Judge Rotenberg Educational Center

The Judge Rotten Rotenberg Educational Center (JRC), located in Canton, Massachusetts, is a torture center for children and adults with disabilities. No, that's not an exaggeration. The Judge Rotenberg Center routinely uses dangerous electric shocks and physical restraints to punish its "students" for "infractions" as mundane as fidgeting and asking "too many" questions.

In 2013, the United Nations' special rapporteur on torture has concluded that the electric shocks and physical restraints, along with other forms of physical and emotional abuse used at the facility, have amounted to torture, and were a severe human rights violation. In March 2020, the Food and Drug Administration has finally prohibited the practice of using electric shock for behavior modification of people with self-injurious behavior, although the Judge Rotenberg Center still remains open to this day, despite repeated attempts by disability rights activists and the Massachusetts State Government to shut it down. In July 2021, the D.C. Circuit Court of Appeals ruled 2-1 that the FDA overstepped its authority and struck down the ban, allowing the JRC to continue using the shock treatment.

History
The center was founded in Rhode Island in 1971 as the Behavior Research Institute, (BRI) a day treatment school. The founder, Matthew Israel, was inspired by B. F. Skinner. The JRC uses principles of applied behavior analysis: reward people for doing something you like, and punish them when they do something you don't like. In 1972, they started their first residential treatments in Cranston, Rhode Island, for two individuals at a private home belonging to the family of a person under their care. In 1977, a sister school was opened in Northridge, California.

The first deaths
On 17 July 1981, 14-year-old Danny Aswad died while restrained face down in a bed. The autopsy determined the cause of death to be natural causes, but the school was placed on probation for two years. In 1982, the California Department of Social Services filed a legal complaint documenting abusive conduct at the facility, including withholding food and hiding student injuries from state agencies. The matter was settled later that year, with the Northridge School prohibited from using anything more harmful than a water spray bottle, and Israel prohibited from the Northridge school.

In July 1985, 22-year-old Vincent Milletich died of asphyxiation. He was restrained, wearing a helmet and headphones playing. A court inquiry led by Judge Paul E. Ryan determined that Matthew Israel and two BRI doctors were negligent in approving his 'treatment', however, no evidence that the 'treatment' resulted in his death could be determined. Specifically, the judge said Israel was "negligent in authorizing the use of this helmet without having an expert in helmet construction design the helmet or subject it to a safety inspection." Judge Ryan did not recommend charges be brought against Israel, and Bristol County District Attorney Ronald A. Pina agreed, and declined to bring charges against anyone involved with the case.

The first attempt to close the JRC
In 1985, the Massachusetts Office for Children attempted to close the facility over abusive conduct and the death of Vincent Milletich. The case was later settled, after Judge Ernest Rotenberg was persuaded by Israel's presentation of one of his worse, self-harming students. Rotenberg concluded that she wasn't fit to make her own treatment decisions and allowed the JRC to use aversives, provided they were approved by the court. A mediator was appointed to deal with further disputes. The Office for Children agreed to pay $580,000, and the agency head later resigned.

More deaths and renaming
On 23 June 1987, 29-year-old Abigail Gibson suffered a heart attack; she died two days later.

On 19 December 1990, Linda Cornelison, a 19-year-old, died of complications related to a gastric perforation. Staff members failed to correctly determine that several days of lethargic behavior, an unusual disinterest in, and later outright refusal of, food, a desire to lie down, and clutching her stomach were signs of a serious medical problem. Instead, they punished her 61 times in the four hours prior to her being discovered unconscious.

The facility was renamed in 1994 to the Judge Rotenberg Educational Center, to honor Judge Rotenberg for his role in allowing operations to continue.

The second attempt to close the school
During the mid-1990s, following the conclusion of the investigation into Linda Cornelison's death, the Department of Mental Retardation (DMR), which took over for the Office of Children, attempted to stop the JRC again. As before, this effort ended in catastrophic failure, with the judge calling it a "war of harassment". The agency was removed from an oversight role of the JRC, ordered to pay 1.5 million in legal fees and once again, the agency head was forced to resign.

More recent history
Attempts to stop the facility at the legislative level have been made in every legislative session since the late 1980s. However, none have passed the legislature due to a mixture of efforts by the JRC and of parents of individuals under their care who believe in their techniques. Additionally, MA state rep Jeffrey Sanchez, whose nephew, Brandon, has been under the JRC's care since 1992, is a major proponent of the JRC and their practices.

