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Disturbing Behavior
COSAC Lobbies NJ Legislators to Prevent
Passage of Bill that would Ban Restraints and Aversives in NJ Schools.
On December 7, 2000, representatives from the NJ
Center for Outreach and Services to the Autism Community (COSAC) lobbied the
Education Committee of the New Jersey State Assembly in an effort to prevent
passage of the current form of a bill that would ban the use of restraints and
aversive techniques in schools. COSAC claimed to support the spirit of the bill,
but urged the legislators not to pass it without changing its language.
Apparently, COSAC believes that banning the use of restraints and aversives
would deprive some autistic children of their "right to receive effective
behavioral treatment." In its testimony, shown in its entirety at the
bottom of this page, COSAC denies that it
is "representing the interests of any particular provider agency or group of
provider agencies," but rather "the best interests of children and
adults living with autism and their families."
In Our Opinion
It
is the opinion of The Asperger's Express that the existence of COSAC's
heavily marketed Parent Series on Behavioral Intervention, its professional
counterpart The XYZ's of Behavioral Intervention, and the glowing terms with
which it describes ABA as the treatment of choice for individuals with autism
render its two statements, above, synonymous. Given that COSAC believes that
"the vast
majority of individuals with autism will benefit most from intervention that
utilizes a clinically-sound and comprehensive behavioral approach,"
it is impossible for us not to conclude that, in COSAC's view of the autism
spectrum, the best interests of children and adults living with autism and the
best interests of a certain "group of provider agencies" are the
same.
COSAC states, on its
web site, that "the behavioral treatment approach has received the most
support from the research literature," echoing similar claims often
made by providers of behavior modification programs on their own sites and in
their marketing materials. However, in Part 8 Chapter 31 of its recently
published Clinical
Practice Guidelines, the Interdisciplinary Council on Developmental and
Learning Disorders casts considerable doubt on the validity of such claims, as
have many other professionals.
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Although we are pleased to hear that
COSAC has recently made some effort to acknowledge the existence of
alternatives to behaviorism, The Asperger's Express believes that COSAC remains firmly convinced that Applied Behavior
Analysis is the only intervention for autism worthy of merit. Given its
strong ties to the ABA industry, including NJ's Eden Institute, we are dismayed though not surprised at
COSAC's opposition to a bill that would place restrictions on that
industry.
Proponents of restraints and aversives
would like us all to believe that they are used in behavioral programs to prevent an autistic child from injuring him or herself or
injuring others in the classroom. This is considerably less than the
whole truth. Restraints and
aversives can be and have been used in both public and private special
education programs in response to far less serious "challenging
behaviors" such as failing to keep both feet on the floor while
seated, refusing to eat when commanded, throwing papers on the floor,
and other "non-compliant behaviors." While The Asperger's
Express does not believe that COSAC specifically advocates the use of
restraints and aversives, we take exception to its use of the term
"restrictive procedures" to describe them as well as the
phrase "temporary discomfort" to describe their effects.
artwork
courtesy of CIBRA
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Not for the
fainthearted. Some examples of how children have been
traumatized, injured, and occasionally killed by the use of restraints
and aversives can be found at the CIBRA
(Children Injured By Restraints and Aversives) web site. We encourage
our readers to visit the Autism National
Committee's review of David Holmes book, Autism Through
the Lifespan: The Eden Model, to get an idea of what types of
"challenging behaviors" merit aversive intervention at this New
Jersey institution.
Here is the text of COSAC's testimony before
the Education Committee.
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Assembly
Education Committee
Testimony of COSAC on A-2540
December 7, 2000
Good afternoon, Chairman Wolfe and
members of the committee. Thank you for the opportunity to provide our
comments. My name is Brenna Fach and I am the Coordinator of Government
Affairs for the New Jersey Center for Outreach and Services for the
Autism Community, COSAC. I am joined by Dr. Suzanne Buchanan, COSAC’s
Director of Clinical Services, who is willing to answer questions that
you may have about behavioral intervention. I am also joined by
COSAC’s Executive Director, Paul Potito, who will share some comments
with you from a parent after I address some of our agency’s concerns
with A-2540.
First, let me preface my statements by explaining that we are not here
representing the interests of any particular provider agency or group of
provider agencies. COSAC represents the best interests of children and
adults living with autism and their families.
