Monthly Archive for June, 2006

What is insubordination?

Published
by
JohnL
on 30 June 2006
in Musings and News
. 3 Comments

If you teach, administer, or are simply concerned about special education and you haven’t been following Miss Dennis’ accounts of teaching in the Bronx, you owe it to yourself to scurry on over to Your Mama’s Mad Tedious and catch up. That’s a link to her blog over there in the list on the sidebar under “blogroll.”

Earlier this year, Miss Dennis reported that she wouldn’t prepare IEPs for students whom she didn’t teach. It made sense to me (and I thought I’d put an entry here or over on Teach Effectively, but I can’t find it).

Now, Miss Dennis reports that her supervisor charged her with insubordination because of her action. The story provides a fascinating commentary on teaching special education. Just what is insubordination? When should someone agree to do something inappropriate?

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Two follow-ups

Published
by
JohnL
on 29 June 2006
in News
. 0 Comments

(1) There is another report in the case of the Conroe (TX, US) suit to which I referred in the entry “school safety” a few days ago. Attorney Michael Josephson, the lawyer for a girl with Emotional and Behavioral Disorders who is one of several girls sexually assaulted on school grounds, “says she now suffers severe and disabling emotional disturbance and needs special educational supervision,” according to a story reported by KGBT. I suspect that the KGBT coverage is based on the earlier story and is just slightly mis-representing it. It would be odd for Mr. Johnson to argue that the school owed the girl protection as a result of her disability and then to argue that the assault caused the disability. I’m enquiring….

(2) I’ve seen nothing added to the new EBD blog. Here’s hoping they return to posting entries.

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Effective autism treatments

Published
by
JohnL
on 27 June 2006
in Autism, News and Research
. 0 Comments

For those who wonder about such things, especially in light of the flaps over (a) facilitated communication (see statement on SpedPro) and (b) the Judge Rotenberg Center (see earlier post on EBD Blog), there are some well-documented procedures for treating autism. The US National Academy of Sciences has published a monograph detailing these procedures and the evidence supporting them. One can get a copy of the monograph from the National Academy Press site.

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Is this shocking?

Published
by
JohnL
on 26 June 2006
in Autism, News and Policy
. 0 Comments

Technical note about “punishment”: If the frequency of a behavior descreases over time when a specific event (the shock, in this case) immediately and consistently follows it, then the event is considered a punisher and the procedure is called punishment. Punishment occurs in the natural environment: The behavior of placing one’s hand on a hot stove is punished by the consequence of doing so. Spanking, although considered punishment in lay terms, rarely is a punishment in psychological terms, because it is rarely administered contingently (consistently and immediately after a specific behavior). Faradic aversive conditioning is used in other therapies, such as some stop-smoking clinics and alcohol aversion treatments. (It is called “Faradic” after Michael Faraday, a researcher who discovered electromagnetic induction in the 1830s.)

The Judge Rotenberg Educational Center in Canton (MA, US) has come into the news recently, apparently regarding its use of Faradic aversive conditioning in the treatment of autism. Faradic aversive conditioning is the administration of an electric shock contingent on the performance of a specific behavior and the center uses it to eliminate dangerous behaviors such as self-injury (biting, hitting, banging one’s head, etc.). Faradic aversive conditioning is a procedure that reduces the frequency of the behavior. Thus, it is a punishment in the psychological sense, not the everyday sense of the word.

The Judge Rotenberg Center, led by Matthew Israel, uses what it calls a “graduated electronic decelerator” that delivers a shock of about 3-11 milliamps for about 2 seconds, similar to what one would get from a few flashlight batteries. The center uses these aversives with approximately 50% of its residents when less-punitive measures have failed to reduce their problem behavior, and it uses them in accord with precisely defined policies that have been approved by parents and courts.

Still, the very term “shock” is enough to frighten some people and when it is combined with “therapy” and “autism,” the concept evokes strong reactions. Glance over the headlines I’ve provided in the links at the end of this entry to get a sense of how the press uses sensational language in its coverage of the story. However, here’s the way Ken Maguire, Associated Press writer who published a carefully researched and worded background piece, characterized reactions to the terms:

Hear about shock therapy and what pops to mind are scenes out of the movie “One Flew Over the Cuckoo’s Nest.” But the skin shocks are not electroconvulsive therapy, which began in the 1930s as a way to treat schizophrenia.

Mr. Israel’s program and the Judge Rotenberg Center have been the focus of attacks in the past—Mr. Maguire’s story was published under the headline, “Canton school’s shock therapy comes under fire — yet again.” In fact, the center is funded in part by money Mr. Israel obtained from lawsuits against people and agencies that used false information in efforts to close the school in the 1970s and 80s.

Questions about using aversive procedures have been debated extensively in the special education and psychology literature. I’ve appended a reference to a very thorough discussion of both sides of the issue for those who are willing to examine it calmly; even if one has a predisposition to argue for or against the use of Faradic aversive conditioning and other aversive, there are worthwhile chapters in the book edited by A. Repp and N. Singh.