Around 2013, the facility reported that it was in charge of over 230 individuals, under the watch of approximately 900 staff, with 37 residential housing buildings in addition to the Canton school facility. In March 2020, the FDA finally banned the electroshock devices due to their severe side effects and malicious usage. The ban has officially took effect in April 2020, but the GED could still be used on people who had physician approval until September 2020. It is estimated that 45 to 50 people were still being "treated" by these devices at that time.

The autism rights movement, along with the greater disability rights movement, have been vocally campaigning to shut down the JRC.

Abusive practices
Instead of showers, I was bathed tied to a restraint board, naked, while staff washed me, putting their hands over me. All in front of cameras, where Monitoring watched, including men. Being tied on a restraint board, naked with my private areas exposed to the staff in the bathroom and the cameras was the most horrible, vulnerable, frightening experience for me.

Victims of the school wear backpacks equipped with a machine called the GED, which administers electric shocks when a remote control button is pushed. The shocks were designed to be extremely painful, and they can leave burns, scabs, and scars on the skin. The shocks may be up to 90 milliamps, while stun guns are typically 1-4 milliamps, and intended for life protection usually trigger at 30 milliamps. In at least one student, the shocks were often followed by epileptic seizures. Other punishments include spraying people with water, pinching them, or forcing them to eat hot sauce. The "portion program" involves starvation, with a piece of someone's meal being thrown away for every infraction.

There are many reasons why students may be shocked: screaming, covering their ears, fidgeting, trying to take off the electrodes, leaving their seats, throwing papers onto the table, playing with a used paper cup, laughing, crying, using the wrong tone of voice, tensing up, and more. Sometimes, the devices go off accidentally.

Other behavioral strategies, such as redirecting someone who is misbehaving, are not supposed to be applied. "Teachers" who do this could be suspended or fired.

Paying attention to a student is considered a reward. Thus, if scared, crying, or upset, students are not comforted.

Terrorizing of students
A staff would rush in at various times during the school-day, yelling and screaming while entering the room and racing to the student, and place either a plastic knife or a metal spoon to the student's mouth, and yell, "Do you want to swallow a knife? Do you want to swallow a knife?" The staff would hold the plastic knife to the student's mouth in a life-threatening manner, the student would scream loudly as though it was his last breath, and another staff somewhere in the room would push a hidden remote control button to shock this student who was already physically helpless to move his body an inch in any direction while being attacked.

New students, when being assessed, are sometimes provoked into misbehavior. Then the records of these behaviors are shown to the judge when it is decided whether students should be given the GED. Staff may also provoke and then punish students seemingly for entertainment.

Effects
He looked like he was gone, like they'd beat him and broke him

One young man, Andre McCollins, became catatonic after a 6-hour session in which he was tied face down to a 4-point restraint and shocked 31 times while he screamed and pleaded (tensing up or screaming was punishable by more shocks). After 37 days in a hospital, he showed extreme anxiety and was terrified of anything resembling a remote, so his mother did not return him to the school. A former teacher testified that what happened to Andre was not unusual.

Students at the JRC show signs of severe anxiety, especially when a teacher reaches for a remote in order to shock someone.

Post traumatic stress disorder can haunt students who leave the center.

The death of Linda Cornelison
Linda Cornelison, 19, died on 19 December 1990, of complications related to a gastric perforation. Staff members, including a facility nurse, assumed the non-verbal student's behavior of refusing to eat, wanting to lie down and clutching her stomach on a bus, were an act or non-serious, despite being present for several days. In a 4-hour period prior to her being discovered unconscious at 8:00 pm on 18 December, she received 13 spatula spankings, 29 finger pinches, 14 muscle squeezes, and was forcibly exposed to ammonia fumes 5 times. After being discovered, she was taken to a hospital, where she died on an operating table at 1:45 am on 19 December. A state investigation launched after her death noted that refusing to eat was, according to staff members, out of character for her. The report also indicated signs that something was amiss appeared as early as 15 December, and became more noticeable and serious through 18 December, particularly in the 24 hours prior to her death.

The report, published by the Massachusetts Department of Mental Retardation (DMR) in 1995, reveals several troubling things that provide a glimpse into the facility and its operations. It found several glaring deficiencies that contributed to the death of Linda, including a lack of information in procedures and training materials to assist staff in distinguishing symptoms of illness from misbehavior, a failure of first shift staff to communicate concerns about her health, which caused second shift staff to see her symptoms as misbehavior and punish her rather than seek medical advice, and delaying calling emergency medical services while waiting for a JRC medical staff member to arrive and assess Linda, after she was discovered unconscious. The last resulted in an approximately 40 minute delay to medical care by emergency medical services.

