When her son Marc was 14 months old, Linda Doherty knew something was wrong. While she nursed him, he would only gaze at her with a blank stare. At other times he would cry incessantly for hours. One day he cried for 14 hours straight.
Doctors constantly told her that Marc was fine, and that he was developing at a normal pace. However, when Marc was about 2 years old, doctors diagnosed him with autism.
Marc began to develop aggressive behavior, and his aggression grew to be so severe that by the time he was 6 he had been thrown out of four schools. At one point he was given a cocktail of 12 psychotropic medications at once.
"There were times that we went up there, and he would sit in a corner drooling," said Doherty. "They just kept on giving him more meds and more meds, 'til he was so doped up he had no personality."
Searching for Answers
The situation continued to worsen as Marc grew. When he was 7 or 8, he began biting his arms until they bled.
"I couldn't tell you what it looked like. It was open sores," said Doherty. By this time, she and her husband Richard were faced with the task of trying to find proper care for their son.
The Dohertys applied to more than 50 schools in New York state. They traveled to visit a school in Virginia, and another in Delaware, but none of the schools would accept Marc. Linda and Richard felt they had run out of options.
The couple was actively involved with the Autism Society of America, and befriended a woman whose son, Linda said, also exhibited "strange behavior." The woman recommended the Judge Rotenberg Center in Canton, Mass.
One of the most controversial schools in the country, the Judge Rotenberg Center (J.R.C.) tries to eliminate the use of psychotropic drugs, and instead uses aversive stimulation -- specifically behavioral skin shock -- to treat children and adults with the most severe cases of autism and emotional and behavioral challenges.
The Dohertys said they were willing to try aversive stimulation to save their son from self-destruction.
The J.R.C. is the only school in the country that uses a device called a graduated electronic decelerator, or G.E.D. It is used to administer an electric skin shock when children engage in aggressive or self-injurious behavior. Students carry a backpack holding the device, which is connected to electrodes that are strapped to their arms, legs and torso.
The school receives parental and court consent before starting a student on the treatment. About half the students receive the therapy.
Though many people object to this type of punishment, Dr. Matthew Israel, the founder and director of the J.R.C., said "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."
Using a combination of punishment and reward has had a positive effect on J.R.C. students, said Israel. Students, if they exhibit proper behavior, earn points that can be redeemed for gifts in what he calls the "rewards room." Students can purchase video games, DVDs, neck ties, jewelry and stuffed animals.
Though many people dispute his theories, many parents of J.R.C. students support Israel. Bonnie Diaz's son Chris has pervasive developmental disorder, attention deficit disorder and post-traumatic stress disorder. He was kicked out of one school after only two weeks for breaking furniture and knocking a bookshelf over on a teacher.
Soon it became dangerous for Diaz to transport her son, because he would hit her while she was driving. Eight months after he began attending the J.R.C and receiving skin shock therapy, Diaz was able to hug her son for the first time in almost two years.
Ed Ferri, a student at J.R.C., received skin shock therapy and has become more independent. He attended J.R.C. for 10 years. For five years he wore the G.E.D. device nearly 24 hours a day, every day of the week. "I would head bang, bite myself," said Ferri.
"I'd be swearing, I'd be getting physically restrained, held down by numerous staff members. And my life really wasn't going anywhere." He has since graduated from J.R.C., works in the school's kitchen and lives in a group home across the street from the school. "I never envisioned me getting this far in my life," said Ferri.
These are the students that Israel said he wants to save. "They're in a life quality-threatening situation," said Israel. "Because without the treatment, they're going to end up with no jobs, on the streets, in an institution of some kind, or warehoused, or on drugs."
Massachusetts state Sen. Brian Joyce sees aversive therapy as cruel and inhumane. "If this same treatment were allowed on terrorists in Guantanamo Bay, there would be worldwide outrage," he said. "It's incredible to me that it is going on today here in Massachusetts, and I do believe it should be stopped."
Dr. Barry Prizant, an expert on autistic children at Brown University's Center for the Study of Human Development, doesn't see any role for the G.E.D. device in the treatment of people with severe autism. "We believe that some kids and some people with autism actually may develop post-traumatic stress disorder based upon these cumulative negative emotional memories [of being shocked]," he said.
Prizant believes that "positive approaches have much longer-term positive effects on people with the most severe behavior."
The New York state Board of Regents, which issued a report in June 2006, recently decided they will no longer allow students from the state to receive skin shock treatment after 2009, except in very rare cases. Israel said the report is biased and is fighting the state action.
A Daunting Decision
Parents like the Dohertys are also not onboard with this decision. Richard Doherty wants his son to enjoy life in the best way he can. "I don't want him strapped down to a bed. I don't want him doped up and drooling," he said. "I want him to be safe."
Linda Doherty also sees the benefit of skin shock therapy. "My son is not biting himself. He's not self-injurious. My son is not attacking people, so people can work with him without fear of being physically harmed," she said. "He's able to work on a computer. He's able to go on field trips and go out into the community. They're able to start giving him some sort of job skills, like sweeping a floor or putting knifes and forks into plastic packs. I think that it is a success."