
months before leaving in 2006. But "to self-teach is not exciting.
Why would the kids want to sit there and read a chapter on their own
without any discussion?"
Croteau says teachers have to spend
so much time monitoring misbehaviors there's often little time left
for teaching. Whenever a student disobeys a rule, a staff member
must point it out, using the student's name and just one or two rote
phrases like, "Mark, there's no stopping work. Work on your task,
please." Each time a student curses or yells, a staffer marks it on
the student's recording sheet. Teachers and aides then use the sheet
to calculate what level of punishment is required—when to just say
"No!" and when to shock.
Employees carry students' shock
activators inside plastic cases, which they hook onto their belt
loops. These cases are known as "sleds," and each sled has a photo
on it to ensure employees don't zap the wrong kid.
Behaviorism would seem to dictate
that staff shock students immediately after they break the rules.
But if employees learn about a misbehavior after it has occurred—by,
say, reviewing surveillance footage—they may still administer
punishment. Rob Santana recalls that Mondays were always the most
stressful day of the week. He would sit at his desk all day, trying
to remember if he had broken any rules over the weekend, waiting to
see if he'd be shocked.
Employees are encouraged to use the
element of surprise. "Attempt to be as discreet as possible and hold
the transmitter out of view of the student," states the employee
manual. This way, students cannot do anything to minimize the pain,
like flipping over their electrodes or tensing their muscles. "We
hear the sound of [a staffer] picking up a sled," says Isabel, the
former student. "Then we turn around and see the person jump out of
their seat."
Employees shock students for a wide
range of behaviors, from violent actions to less serious offenses,
like getting out of their seats without permission. In 2006, the New
York State Education Department sent a team of investigators,
including three psychologists, to the Rotenberg Center, then issued
a scathing report. Among its many criticisms was that the staff
shocked kids for "nagging, swearing, and failing to maintain a neat
appearance." Israel only disputes the latter. As for nagging and
swearing? "Sometimes a behavior looks innocuous," he says, "but if
it's an antecedent for aggression, it may have to be treated with an
aversive."
New York officials disagreed, and
in January 2007 issued regulations that would prohibit shocking New
York students for minor infractions. But a group of New York parents
filed a federal lawsuit to stop the state from enforcing these
regulations. They prevailed, winning a temporary restraining order
against the state, one that permits the Rotenberg Center staffers to
continue using shock. The parents' case is expected to go to trial
in 2008.
When they talk about why they use
the shock device, Israel and his employees like to use the word
"treatment," but it might be more accurate to use words like
"convenience" or "control." "The ged—it's two seconds and it's
done," says Patricia Rivera, a psychologist who serves as assistant
director of clinical services. "Then it's right back to work." By
contrast, it can take 8 or 10 employees half an hour or longer to
restrain a strong male student: to pin him to the floor, wait for
him to stop struggling, then move his body onto a restraint board
and tie down each limb. Restraining five or eight kids in a single
day—or the same student again and again—can be incredibly
time-consuming and sometimes dangerous.
Even with the ged, the stories both
students and employees tell make the place sound at times like a war
zone: A teenage boy sliced the gym teacher across the face with a
cd. A girl stabbed a staffer in the stomach with a pencil. While
staff have been contending with injuries ever since Israel opened
his facility, the recent influx of high-functioning students, some
with criminal backgrounds, has brought a new fear: that students
will join forces and riot. Perhaps tellingly, among high-functioning
kids most of the violence is directed at the staff, not each other.
"Our Students Have a Tendency to
Lie" Rotenberg staff place the more troubled (or troublesome)
residents on 1:1 status, meaning that an aide monitors them
everywhere they go. For extremely violent students, the ratio is
2:1. Soon after I arrived, right before I set off on my tour, a
small crowd gathered—it seemed that almost the entire hierarchy of
the Rotenberg Center was going to follow me around. That's when I
realized I'd been put on 5:1. As I began to roam around the school
with my escorts, my every move monitored by surveillance cameras, I
realized it would be impossible to have a private conversation with
any student. The best I could hope for would be a few unscripted
moments.
Ten years ago, a reporter visiting
Israel's center would have been unable to talk to most students;
back then few of them could speak. These days, there are more than
100 high-functioning kids fully capable of voicing their views, and
Israel has enlisted a few in his campaign to promote the ged. "If we
had only [severely] autistic students, they couldn't talk to you and
say, 'Gee, this is really helping me,'" Israel says. "Now for the
first time we have students like Katie who can tell you it helped
them."
In the world of the Rotenberg
Center, Katie Spartichino is a star. She left the facility in the
spring of 2006 and now attends community college in Boston. Around
noon, a staff member brings her back to the facility to talk to me.