Another concerning policy was requiring 'ill' students to go to school, in Linda's case enduring a 1-hour bus ride each way. Once at school, they would be allowed to rest in their classroom. This is due to a lack of any policy or provisions to keep an ill student at home. Furthermore, the facility lacked a dedicated examination room/nurse's office, instead using an empty classroom when such a space was needed. Investigators also found issues with the licensing and training of medical staff employed by the JRC. Additionally, investigators reviewing a 1993 training manual noticed it still listed a limit of 20 taste aversives per hour as policy, despite it having been lowered to 3 aversives per hour in 1991. Staff members interviewed by investigators seemed completely unaware of this policy change.

The report noted multiple concerns unrelated to the death of Linda Cornelison that were observed during their investigation, such as a failure to follow basic refrigeration/food safety rules by storing milk for up to 4 hours in unrefrigerated 'vending machines' in classrooms, failure to communicate changes in punishment limits for Linda to staff, and use of ammonia in a manner that was completely inconsistent with the manufacturer's recommendations.

When inspecting the residence in which Linda lived, investigators noticed that students were required to keep a 1st floor bathroom door open. This was due to the bathroom's lack of monitoring equipment, as staff also used it (other bathrooms are monitored, and those doors are allowed to be shut). Also noted were an unlocked door with an alarm, which exited next to an uncovered sump pump well with water, in a student bedroom, and alarm devices on beds, not mentioned on various forms and documents, apparently contradicting the claim that they had been approved by the court.

Investigators also reported significant difficulty in obtaining information from JRC at times, through their failure to provide documents and video tapes, and their providing truncated copies of documents, like notes by staff, that omitted information. Investigators noted that the obstructive conduct was in defiance of state laws in some cases.

The report Pages 52 to 55, which summarize the report in some simple categories and yes/no/unknown questions, notes the following: 2. Focus on Alleged Abuser:
 * a. Actions by alleged abuser: 7. Slapped, hit, kicked. [and] 10. Other - Squeezes, pinches, forced inhalants & taste aversives.
 * b. Omission by alleged abuser: 4. Basic medical/psychological needs - c. Access to medical/psych.

1. Did physical and/or emotional injury occur as a result of physical abuse? - Yes. 2. Did physical and/or emotional injury occur as a result of emotional abuse? - Yes. 3. Did physical and/or emotional injury occur as a result of sexual abuse? - No. 4. Did physical and/or emotional injury occur as a result of omission? - Yes. 5. Did death occur as a result of an act or omission? - Yes. 6. Is there risk of injury in the future? - Yes (To Other Students). ... 3. Suspected Cause(s) of Abuse - k. Caretakers's lack of knowledge regarding disability. [and] m. Unmet clinical needs (e.g. behavior program). ... 11. Is there a risk of abuse to other disabled persons, children, or elders at the same location? - Yes.

Somehow, this incident, which was described at one point as having "violated the most basic codes and standards of decency and humane treatment", did not result in the closure of the facility.

Graduated Electronic Decelerator
In the late 1980s, the JRC started moving towards the use of electric shock, to replace its earlier physical punishments such as pinches, spanks, and the use of spatulas as paddles. They acquired a system developed by the parents of an autistic girl, called the Self-Injurious Behavior Inhibiting System, or SIBIS. The device was designed to administer a mild shock for 0.2 seconds. The device was used on 29 students including Brandon, regarded as one of the center's more challenging individuals.

However, Israel determined that it had limited effectiveness on some individuals, having observed a notable day on which Brandon received more than 5,000 shocks. JRC contacted the manufacturer to request a modified version, using a stronger shock, but the company refused. As a result, Israel designed the Graduated Electronic Decelerator (GED), an in-house built device similar to the SIBIS, but capable of a more powerful shock at 15.5 milliamps. However, he eventually discovered that some students could adapt to the shock, leading to the introduction of the GED-4, which uses 45 milliamps, about three times more powerful than the original GED.

