Electric shock therapy on special needs students: Treatment or torment?

A Massachusetts school for special needs children can continue to use a form of electric shock therapy on students after a long-running battle with state officials over the controversial treatment was decided in their favor.

The Judge Rotenberg Center in Canton is the only learning center in the country to use the graduated electronic decelerator to control the behavior of students with development delays.

The commonwealth had been trying since 2013 to ban the practice, but last week, Judge Katherine Fields, the first justice of the Bristol County Probate and Family Court, sided with the school.

The school did not respond to a request for comment, but instead directed ABC News to contact the JRC Parents Group, which said in a statement, “No one loves our children more than we do; we have tried and continue to try everything available to them, including positive behavior therapies and medications to help our children, but as the Court found - there is no evidence that any alternative treatment would be effective to treat our children and keep them safe.”

What is the treatment?

According to the FDA, the GED is used for “aversive conditioning.” That’s a psychology term meaning giving a negative stimulation whenever a particular unwanted action occurs. For example, people put a rubber band around their wrist and “snap” it whenever they have a cigarette; the goal is for the behavior to eventually be eliminated because of the association.

The GED works by delivering skin shocks for particular behaviors, trying to eliminate the behaviors.

The JRC Parents’ Group told ABC News, “It is a treatment of last resort. That is the important part to know about GED.”

What is it used for?

At JRC, the electrical shocks associated with GED are used to prevent and control self-injury or violent aggression. The skin shock might be used when the patient is aggressive against someone else (hitting, biting, or throwing things), or even to themselves (slamming their own head against a wall, or trying to hurt themselves in another way).

“There is a process the committee goes through where the therapy is peer reviewed to see what has been tried and what worked. Some of these parents have been dealing with these issues for 15 years; there are times when children attack their own parents. To people who think we don’t care, it’s not that, but it is an option when everything else fails,” said the JRC Parents’ Group.

Is it painful?

GED is not the same as Electroconvulsive therapy (ETC), which is when volts of electricity are directed towards the brain to treat depression. However, it does deliver painful shocks to the skin to condition patients with autism or behavioral disorders to stop a certain behavior or action.

What are the benefits and drawbacks?

While use of GED may slow down the student’s aggressive or inappropriate behavior, it’s a management technique, not something that will treat the underlying cause of the problem. While aversive treatment can be useful in stopping a behavior, it is hard to regulate what is considered excessive and what will be successful for certain patients as opposed to others.

Additionally, it’s virtually impossible to do studies on the exact dosage, timing and factors involved in GED needed to stop a certain behavior.

Controversy surrounding the issue

There is controversy surrounding the use of GED because of the unclear intersection of medical use, ethics, who has the ability to administer the shocks, state supervision and the judiciary system. While Fields’ ruling allows JRC to continue with the aversive therapy, it may be mooted by an FDA proposal to ban the use of electrical stimulation devices to control aggressive or self-injurious behavior.

Beyond the power dynamic between government and health care, many, including the disability rights group ADAPT and the American Civil Liberties Union, oppose GED as inhumane. And, in 2013, a United Nations report by the Special Rapporteur on Torture said the rights of the children treated with GED “have been violated under the UN Convention against Torture and other international standards.”

What does the FDA say about the treatment?

The FDA has previously reported that electroshock therapy, such as GED, can result in physical effects -- burning of the skin, trauma, including contusions, falls, oral injury, and fractures, seizure complications or impacts on the heart.

In 2011 and 2012, the FDA put forth warnings to JRC, saying the center was not following guidelines in regard to GED.

And, in 2016, the FDA put forth a proposal to ban GED, but the rule has yet to be implemented.