We sit at an outdoor picnic table away from the surveillance cameras
but there's no privacy: Israel and Karen LaChance, the assistant to
the executive director for admissions, sit with us.
Katie, 19, tells me she overdosed
on pills at 9, spent her early adolescence in and out of psych
wards, was hooked up to the ged at 16, and stayed on the device for
two years. "This is a great place," she says. "It took me off all my
medicine. I was close to 200 pounds and I'm 160 now." She admits her
outlook was less rosy when she first had to wear the electrodes. "I
cried," she says. "I kind of felt like I was walking on eggshells; I
had to watch everything I said. Sometimes a curse word would just
come out of my mouth automatically. So being on the geds and knowing
that swearing was a targeted behavior where I would receive a [GED]
application, it really got me to think twice before I said something
disrespectful or something just plain-out rude."
As Katie speaks, LaChance runs her
fingers through Katie's hair again and again. The gesture is so
deliberate it draws my attention. I wonder if it's just an
expression of affection—or something more, like a reward.
"Do you swear anymore?" I ask.
"Oh, God, all the time," Katie
says. She pauses. "Well, I have learned to control it, but I'm not
going to lie. When I'm on the phone, curse words come out."
The hair stroking stops. LaChance
turns to Katie. "I hope you're not going to tell me you're
aggressive."
"Oh, no, that's gone," Katie says.
"No, no, no. The worst thing I do sometimes is me and my mom get
into little arguments."
For Israel, of course, one drawback
of having so many high-functioning students is that he cannot
control everything they say. One afternoon, when I walk into a
classroom of teenagers, a 15-year-old girl catches my eye, smiles,
and holds up a sheet of paper with a message written in pink marker:
HELP US. She puts it back down and shuffles it into her stack of
papers before anyone else sees. When I move closer, she tells me her
name is Raquel, she is from the Bronx, and she wants to go home.
My escorts allow me to interview
Raquel while two of them sit nearby. Raquel is not hooked up to the
ged, but she has many complaints, including that she has just
witnessed one of her housemates get shocked. "She was screaming,"
Raquel says. "They told her to step up to be searched; she didn't
want to step up to be searched, so they gave her one." After 20
minutes, my escorts cut us off. "Raquel, you did a great job—thank
you for taking the time," says Patricia Rivera, the psychologist.
Once Raquel is out of earshot,
Rivera adds, "Some of the things she said are not true, some of them
are. Our students obviously have a tendency to lie about things."
She explains that a staff member searches Raquel's housemate every
hour because she's the one who recently stabbed an employee with a
pencil.
The Rotenberg Center does not have
a rule about how old a child must be before he or she can be hooked
up to the ged. One of the program's youngest students is a
nine-year-old named Rodrigo. When I see him, he is seated outside at
a picnic table with his aide. Rodrigo's backpack looks enormous on
his tiny frame; canvas straps dangle from both legs.
"He was horrible when he first came
in," Rivera says. "It would take five staff to restrain him because
he's so wiry." What was he like? "A lot of aggression. A lot of
disruptive behavior. Whenever he was asked to do a task that he
didn't feel like doing, he would scream, yell, swear. The stuff that
would come out of his mouth you wouldn't believe—very sexually
inappropriate."
"Rodrigo, come here," one of my
escorts says.
Rodrigo walks over, his straps
slapping the ground. He wears a white dress shirt and tie—the
standard uniform for male students—but because he is so small, maybe
4 feet tall, his tie nearly reaches his thighs. "What's that?" he
asks.
"That's a tape recorder," I say.
"Do you want to say something?"
"Yeah."
Unfazed by the presence of Israel,
Rivera, and my other escorts, Rodrigo lifts a small hand and pulls
the recorder down toward his lips. "I want to move to another
school," he says.
The Employee-Modification System To
understand how the Rotenberg Center works, it helps to know that it
runs not just one behavior-modification program, but two—one for the
residents, and one for the staff. Employees have no autonomy. If a
staffer believes it's okay to shock a kid who is smashing his head
against a wall, but it's not okay to shock someone for getting out
of his chair without permission, that could spell trouble. "There's
pressure on you to do it," a former teacher told me. "They punish
you if you don't."
I met this former teacher at a
restaurant, and our meeting stretched on for six hours. At times it
felt less like an interview than a confession. "The first time you
give someone a ged is the worst one," the teacher said. "You don't
want to hurt somebody; you want to help. You're thinking, 'This has
got to be okay. This has got to be legal, or they wouldn't be doing
this.'" At the Rotenberg Center, it's virtually impossible to
discuss such concerns with coworkers because there are cameras
everywhere, even in the staff break room. Staff members who want to
talk to each other without being overheard may meet up in the
parking lot or scribble notes to each other. But it's hard to know
whom to trust, since Israel encourages employees to file anonymous
reports about their coworkers' lapses.
