For more information, click on any of the underlined links to obtain additional information and photos. For a 10 minute video presenting the essence of the below material, click here.
JRC is a special needs
residential school in
2. Can you briefly summarize
JRC's approach to treatment?
Because JRC has a near-zero rejection and near-zero expulsion policy, we treat a very wide range of problem behaviors. We treat students with behavior or psychiatric problems such as aggression, persistent noncompliance, psychosis, bipolar disorder, conduct disorders, suicidal behaviors, runaways, fire-setting and depression. To hear a few of JRC's emotionally disturbed students talking about their experiences with our intensive treatment procedures, please click here.
We also treat autistic students who function at a lower level and who have problem behaviors such as self-abuse, aggression, stereotypy and problems with communication. For a brief film that shows some of our autistic students before and after their treatment at JRC, please click here.
JRC differs from other special needs residential schools in several aspects:
6. JRC also has uniquely decorated and beautifully maintained school buildings and residences.
For a list of the other special features, please click here.
JRC uses no or minimal
psychiatric medication. Such drugs are often ineffective and often have damaging
and even irreversible side effects, some of which are not
discovered until years after they have been used on a child.
JRC uses a consistent program of behavior modification therapy.
Briefly stated, this means arranging positive rewards and educational procedures for behaviors that
JRC wants to encourage and corrective procedures for behaviors that need to
JRC has a broad and varied set of reward systems to motivate students to show desired behaviors. These include: a large arcade-like reward lounge; a retail store where students can purchase personal items; behavioral contracts in which students can earn rewards for displaying desired behaviors; reward areas and reward boxes in many classrooms; a weekly reward afternoon which features barbecues and special fun activities; and access to a variety of other indoor and outdoor sports and recreational activities. In addition, students can gain increasing levels of independence, can advance to more normalized classrooms, and can live in residences with more privileges as their behaviors improve.
JRC designs multiple, individualized, and continually adjusted reward contracts in which students must reduce or eliminate problem behaviors in order to gain access to these rewards. JRC's clinicians evaluate the effectiveness of the treatment by, among other things: reviewing daily, weekly and monthly charts that show the frequency of each of the behaviors targeted for treatment; meeting frequently with the student and the student’s treatment team; and using JRC’s unique digital video monitoring system to view the student and review incidents. Using this information, the clinicians make frequent and continual changes in the reward, corrective, educational, counseling, self-management and other procedures until they succeed in producing progress in the student’s behaviors. The behavior charts that the clinical staff use to make treatment decisions are continuously available for view by the student’s parents and placement agencies by means of a Parent/Agency website.
8. Does JRC teach students behaviors to replace the problem behaviors that it seeks to eliminate?
Yes. JRC provides behavioral counseling, which means
counseling that is provided in a behavioral framework so that it will mesh
with and support JRC's behavior modification program. This counseling is
provided by a clinician with a doctoral or masters level degree in
psychology who oversees each student's program. A key objective in
JRC's treatment of its emotionally disturbed students is to teach them how to
understand and control their behaviors using behavioral principles.
10. How long does JRC try its positive procedures (rewards, educational procedures and behavioral counseling) in order to see if they can be effective enough to change the student's behaviors?
Approximately 11-12 months, on
11. How often do JRC's positive programming procedures prove to be sufficiently effective to treat the students problem behaviors effectively?
Sixty percent of JRC's incoming
school age students are treated successfully with positive-only treatment
JRC first discusses the
situation with the parents. If the parents agree, and if JRC can obtain
student-specific permission from a
13. What corrective stimulus does JRC use?
JRC uses a behavior modification
procedure in which a mild current from a battery
operated device is passed for a two-second period through a small
area of the surface of the skin, typically on the arm or leg. The sensation
has been compared to a hard pinch with no after-sensation. It has no
significant negative side effects.
14. Is skin shock the
same thing as electroconvulsive shock?
