August 20, 2014

Behavior Analysts to Youth with Disabilities: Dissent Is Not Allowed

B. F. Skinner said, "In the long run, punishment, unlike reinforcement, works to the disadvantage of both the punished organism and the punishing agency (2014, p. 183)." However, Board Certified Behavior Analysts (BCBA's), professional followers of the science he founded, can easily ignore and even punish children who complain about their punishments.

According to the following interpretation of the consent1 language in two documents about the guidelines and disciplinary procedures for BCBA's, if a child or incapacitated adult says, "Leave me alone," during a punishment procedure and a parent or guardian has signed a legally-written informed consent agreement to that person's behavior change program, then the behavior analyst can continue with the punishment unless it causes serious harm and deviates from the customary standard practice accepted in the behavior analytic community.

Painful Electric Shock Is Permitted by the Behavior Analysis Community

The Judge Rotenberg Center (JRC) near Boston, Massachusetts illustrates the most extreme publicized example of a lack of consumer2 consent to the behavior modification programs of BCBA's. Gonnerman (2007, p.1) said,
Employees shocked him for aggressive behavior, he says, but also for minor misdeeds, like yelling or cursing. Each shock lasts two seconds. "It hurts like hell," Rob says. (The school's staff claim it is no more painful than a bee sting; when I tried the shock, it felt like a horde of wasps attacking me all at once. Two seconds never felt so long.) On several occasions, Rob was tied facedown to a four-point restraint board and shocked over and over again by a person he couldn't see. The constant threat of being zapped did persuade him to act less aggressively, but at a high cost. "I thought of killing myself a few times," he says.
If the analysts or the government don't condemn it, then painful electric shock will continue. Rather than censuring JRC, however, the Association for Applied Behavior Analysis International (ABAI) gives them the green light.

Autism advocate Michelle Dawson (2009) said, "The three presenters in Symposium #403" at the 2009 ABAI Convention "are all from the Judge Rotenberg Center." The title (and some details) of the seminar included: "The Use of Contingent Skin Shock (CSS) ('in 72 students') in Treating Behaviors Other than Aggression and Self-Abuse (including 'noncompliance...yelling, tantrums...with fading of CSS accomplished with some students...during this study')." (ABAI, 2009)3

Dr. Matthew Israel, "disgraced" founder of JRC (Grohol, 2011), said, "Each year we update a follow-up study in which we report follow up data (typographical correction) on all of our former students that we have been able to keep in touch with. We present this report each year at the annual convention of the Association for Behavior Analysis International and we post the updated report on our website (Packer, 2010)."

Eventually the Autistic Self-Advocacy Network (ASAN) ran a protest against JRC at ABAI's May 2012 convention in Seattle (Ne’eman, 2012).

The following June,
Two ASAN representatives,...a former JRC teacher’s aide, and the mother of (a) former JRC student...who recently received a settlement in a lawsuit against JRC...(delivered a letter to members of the Massachusetts State House to support) Massachusetts Senate Budget Amendment #548, which would impose a statewide ban on the use of aversives on people with disabilities.... This letter was cosigned by statewide, national and worldwide disability rights organizations including the Disability Law Center of Massachusetts and Disability Rights International, which oppose aversive use such as that practiced at the Judge Rotenberg Center, which is at this point the only program in Massachusetts and in fact the world to use contingent electric shock. Along with Miller and McCollins, they also presented the members of the conference committee with over 260,000 signatures obtained from two online petitions calling for an end to the use of contingent electric shock, over 8,000 of which were from Massachusetts residents. (Neumeier, 2012)

Then Lydia Brown (2014, Introduction) wrote a report for a meeting of the Neurological Devices Panel of the Medical Devices Advisory Committee of the Food and Drug Administration (FDA). She argued that "historical and current practices with respect to contingent electric shock constitute both a moral and legal imperative for the FDA to ban aversive conditioning devices used for...('abusive')...purpose."

Until recently, August 5, CBS News correspondent, Anna Werner (2014), said the FDA may ban the devices.

The Consent Clauses in Behavior Analysts' Conduct Guidelines Appear Unenforceable

The certification board's Guidelines for Responsible Conduct for Behavior Analysts say that research with persons "legally incapable of giving informed consent" should "discontinue...if the person gives clear signs4 of unwillingness to continue participation (2013, p. 18)." The more clinical BCBA's apply the findings of the carefully-controlled experiments to design behavior change programs for individuals with "problems of social importance" (SEAB, 2014). The Guidelines say, "The behavior analyst...involves the client or the client-surrogate in the planning of such programs, obtains the consent of the client, and respects the right of the client to terminate services at any time (2013, p. 9)." So the BACB defines the right of consumers to dissent during experiments with more objective behavioral language than how they define it during real-world situations. The clauses where these guidelines fall, however, seem virtually unenforceable.

The BACB (2013, Introduction) said, "The Guidelines may be referenced in complaints alleging violation of Section 6 of the BACB's Disciplinary and Ethical Standards; these Guidelines, however, are not separately enforced by the BACB." Withing the Standards they said that the grounds for issuing "sanctions" (BACB, 2012, p. 1) for Section 6 violations include "professional conduct that constitutes an extreme and unjustified deviation from the customary standard of practice accepted in the applied behavior analytic community and (italics added) that creates a serious risk of harm to or deception of consumers (2012, p. 2)." Neither document contemplates the existence of any customary rejection of their practices by the community of people with disabilities.

Therefore, People with Disabilities Are Denied the Right To Dissent

So by this reading, the certification board does not penalize analysts when they harm children or adults with incapacities unless their community-at-large condemns such acts, regardless of what their guidelines recommend, and regardless of whether or not the general public, the media, and leading advocates with disabilities object. The profession has had the opportunity to rebuke the "school of shock" as a "deviation" of their customs, but instead they give them an audience of their peers. What happens in the real world to people with less power when so many eyes aren't watching?

Footnotes

1 (Consent) and dissent are antonyms.

2 Many advocates with substantial mental health challenges prefer to be called consumers (or survivors) rather than clients or patients. Consumer connotes choice (Zinman, 2009, p. 18), the right to shop around until they find an acceptable professional

3 A file called "Event Detail...# 403 Symposium" was retrieved August 22, 2014 from an ABAI search engine by entering "403" as the "event number." A matching, dynamic URL was simultaneously retrieved. Adding its link into this post and clicking on it did not access the file directly. The ABAI (2009) citation quotes from this file. This Symposium 403 paragraph was revised August 22, 2014. Italics were added by this blogger.

4 For example, newborn infants will seal their lips together and turn their heads away to tell their parents it's time to stop feeding (U. S. Department of Agriculture, p. 45-46).

5 The reference list is still being compiled.

Related Blog Post

Behavioral Ethics: The Consent of the Subject of Behavior Research and Therapy

Reference List5

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I am an advocate for people with disabilities certified to teach special education with a Master of Arts in Teaching. I am not a Licensed Psychologist or a Board Certified Behavior Analyst. When in doubt, seek the advice of an MD, a PhD, or a BCBA. My ability to analyze the ethics of ABA stems from the fact that I am disabled and ABA interventions are often done to people like me, which I voluntarily accept, but only when I alone am the person granting consent, and not a parent, sibling, guardian, or institution.