Proposed legislation would ban aversive therapy in Massachusetts
Judge Rotenberg Center uses, defends practice
Opponents of the use of electric shock therapy to treat severe behavioral issues turned out in force to testify before the Massachusetts Legislature in November, in favor of a bill that would prohibit the use of aversive therapies on disabled individuals.
Only one treatment center in the country — Judge Rotenberg Center (JRC) in Canton, MA —still uses electric shock therapy, in the form of a graduated electronic decelerator (GED), which delivers electric shocks to the skin.
A 2020 Food and Drug Administration ban on the devices was struck down in 2021 as an impermissible attempt to regulate the practice of medicine, but in January 2023, Congress added language to an omnibus bill giving the FDA the authority to institute a ban. In September, the Supreme Judicial Court upheld a 1987 consent decree allowing the JRC to continue using the GED.
H.180, sponsored by Rep. Danielle Gregoire (D-Marlborough), states that no program, agency, or facility funded, operated, licensed, or approved by a Massachusetts agency may administer procedures that cause obvious signs of pain to any person with a physical, intellectual, or developmental disability.
Several similar bills have previously been introduced in the state Senate and House of Representatives but did not move forward to law.
Nathan Blenkush, LP, clinical director of the JRC, spoke in opposition of the bill, as did parents of two current residents of the center. Blenkush testified that for some individuals with severe behavioral disorders, the GED has been the only effective treatment in controlling their violent behavior. Former patients testified in favor of the bill. (See sidebar)
Gregoire testified that she had visited the center and tried the GED herself. “Those that would refer to it as bee sting or a small annoyance are misleading, because it hurts.” She advocated for finding other options for those at the JRC. “There have got to be medical advances in the 30 or 40 years since we started this device. I will do whatever I can to help families of patients living on the GED to find an alternative.”
The Association for Behavioral Analysis International in 2022 released a statement opposing the use of contingent electric skin shock under any condition, citing a lack of social validity and the potential for harm for recipients of the treatment
In 2018, the United Nations Human Rights Council condemned the practice as torture
At the November hearing before the Joint Committee on Children, Families, and Persons with Disabilities, numerous concerned Massachusetts residents spoke in favor of H.180 as did multiple parents, who testified that therapies centered around positive reinforcements had helped their own children who were on the autism spectrum.
“This bill is important because it offers wide protections to disabled people in this state, from students in educational spaces to adults in residential programs to adults in nursing homes,” testified Lisa Jeanne Graf, who described herself as a self-identified autistic woman. “Protections should be there for all, regardless of age or whether they have a disability.”
Suzanne Stillinger, an educator at the New Village Preschool in Northampton, MA, noted at the hearing that she was “deeply saddened and angry” that these strategies are still up for debate. “We would not be having this conversation about able adults and children,” she said, noting she was speaking not only as a teacher but an autistic adult. Behaviors are communication, she added, and individuals who exhibit dangerous behaviors are “communicating that they don’t feel safe. They can’t self-regulate, and they don’t know what to do.”
“We need to dispel the myth that any amount of training, licensure, or safeguards will make aversive electronic shock an acceptable practice,” testified Jules Good, program coordinator for the Autistic Self-Advocacy Network, one of more than 30 advocacy groups working together as the Stop the Shock Coalition in support of the legislation.
Leo Sarkissian, executive director of The Arc of Massachusetts, an advocacy group focused on inclusion for individuals with intellectual and developmental disabilities, said in an interview he is pleased with the grassroots support he has seen focused on the bill.
“I’m struggling to understand how legislation [that would ban the GED] has never before passed, but it is hard to stop something once it has started. It’s a lot easier to just keep the status quo.”
Aversives and shocks in particular are “an infective and unethical way” to change behaviors of individuals who are neurodiverse, testified Alex Bou-Rhodes, JD, a staff attorney for the Mental Health Legal Advisors Committee.
“There are tens of thousands of people like those at JRC who are not treated with aversive interventions. There is no reason people in Massachusetts should not be entitled to the same standard of care,” he said, adding that medical research does not support using these types of interventions.
Punishment does not work over the long term, testified Dimity Peter, Ph.D., an associate professor in the school of global inclusion and development at University of Massachusetts Boston. “Once punishment is removed, the child reverts to the original behavior,” she said. “Electric shock models aggressive behavior, which is often the behavior [the treatment] aims to eliminate.”
Supporters of the bill also advocated for the inclusion of specific language to protect other vulnerable populations, including the elderly, people with brain injuries and psychiatric disabilities, and children with behavioral disabilities. They also expressed opposition to related bills H.170 and S.81, which would require licensure for GEDs if their use was continued.