It may look like any leafy New England campus, but inside one Massachusetts school for special needs children, the method of teaching at work is anything but ordinary.
The Boston-area's Judge Rotenberg Center educates and treats enrollees ages 3 to adult, all of whom are struggling with severe emotional, behavior, and psychiatric problems, including autism-like disorders. And for about half of the 250 students here, undesirable behavior means getting hooked up to a special machine and administered an electric shock.
The skin shock treatment, used only after both a court and the student's parents have approved, has drawn criticism for years. But after the release of a recent study by Mental Disability Rights International, Rotenberg has come under the scrutiny of no less than the United Nations, which is calling the school's practices "torture."
"To be frank, I was shocked when I was reading the report," said Manfred Nowak, the UN's Special Rapporteur on Torture. "What I did, on the 11th of May, was to send an urgent appeal to the U.S. government asking them to investigate."
Click HERE for the Mental Disability Rights International (MDRI) appeal to the United Nations on electric shocks and long-term restraint at the Judge Rotenberg Center.
In a response to ABC News, the Judge Rotenberg Center wrote: "It is just as ridiculous to equate JRC's aversive therapy (which is court approved, on a case by case basis) with torture as it is to call a surgeon's knife cutting into flesh an 'assault with a dangerous weapon.' If a two-second shock to the surface of an arm or leg can stop a behaviorally disabled child from blinding himself through eye-gouging, from pulling out all of his own teeth or from starving himself to death, no sensible person would refuse to use such a humane treatment. The alternative is to be drugged into insensibility, restrained, secluded and warehoused in a state mental hospital--in effect, a form of living torture."
Click HERE for the full Judge Rotenberg Center reply to the MDRI report.
In a 2007 interview with ABC, Matthew Israel, the doctor who runs the Rotenberg Center and developed the shock treatment equipment, had his own take on the line between therapy and torture. "The real torture," Israel said, "is what these children are subjected to if they don't have this program. They're drugged up to the gills with drugs that cause them to be so sedated that they essentially sleep all day."
The patients wind up in state institutions or warehoused in jails, Israel said.
For about half of Rotenberg's students, a mix of adults and children, shock treatment is a regular part of life, meant to help teach them to stop hurting themselves or others. Their cases are extreme. Many here cannot speak. And many are real dangers to themselves, such as the child who would bite and bloody himself from his knuckles all the way up his arm, so that it looked as if he had scales, his mother said. Or another student who gouged out his own eye and blinded himself.
The shock treatment "has no detrimental effects whatsoever," Israel said in the 2007 interview with ABC.
The treatment works by hooking the students up to electrodes worn on different parts of the body, which communicate with a small device carried around in a backpack or fanny pack. When the student engages in forbidden behavior, a staff member administers a shock. Some students wear the electrodes as much as 24-hours a day, seven days a week. And sometimes for years.
"The device is simply a device that administers a two-second shock to the surface of the skin that has absolutely no side effects and is extremely effective as a corrective procedure to encourage children not to show violent behavior, not to show self-abusive behavior," Israel said.
The skin shock is not used until a court and the child's parents have approved.
Shock Treatment: 'It Has to Hurt Enough'
The treatment is not painless, however. "And if it didn't hurt it wouldn't be effective," said Israel. "It has to hurt enough so that the student wants to avoid showing that behavior again."
The skin shock is not used until a court and the child's parents have approved.
As a compliment to the punishment, Rotenberg houses a reward room, where students can buy prizes with points earned for good behavior.
"I'm quite confident that the procedures here are all based firmly on the professional literature of behavioral psychology," said Israel, whose theory of reward and punishment is based on work he did studying under the psychologist B.F. Skinner at Harvard.
The price tag per student at Rotenberg is $200,000 a year, and is financed by tax dollars.
Israel and his supporters say the school's system of reward and punishment is both appropriate and effective. When one student began his shock therapy, he repeatedly would hit himself over the head. And he had nearly starved himself to death. But thanks to the therapy, school officials and his parents believe, he has shown major improvements.
Another student, Mark Doherty started biting himself when he was seven or eight. Psychiatric drugs had rendered him zombie-like, often comatose and drooling, according to his mother. And years of other treatments were not effective. Fifty schools rejected him before he started at Rotenberg. The shock treatments he has received have made a difference, say his parents.
Mark, now 24, still lives at the center. But he is able join his family for picnics and at restaurants, a major success. And for the first time after the treatment started working, the Dohertys say, they can hug their son.
"When he stopped biting himself," said Linda Doherty, "when it went from 40 applications [of the skin shock] one week to 18 applications the next week, in my heart and soul I know it's the right thing for my son."
Mark's father, Richard, added, "It's definitely not the end of the rainbow, but it's the best for our son right now."
But Eric Rosenthal, an advocate for the disabled, disagrees. He says there are a wide range of other treatments available. "A person with a disability is vulnerable," he said, and should be considered distinctly different from an adult who chooses to undergo the treatment.
"A child with a disability, who has to get this day in and day out? The courts have approved it, but did anyone ask the child if they want to be there?" he said.
Rosenthal's recent report on the center's tactics is what spurred a United Nations official into action. For years after ABC first reported on Rotenberg in 2007, State Sen. Brian Joyce tried repeatedly to shut down the school, without success.
"If this same treatment were allowed on terrorists in Guantanamo Bay, there would be worldwide outrage,'' he said.
Now, after Rosenthal released his organization's report, the United Nations has become interested. "I've visited many countries where electric shocks are applied, unfortunately," said Nowak, the U.N. specialist. "Of course this is absolutely prohibited."
Nowak said that when he finished reading Rosenthal's report, he sent an urgent appeal to the U.S. government, urging an investigation into the school.
"This is torture,'' said Nowak. "Of course here they might say, but this is for a good purpose because it is for medical treatment. But even for a good purpose -- because the same is to get from a terrorist information about a future attack, is a good purpose. To get from a criminal a confession is a good purpose.
To Rosenthal, there are two factors for the Obama administration to consider; the United States' international treaty obligations on torture, and President Obama's own reputation. "President Obama has staked his international reputation on ending torture and the world is now looking,'' said Rosenthal. "Are we gonna live up to our obligations and is President Obama gonna live up to his promise to end torture by the United States government?"
The issue is clear, says Nowak: "You cannot balance this. The prohibition of torture is absolute."