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Fact Sheet on GED Treatment

  1. What is Graduated Electronic Decelerator ("GED") treatment for?

    1. Self-mutilating behaviors such as: head-banging; eye-gouging; scratching that produces blood and bone infections; biting off one's fingertips; cutting off one's earlobe.

    2. Other life threatening self-abuse, aggression and other serious problematic behaviors that interfere in a major way with learning and social development and that are resistant to all traditional forms of treatment such as drugs and counseling.
       

  2. What is the GED? A device that produces a temporary, painful (but harmless) skin-sting that is produced by passing electric current through a small area on the surface of the skin, such as on the arm or leg, for 2 seconds. It is applied as a decelerative consequence, each time a pre-specified problem behavior is shown.

    1. The GED is used only with court approval and parental consent.

    2. The GED is used, on average (median) 1/week.

    3. The GED is not to be confused with Electroconvulsive Therapy (ECT). ECT is a psychiatric procedure, done in a hospital in which: patient is sedated; muscles are paralyzed by medication; electric current is passed through the brain that causes a brain seizure for 30sec. to 1 min; and the procedure is used to treat psychiatric problems such as depression.

    4. The GED's current passes through a small area of surface skin and does not enter the body.

    5. The stimulation is comparable to a 2-second bee sting.

    6. The GED is used as a supplement to ongoing reward/educational treatment and is used only when needed. (Fifty per cent of JRC students do not need it and are treated with rewards/educational procedures alone.)

    7. The GED has no negative side effects.

    8. JRC is licensed to use this therapy by MA Dept. Mental Retardation, MA Dept. Early Education and Care, and is approved by NYSED and MA Dept. of Education.
       

  3. How effective is the GED?

    1. While students are enrolled at JRC:

      1. Problem behaviors are reduced by 95%

      2. 96% of those who enter JRC on psychotropic meds are taken off of them while enrolled at JRC.

      3. 99% of those who require restraint before starting GED treatment require non after GED treatment is added.

      4. All students make educational progress.

      5. Students enjoy a vastly improved quality of life; field trips, restaurants, paid jobs in the community, etc.

      6. Students enjoy improved relations with their family.

    2. After leaving JRC:

      1. 83% of those that had GED treatment for 18 months or more are doing well.

      2. 50% are able to remain off of psychotropic medication.

      3. 61% are now working in jobs and/or attending school.
         

  4. What are the alternatives?

    1. Psychotropic drugs. They are ineffective and are used only as a form of chemical restraint that can turn the individual into a drooling, half-asleep zombie who may suffer permanent damage to the nervous system, liver and kidneys, and who may end up being confined in a mental hospital.

    2. Warehousing. This means being confined in a mental hospital correctional facility, or other residence with no education or treatment.

    3. Restraint.

    4. Non-aversive, positive-only treatment (often called Positive Behavior Support). Major review paper (1) shows that positive-only procedures work only 50% of the time. JRC treats the other 50% and decreases their problem behaviors by 95% by adding supplemental aversives.

    5. Psychotherapy. This is usually not effective with severe behavior disorders.
       

  5. What are the safeguards?

    1. Parental consent

    2. Individual court approval

    3. Medical and Psychiatric pre-approval

    4. Yearly reviews by court

    5. Daily oversight by clinicians

    6. Review by Peer Review Committee

    7. Human Rights Committee approval
       

  6. What professional support is there for this procedure?

    1. 111 peer reviewed papers (1960s-2004) (2) support the use of behavioral skin shock treatment.

    2. 8 of these used the SIBIS device. GED is a stronger version of SIBIS.

    3. The 1989 NIH Consensus Report on Destructive Behaviors acknowledges the SIBIS device as one of several professionally supported decelerative procedures.

    4. The Association for Behavior Analysis supports the individual's right to have the most effective treatment. (3)

    5. The Autism Society of America's Options policy (4) allows parents entitled to choose the treatment they feel is most appropriate to their needs
       

  7. For more information see www.judgerc.org

(1) Carr, et al, "Positive Behavior Support for People with Developmental Disabilities," published as Research Monograph by American Association for Mental Retardation, 1999. The key statement is that only positive-only behavior supports are effective in only 50% of the cases (page 16).

(2) http://www.effectivetreatment.org/bibliography.htm

(3) http://www.abainternational.org/sub/membersvcs/journals-pubs/rtrrebt/index.asp

(4) http://www.autism-society.org/site/News2?&cmd=articles&page=NewsArticle&id=7351&start=0&news