In addition, staff members are
prohibited from having casual conversations with each other. They
cannot, for example, say to a coworker, "Hey, did you see the Red
Sox game last night?" "We don't want them discussing their social
life or the ball games in front of the students or while they're on
duty," Israel says. "So we'll sometimes actually have one staffer
deliberately start a social conversation with another and we'll see
whether the other—as he or she should—will say, 'I don't want to
discuss that now.'" Monitors watch these setups on the surveillance
cameras and punish staffers who take the bait.
Former employees describe a
workplace permeated with fear—fear of being attacked by students and
fear of losing their job. There are so many rules—and so many
cameras—it's not easy to stay out of trouble. Employees quit or are
fired so often that two-thirds of the direct-care employees remain
on the job for less than a year.
New employees must sign a
confidentiality agreement promising not to talk about the Rotenberg
Center—even after they no longer work there. Of the eight
ex-employees I interviewed, most did not want to be identified by
name for fear of Israel suing them; all were critical of how the ged
is used. Maybe, says one, the use of shocks was justified in a few
extreme self-injurious cases, but that's all. "Say you had a
hospital that was the only hospital in the nation that had
chemotherapy, and they were treating people who had the common cold
with it," she says. "I think the extreme to which they abuse their
power has outweighed what good they do."
The Hard Lessons of Connie Chung
Matthew Israel has been fielding questions from journalists since
the 1970s, but few have examined his operation as thoroughly—and
critically—as the producers at Eye to Eye with Connie Chung did. In
1993, they spent six months investigating the facility. They even
found an employee willing to go inside with a hidden camera. But
Israel ended up getting the last laugh. As he recounts the story for
me, he can barely contain his glee. "We refused to meet with her
unless the parents could be in the same room," he says, grinning.
"She talked to the parents, and they really gave it to her." This is
no exaggeration: When Chung tried to ask him tough questions, his
parent-supporters shouted her down.
Throughout this raucous meeting,
Israel had his own camera rolling, too, which turned out to be a
brilliant move. Before cbs got its 40-minute story on the air,
Israel launched a national campaign to discredit both Chung and her
report. He accused her of being "biased" and "hostile," and to prove
it, he distributed edited videotapes of her interview to media
critics and cbs affiliates. It worked. A New York Times television
critic savaged cbs, accusing it of using "shabby tricks of the
trade." Suddenly the story was not about whether the school had
abused students—but whether cbs had abused the school.
"I don't think it was a positive
thing for her career," says Israel, still smiling. It's late in the
day, right near the end of my visit, and I'm starting to wonder why
he's brought up this topic.
By now I've spent 22 hours with
Israel and his staff—wandering around the facility, meeting parents
they've brought in for me to interview. But before I depart, there's
one more place I want to see, the room where they repair the geds.
Israel and Glenda Crookes, an assistant executive director, agree to
take me there. It is just past 7 p.m. and drizzling as we climb into
Israel's Lexus for a short drive to the maintenance building.
There, Crookes and Israel lead me
down a hall, past storerooms filled with red helmets, ged sleds,
batteries and their chargers. The room at the end of the hall looks
like it could be a repair shop for any sort of electronics
equipment: scissors, screwdrivers, industrial-grade glue, a Black &
Decker Pivot Driver. On one desk, I spot a form called a ged Trouble
Report. The report explains that someone dropped off Duane's shock
device because it was "making rattling noises." Crookes explains,
"Anytime a screw is loose or anything is wrong with the device, it's
automatically sent back here."
A Trouble Report on another desk
suggests a more serious problem: "Jamie Z was getting his battery
changed, Luigi received a shock." "What does this mean?" I ask.
Crookes picks up the paper, reads it, then hands it to Israel and
walks away. Her gesture seems to say, I cannot believe we just spent
two days with this reporter and now this is the last thing she sees.
Israel stares at the report, then
reaches into his pocket and pulls out a pair of reading glasses.
Nobody says anything. Outside, one car after another races by, the
tail end of the evening commute.
After a minute or two, Israel says,
"Well, I don't understand the whole of it." He is still staring at
the paper in his hand. "But there was apparently a spontaneous
activation." The ged, in other words, delivered a shock without
anyone pressing its remote.
This moment reminds me of something
Israel told me earlier about the premise of Skinner's Walden Two,
that by changing people's behaviors you can help them have a better
life. But, Israel was careful to add, "The notion was that you
needed to have the whole environment under control. With a school
like this, we have an awful lot. Not the whole environment, but an
awful lot."
He was right; he controls nearly
every aspect of his facility. But all of his surveillance cameras
and microphones and paperwork and protocols had failed to protect
Luigi, a mentally retarded resident who had done nothing wrong.
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