Effectiveness of GED
The JRC points people to a list of 110 articles that agree with the ideas behind their use of shock. However, examining this list reveals some noticeable problems. The list, from 2007, contains just 5 papers published from 2007 to 1998 (less than 10 years old), 19 published between 1997 to 1988 (10 - 19 years old), and 84 published from 1987 and earlier (20+ years old). Of those 84, 67 were published before 1977, making them over 30 years old. Notably, Lovass, who wrote or co-wrote 8 of the 110 research articles (most in the 1960s, with two in the early 1980s), said in 1993 that shocks offered "only a temporary suppression”, since “these people are so used to pain that they can adapt to almost any kind of aversive you give them." Furthermore, Dr. Brian Iwata, who was involved in development of the SIBIS, has also distanced himself from Israel and JRC's approach and use of the GED.

FDA ban
Since 2014, the has considered prohibiting the use of "electrical stimulation devices" for behavior modification of people with self-injurious behavior. In 2016, the FDA formally proposed the ban, but failed to finalize and enact such a ban for three and a half years. However, on 4 March, 2020, the FDA announced the final rule which banned the use of electrical stimulation devices for behavior modification of individuals engaged in self-injurious behavior or aggressive behavior. The FDA cited several concerns when deciding to ban the device, a rare move for the agency which has only banned two other medical devices in 40 years. The reasons included were a lack of evidence of their long-term effectiveness as a treatment, significant evidence of long term emotional and physical harm, and the disproportionate use of such devices against people with intellectual and developmental disabilities. Disabled people often have limited input on their treatment decisions, and have problems with communicating concerns about the device and the harm being inflicted by it. At the time of the ban, it was estimated that 45 to 50 people were being "treated" by the devices.

The rule took effect one month later, on 6 April, 2020.

Overturn of the FDA Ban
On 23 April, 2021, lawyers representing Judge Rotenberg Education Center and a group of parents of students, argued before the D.C. Circuit Court of Appeals that the US Food & Drug Administration exceeded its powers by banning the use of electric shock devices to treat aggressive or self harming behaviors. The argument made by the JRC's legal team was that the FDA exceed its authority, by regulating a medical treatment and not a medical device. The Department of Justice, representing the FDA, argued the agency acted under its power to prevent the manufacture, distribution or promotion of "adulterated" or modified devices.

On 6 July, 2021, in a 2-1 decision, the judges ruled that the FDA exceeded its authority, by straying into the regulation of medicine, which is not under the authority of the FDA. The decision stated that the statute for banning dangerous medical devices, does not give the FDA the ability to ban a medical device from a specific use, while allowing other uses. The lone dissenting judge argued in his opinion that if the FDA had the power to completely ban a medical device, it was "hard to perceive why Congress could want to deny the agency that middle-ground option."

Future
In spite of their efforts, the facility is gradually winding down its worst practices.

In the summer of 2007, an individual, pretending to be a staff member from monitoring department, called staff in one of the residential facilities and convinced them to shock two students 27 and 77 times before the staff realized they were being tricked. Israel allegedly ordered the destruction of footage of the incident, which resulted in his indictment for obstructing justice. In 2011, he agreed to a deal in which he stepped down and faced probation; he was not required to admit guilt.

Since 2009, the New York State Board of Regents prohibits new students from New York State from using the GED, and since 2011, Massachusetts has prohibited new students from being put on the GED. In 2012, approximately one-third of the 230 individuals under JRC care are allowed to receive shock.

In June 2018, in response to a 2013 lawsuit from from the State of Massachusetts, a judge ruled in favor of JRC stating, "the court found that the treatment is humane, safe and highly effective for a population of clients who have exhausted all other options available to them." The state planned to appeal the decision.

In July 2021, the U.S. House of Representatives passed a massive spending bill that includes a clause added by Representative Katherine Clark (D-MA) that would prohibit Department of Education funding from being provided to schools that use electric shocks as a disciplinary measure. However, in September 2022, this proposal was removed from the spending bill and replaced with a provision that instead clearly granted the FDA jurisdiction to regulate use of the GED devices. This provision was ultimately passed, with the FDA confirmed to have the authority to regulate the devices, however the FDA has not taken action to ban the devices with this power as of January 2023.

Proponents
Proponents claim that this is the only way to handle "severe" people who have self-injury problems, which is basically another way of saying that it is not okay for disabled people to hurt themselves, but perfectly okay for other people to hurt them.

Autism Speaks has allowed the JRC to participate in a resource fair.

Opposition
The autism rights movement has long opposed the JRC and called for the electric shocks to be banned and for the Judge Rotenberg Center itself to be permanently shut down. The Food and Drug Administration has, from 2016, slowly moved towards banning the practice, and in 2020 finally banned the use of electroshock devices for behavior modification in people with self-injurious behavior.