Aversives have helped an autistic brother

First published: Monday, August 14, 2006

I am responding to Clarence Sundram's July 16 op-ed "Unlearn shocking behaviors" and Lawrence Dana's July 22 follow-up letter.

I am a practicing psychiatrist with twin brothers and a daughter with autism. Most persons with autism will never need aversives. However, in the recent research literature it is clear that there are persons with autism who will not respond to positive behavior supports or medication and aversives are appropriate under these circumstances.

Furthermore, I received the 2000 New York Medical College Award for Academic Achievement for my research on behavioral skin shock. Is Dr. Dana suggesting the administrative psychiatrists who awarded me are supporting outmoded and unethical treatments?

My brother Matthew banged his head compulsively, requiring surgery. This occurred despite positive behavior therapy and multiple medications. Since my brother's arrival at the Judge Rotenberg Center, his head banging ceased, he has been off all medications and he has been the happiest I have ever seen him. He still has discomforting involuntary movements as a permanent medication side-effect from his past.

Yet his twin who resides in a residence in New York has been on multiple unsuccessful medication cocktails for his aggression and fire setting. He has developed obesity, seizures, and involuntary movements. He has failed positive behavior supports. He has had multiple psychiatric hospitalizations, has been sleeping excessively, has not been attending a day program and feels miserable and there is nothing our family can do, all thanks to the anti-aversive zealots.

ILANA SLAFF, M.D.

Staff Psychiatrist

Mount Sinai Medical Center

New York