Very. The frequency of problem
behaviors generally drops immediately (sometimes becoming as much as 1000
times less frequent) within days or weeks of implementing the
treatment. Skin-shock is far more effective than
psychotropic drugs, which are sometimes so sedating that a student can only
sleep and cannot learn. Once JRC's skin-shock aversives have decreased a
student's problem behaviors to a point where those behaviors no longer block
out all other behaviors, a window of opportunity opens that enables the
student to learn and display positive behaviors and to be rewarded for doing
so. The overall result is that students' lives have been
saved, their behaviors improve dramatically and families are able to enjoy
positive experiences with their children.
16. How many of JRC's school-age students receive this optional intensive treatment?
This treatment is optional and
is subject to the approval of parents and a probate court judge.
Approximately forty percent of our school-age students currently benefit from
17. For those students who receive skin shock, how often is the procedure used?
One two-second application is given
per week, in the average case.
18. How do students react to this procedure?
For some brief film clips of
students talking about their reactions to this treatment, please click
A probate court judge must
pre-approve an individualized treatment plan authorizing
the use of the skin shock and reviews the plan and its results yearly.
Parents must give their prior informed consent and the use of skin shock must
be included in the student's Individual Education Plan. A physician,
psychiatrist, human rights committee and peer review committee must also give
prior approval. JRC has a state-of-the-art digital video monitoring system
that is used by experienced supervisors to monitor, from JRC's administration
building, even in the middle of the night, the conduct of all staff and
students on a 24/7 basis. This includes viewing what is going in each of our
residences, some of which are located 20 miles away. A special website provides each parent with
immediate access to every detail of the child's behaviors and behavior charts
and every note by the child's clinician. JRC has a special certification to
use aversive procedures that is granted by the MA Department of Mental
Retardation and which is reviewed every two years.
20. Do students who receive skin-shock therapy ever 'graduate' so that they no longer need this treatment?
Yes. Students whose cognitive
level is medium or high are often able to graduate from needing the aversive.
Some have gone on to college or other independent situations. Those who
function at a lower level may need to have skin shock available for longer
periods of time.
21. Can JRC's students be treated in other programs without the use of aversives?
No. All of JRC students have
been rejected or expelled by other programs that employ positive-only
22. If there were no JRC program, what alternatives would the parents of the JRC students have?
Heavy psychiatric medication: This can be so sedating that the students sleep most of the day and cannot even recognize their parents. This medication often does not work and always has dangerous and sometime irreversible side effects. Some of these negative side effects are not discovered until years later when it is too late to reverse them.
Warehousing: The student may have no program at all to go to, and may have to languish at home, on the streets, in a state institution for the retarded or mentally ill, in a psychiatric hospital or in jail. 10% of JRC's emotionally disturbed students were either sent to JRC from a correctional facility or were sent to JRC as an alternative to one.
Restraint: If students have aggressive, self-abusive or disruptive behaviors, they may be subjected to frequent restraint, isolation and physical take-down procedures.
In comparison to these alternatives, skin shock is far less intrusive and far more effective. It is no wonder that the parents of our students are JRC's strongest advocates. See, for example some of their letters to legislators and agency officials, their comments, and the comments of both former and current students who have benefited from the skin shock treatment.
23. Why is there so much opposition to the use of skin-shock therapy?
This is a relatively new and
rarely used procedure and most people are unfamiliar with it. Many do not
realize how extremely self-abusive or aggressive some autistic or behavior
disordered persons can be. Some people are simply unwilling to weigh the
intrusiveness of the procedure against its many benefits. Some people mistakenly confuse behavioral skin-shock with
electroconvulsive shock therapy (ECT) a totally different
psychiatric procedure in which a patient is hospitalized and in which an
electric current is passed through the brain in order to deliberately cause
the brain to experience seizures.
24. Some opponents of aversive therapy say "You would not use skin shock on a prisoner or a prisoner of war. Why use it on a handicapped child?" How do you answer this?