We would like to thank the sponsors of this legislation, Assemblywoman
Cruz-Perez and Assemblyman Melvin Cottrell, for their interest in
providing safe learning environments for children with autism. COSAC strongly
supports the intent of A-2540. The intent of this legislation is to
protect children with autism; to ensure that they are treated with the
dignity and respect that is afforded to all children. However, we feel
that the current language of the bill will NOT meet this
intent. COSAC is concerned that the language of A-2540 is too broad and
will impede the right of children with autism to receive effective
behavioral treatment.
I would like to specifically address the possible repercussions this
bill will have on the treatment of children with autism. Children with
autism who engage in challenging behavior, self-injury included, deserve
the most positive and effective treatments available. Professionals who
treat children with autism must always consider positive treatment
approaches first.
Unfortunately, in a minority of situations, positive approaches are not
always effective in decreasing some children’s challenging behaviors.
In extreme cases where the child is likely to severely injury himself or
others and positive approaches have been completely exhausted,
professionals and parents may decide that more restrictive procedures
are warranted. Very often these techniques elicit a negative
emotional response from the child. However, the treatment team is
responsible for evaluating whether the child’s temporary discomfort is
worse than allowing his challenging behavior to continue. The goal is to
effectively and safely reduce the challenging behavior thereby affording
the child the opportunity to meet his goals as outlined in his
educational plan. Whatever option the treatment team chooses, they must
always consider the child’s safety first and continually communicate
with the child’s parents about the effectiveness of the procedure. The
enactment of A-2540 will eliminate the use of restrictive procedures
thereby limiting the options that parents have in considering the
best treatment for their child with challenging behaviors.
COSAC is aware that all of the conditions that we recommend in the
treatment of a child with challenging behaviors are not always met by
treatment professionals and educators. We believe this is a result of
the current lack of state-mandated guidelines regarding the use of
restrictive procedures for both private and public school programs that
serve children with autism.
To illustrate this point, I spoke to a mother yesterday morning that was
in the process of enrolling her daughter with autism in a private school
program. A condition of her daughter’s admission was the parent’s
signature on a release form that stated that the program was permitted
to use restraints in the treatment of her daughter. The school did
not give her any reasons for the use of restraints or any conditions on
how and in what instances the restraints would be used. One of the major
problems in this situation, and many other similar experiences of
families, is the lack of communication between the school and parents
regarding the use of restrictive procedures. This lack of communication
ultimately leaves parents feeling uncomfortable with the use of these
procedures.
However, the solution to reducing the parent’s discomfort is not to
completely outlaw the use of restrictive procedures. Rather, COSAC
recommends that all schools that serve children with autism follow
mandated guidelines and procedures for the development, implementation
and evaluation of each child’s behavior modification plan. An example
of appropriate guidelines is the Division of Developmental
Disabilities’ Circular 34 entitled “Behavior Modification
Programming”. In addition to mandated guidelines, schools must include
the parents of the child in every aspect of their child’s treatment.
The parents must be involved in developing their child’s behavioral
plan, in giving consent to its implementation, and in evaluating the
effectiveness of the plan.
Due the concerns that I have outlined above, COSAC would sincerely
appreciate the opportunity to meet with the sponsors of A-2540, parents
of children with autism, and treatment professionals to discuss
legislation that would more effectively addresses parental concerns
without eliminating educational treatment options that have been
effective and continue to be effective in treating the minority of
children with autism whose behaviors require restrictive procedures.
Therefore, on behalf of COSAC and the community that we serve, we
respectfully urge this committee to hold A-2540. Thank you again for the
opportunity to provide our comments. |
The text of Assembly Bill 2540 appears below.
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ASSEMBLY, No. 2540
INTRODUCED JUNE 1, 2000
Any treatment
option or teaching method that exhibits some or all of the following
shall be discontinued: obvious signs of physical or emotional pain
experienced by the pupil; potential or actual side effects, such as
tissue damage, physical illness, severe physical or emotional
stress-effects which would properly require the involvement of medical
personnel; ambivalence and discomfort by the pupil, family, staff, or
care givers regarding the necessity of extreme strategies; and obvious
stress felt by the peers of the pupil exhibiting the behavior. |
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