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RESOURCES DEALING WITH THE AVERSIVES CONTROVERSY
v5

JRC’s website contains a bibliography and a number of full text articles that deal with the issue of the use of aversives. The links found in the material below will take the user directly to the appropriate document on the JRC website.

Bibliography and Full text Articles

For a bibliography of 110 professional articles between 1965 and the present showing the effectiveness of aversives, please see http://www.effectivetreatment.org/bibliography.htm. For the full text of 7 papers dealing with the use of the SIBIS skin shock device, which is a forerunner of the GED skin shock device that the Judge Rotenberg Center (JRC) uses, please see http://www.effectivetreatment.org/bibliography.htm#SIBISbib For the full text of the 14 most recent professional papers on aversives that have appeared in the psychological literature, please see http://www.judgerc.org/14_papers.pdf. For charts of 36 students at JRC that show the effectiveness of supplementing a positive behavior program with the use of the GED skin shock aversive, please see http://www.judgerc.org/thumbwriteup.html. 

Position Statements by Professional Organizations

Several national professional or advocacy organizations have adopted position papers supporting either the use of aversives or the right of parents to choose the form of professionally-approved treatment to be used with their children. To view these, please click on the appropriate link:

1. Assoc. for Advancement of Behavior Therapy, 1982

2. National Institute of Health Conference 1989

3. Association for Behavior Analysis, 1990

4. Division 33 (Mental Retardation) of APA

5. Autism Society of America 1995

Treatment of Aversive Therapy by a Standard Textbook in Psychiatry

Autism Spectrum Disorders[1], edited by Eric Hollander, M.D, is a standard psychiatric textbook (2003) that is used to train psychiatrists in autism. This book contains a chapter on movement disorders written by Dr. John Robert Brasic. In it Dr. Brasic sums up accurately the current status of the use of aversives such as skin shock.

Refutation of the Assertion that Positive-Only Procedures can Successfully Treat Severe Problem Behaviors
 

Opponents of the use of aversives often argue that there are now positive behavior support procedures that make it unnecessary to use aversives. For the full text of papers that show that this is not the case, please make use of the links supplied below. A 1999 paper by Carr et al, “Positive Behavior Support for People with Developmental Disabilities,”[2] reviewing 109 articles in the field of Positive Behavior Support, and showing that positive-only procedures were effective in only 50% of the cases may be found in full text at http://www.judgerc.org/PositiveBehaviorSupport.pdf. A 2005 paper by Richard Foxx, “Severe Aggressive and Self-Destructive Behavior: The Myth of the Nonaversive Treatment of Severe Behavior,”[3] shows that the assertion that positive procedures can be used to treat the really difficult behaviors such as severe aggression is a myth. The full text of this paper is found at http://www.judgerc.org/SevereAggressive.pdf. A 2005 paper by Michaels et al, “Personal Paradigm Shifts in PBS Experts: Perceptions of Treatment Acceptability of Decelerative Consequence-based Behavioral Procedures,”[4]  shows that even when those who espouse positive behavior support procedures were surveyed anonymously, as much as 10% of the respondents stated that they would use skin-shock to treat major problem behaviors. The full text is found at http://www.judgerc.org/PersonalParadigmShifts.pdf. Dr. Israel’s 2007 paper, “Difficult-to-Treat Students are Expelled from or Rejected by Treatment Programs Using Positive-Only Procedures, and are then often Referred to the Judge Rotenberg Center,” supports the assertion contained in the title with information about 11 JRC students who were expelled from 6 different highly respected programs that use positive-only procedures and then referred to JRC. See http://www.judgerc.org/posonlyprograms.pdf.

History of the Anti-Aversives, Positive Behavior Support Movements

A 2005 paper giving the history of the anti-aversive movement, titled “Nonaversive Treatment,”[5] by Newsom, C. and Kroeger, K., is found at http://www.judgerc.org/NonaversiveTreatment.pdf. A 2005 paper giving the history of the Positive Behavior Support movement is by Mulick, J., and Butter, E., entitled “Positive Behavior Support: A Paternalistic Utopian Delusion”[6] is found in full text at http://www.judgerc.org/PositiveBehaviorSupport2.pdf. The political clout of these groups is described in a 2005 paper by Richard Foxx, “The National Institutes of Health Consensus Development Conference on the Treatment of Destructive Behaviors: A study in Professional Politics,”[7] whose full text is found at http://www.judgerc.org/SevereAggressive.pdf.

Explanation of how Aversives are Used within JRC’s Program

Most persons are not aware of the following facts about JRC’s use of aversives:

• aversives are used only for severe self-abusive, aggressive or other major problem behaviors that are resistant to positive-only treatment;

• they are used as a supplement, and not a replacement, for powerful positive and educative programming;

• they are used as a replacement for psychiatric drugs that are ineffective, that have dangerous side effects or that cause allergic reactions; 

• they are used on only 38% of JRC’s school-age students;

• they are used only once per week in the average case;

• many students are able to graduate entirely from their use as their behaviors improve;

• JRC tries the use of a powerful positive programming for 11-12 months before deciding whether it needs to be supplemented with aversives;

• JRC must obtain parental permission and individualized authorization from a family court judge before using aversives.

For a description of the JRC treatment program (www.judgerc.org), please see http://www.judgerc.org/progdesc.html. For a table of contents for JRC’s web site, including a subsection on aversives, please see http://www.judgerc.org/tableofcontents.html. For the subsection of the table of contents that deals with aversives, see http://www.judgerc.org/tableofcontents.html.

The Alternative to Aversives: Psychiatric Medication
 

To understand the valuable role of aversives one must appreciate the fact that the most common alternative to them is the use of psychiatric medication. This medication is generally ineffective in producing changes in specific behaviors, has dangerous side effects, and has not been approved by the FDA for use with children. For some articles dealing with these problems, please see http://www.judgerc.org/Key_Features/medpolicy.html.