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The Use of Electrical Stimulation in Behavioral Treatment at the Judge Rotenberg Educational Center (JRC)

Matthew L. Israel
Abstract of paper presented at EMEAB4, July 10, 2000, Amiens, France

Click here for the full text outline of the talk with photos and charts.

JRC is a residential education/treatment program in Canton, Massachusetts (USA) for children and adults with autism or severe behavior disorders. JRC primarily uses positive reward and educative procedures, but employs supplementary aversives, with parental and court approval, when positive procedures alone are insufficiently effective. JRC first employed skin-shock in 1989-1990, using the SIBIS device with 26 students. This proved ineffective. For some students it was effective for only a few months. For others it showed little effect and for one or two the targeted behaviors appeared to increase.

In 1990, JRC designed its own device, the GED (Graduated Electronic Decelerator) and has been using it ever since. The GED produces a more intense stimulus than SIBIS. The GED has been used with 72 students, for 66 of whom we have retained all data for the past 10 years of use. GED was successful, and has continued to be successful for up to 10 years, for 60 of those 66 clients. For the remaining 6, JRC developed a stronger version called GED4. This was successful for 5 of those 6. JRC now has 354 student-years of experience with skin shock.

JRC’s experience with skin-shock has led to the following discoveries and/or beliefs:

1. Skin shock as a decelerator can continue to be effective for up to 10 years.
2. It is desirable to punish a behavior at its earliest possible stage.
3. Start with the strongest stimulus possible. Do not go up the intensity ladder.
4. It is feasible to treat, simultaneously, a wide variety of behaviors—including self-abuse, aggression, destruction, noncompliance, inappropriate urination/defecation and other major disruptive behaviors.
5. Skin-shock can be successfully used in a preventive fashion (behavior rehearsal).
6. Use of skin shock in a negative reinforcement paradigm may be helpful.
7. Holidays from treatment may help an "adapted" stimulus recover some effectiveness.
8. These features of a skin-shock device are desirable:

1. Electrodes connected to the stimulator by wires allow more sites to be stimulated.
2. Multiple electrodes (JRC uses up to 5) in different sites are useful.
3. A "spread" electrode is more effective than a concentric one.

1. There have been no negative side effects from the use of skin-shock.
2. Skin shock, combined with a powerful reward and educative program, should be viewed as the treatment of choice for severe problem behaviors when less intrusive procedures are insufficiently effective.

. For JRC’s web site please see www.judgerc.org.

Click here for the full text outline of the talk with photos and charts.

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