This question mixes apples and
oranges. Prisoners are removed from society as a punishment and/or public
safety procedure. Disabled children, on the other hand, have committed no crimes
and deserve the best possible care and treatment to overcome their handicaps.
Treatment procedures used to help children with special needs overcome their
handicaps are necessarily different from those used with prisoners.
25. Why is it that no other residential programs for special needs children use skin shock aversives?
No other program serves as many
extremely difficult-to-treat students as does JRC. People are often afraid of
what they don't yet understand. As a result, skin-shock treatment is still
controversial. Most residential programs find it easier to simply expel or
reject the very-difficult-to-treat student. Many such students are then
referred to JRC.
26. Does JRC analyze the causes (functions) of behaviors and base its treatment upon that analysis?
JRC does a thorough assessment
at intake and then evaluates the causation of behaviors on a continuing basis
using its unique behavior charting system. It also designs its
treatment systems redundantly to take into account all likely causes. Some
persons believe that if one bases treatment on a functional assessment, there
will be no need to use aversives. Unfortunately, a
comprehensive review of studies using positive-only treatment procedures
(1) showed that they are effective in only sixty percent
of the cases, even when a functional assessment is done.
27. What do you say to people who say that the use of a skin-shock aversive, as a part of behavioral treatment, is inhumane?
A procedure is not inhumane
because it causes pain, provided the benefits outweigh the risks. Surgery and
dentistry, although they cause pain, are not inhumane. Those who argue that
skin-shock is inhumane are unfamiliar with the harmful life-threatening
behaviors presented by many of JRC's students and are unaware of the
significant benefits derived from skin-shock therapy.
28. Is it true that JRC uses skin shock to punish minor behaviors?
In order to assess treatment properly, one must be given information about the entire context of the treatment to understand how any one component of the treatment fits into the total treatment picture. For example, to successfully and completely treat certain behaviors one needs to treat all of the forms that the behavior may evolve into during the course of treatment. For example, during the treatment of pulling out one's hair to the point of going bald, this behavior often evolves into lesser forms such as merely hair tugging and then just to hair touching. To treat this behavior effectively and completely, it may be necessary to treat each of these forms of behavior, as well as the pulling of the hair out of the scalp.
Similarly, problem behaviors
often occur as the last member of a chain of behaviors. When this is the
case, it is often important to treat the chain of behaviors at its earliest
stage. For example, if a student has the behavior of jumping out of his/her
seat and attacking the teacher, it may be necessary to treat the jumping out
of one's seat and not wait for the full attack to occur.
29. Is it true that JRC's skin shock causes burns?
No. On occasion and with very
few students an application causes a superficial, harmless, and temporary
reddening which is not a burn and which clears up within hours or days.
In the spring of 2006 NYSED
decided, after making use of JRC's services for 30 years, to take a
philosophical stand against the use of aversives. In furtherance of this,
NYSED proposed to the New York State Board of Regents to ban the use of
aversives. NYSED was unable, however, to justify this proposed ban by
referring to any negative findings they had made on JRC's use of aversives in
its treatment of
31. Are there any published research articles about the use of skin-shock to modify behavior?
Skin shock is one of the most widely published procedures in the behavior modification literature. JRC's skin-shock device, which JRC does not allow to be used outside of JRC, is simply a stronger version of the "SIBIS" (Self Injurious Behavior Inhibiting System) device for which there are 14 peer reviewed studies in the professional literature.
Other Questions and Answers
JRC's web site contains more extensive answers to each of the above questions as well as answers to the following additional questions:
(1) Carr, E.G., Horner, R.H., Turnbull, A.P., Marquis,
J.G., Magito McLaughlin, D., McAtee, M.L., Smith, C.E., Anderson Ryan, K.,
Ruef, M.B., & Doolabh, A. (1999). Positive behavior support for people
with developmental disabilities: A research synthesis.