Also, for the rational, the Boston (MA, US) Globe published a sensible editorial 23 June about the controversy. It takes a reasoned approach to the aversives issue but raises legitimate questions about another matter (staff licenses). The editorial predates more recent allegations that some residents at the Judge Rotenburg Center have burns; these allegations are not yet substantiated and it will be important to get the facts about them before condeming or defending the center on that count.

Repp, A. C., & Singh, N. N. (Eds.). (1990). Perspectives on the use of nonaversive and aversive interventions for persons with developmental disabilities. Sycamore, IL: Sycamore.

Link to Mr. Maguire’s article, as printed in the Boston Globe. Links to other news coverage on this story:

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School safety

Published
by
JohnL
on 26 June 2006
in News and Policy
. 0 Comments

A former police officer named Donald P. Mauro was convicted on 18 counts of sexual assault in June 2005 after four students said he had sexual contact with them on the campus of a Conroe (TX, US) school. According to a story by Renée C. Lee in the Houston Chronicle, attorney Michael Josephson has amended a law suit brought on behalf of one of the students and her parents against Mr. Mauro to name the local education agency as a defendant, too. The suit alleges that the LEA failed in its duty to follow a feature of the girl’s Individualized Education Plan.

Josephson said his client required a special education plan because she suffers from a severe and disabling emotional disturbance. The plan called for her to be monitored at all times and escorted to her classes by educational staff, he said.

Link to Ms. Lee’s story.

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EBD in GB

Published
by
JohnL
on 25 June 2006
in News, Policy and Research
. 0 Comments

The British Medical Association (BMA) issued a report 20 June 2006 about the mental health of children and youths in Great Britan. News coverage of the report by Sarah Hall of the Guardian emphasized findings that the prevalence of emotional and Behavioral Disorders has doubled to ~10%.

The report, Child and Adolescent Mental Health, reveals that 9.6% of children aged between five and 16 experience some kind of mental health disorder such as eating, emotional or behavioural problems. The study finds that in the 11-16 age group, 12.6% of boys and 10% of girls suffer from a mental disorder.

The report itself provides no new data about mental health, but summarizes data from other studies and integrates them to develop policy recommendations. In addition to examining earlier studies and reports on prevalence and risk factors, health inequalities, barriers to receiving treatment, strategies for improving care (in England, Scotland, Wales, and Northern Ireland), multi-agency collaboration (what US readers would call “wraparound services”), and methods for promoting good mental health. The report’s conclusion and recommendations are worth noting.

  • Recommendations
    • Government policies and strategies that are currently being implemented, such as ‘Every child matters’, ‘Choosing health’ and the national service frameworks, must be fully monitored, and data collected and analysed to ensure that they are effective and addressing need. This information should be made publicly available and accessible.
  • Child and adolescent mental health services
    • The government must address the current shortage of mental healthcare professionals.
    • There must be adequate funding for CAMHS to ensure that they are properly resourced and staffed.
    • Innovative services are needed to meet the needs of young people, and access to such services must be improved. Examples include a range of venues that differ from the traditional clinical setting, and easy access to a mixture of services.
  • Multi-agency working
    • It is essential that all professionals providing CAMHS receive adequate training and support enabling them to work effectively together. Measures that have already been taken to implement multi-agency working must be continued and extended. Governments need to ensure that the resources, including training in the healthcare information technology system, are available to allow this to happen.
  • Mental health inequalities
    • The provision of appropriate mental health services to 16 and 17 year olds must be improved. Young people should not be receiving adult care when they are not mature enough to do so. CAMHS should be extended to encompass this age group in all areas.
    • Collaboration between CAMHS and AMHS must continue and improve to ensure a smooth transition to adult services.
    • The provision of mental health services to looked after children and young people must be improved. CAMHS professionals and registered carers need training in order to support these groups in their particular needs.
    • The current inadequacy of mental health services for children and young people with learning disabilities must be addressed.
    • The reforms outlined in the Child Poverty Review must be implemented to end child deprivation and therefore reduce risk factors for mental health problems.
    • Current inequalities in mental healthcare experienced by BME groups must be tackled:
      • initiatives set out by NIMHE and DH must be properly implemented
      • healthcare professionals and providers of CAMHS should receive training in cultural values and beliefs, to enable them to care for children and young people from BME backgrounds more effectively. Language translation services must be available
      • racism within mental health services must be tackled and eliminated.
    • Barriers to receiving healthcare faced by asylum seeker and refugee children must be addressed.
    • Actions must be taken to improve access to mental health services in young offender institutions, and to tackle the high rate of suicide among young offenders.
    • In addition to the above, CAMHS in Northern Ireland must be reformed and modernised, in line with current policy recommendations, to address gaps in provision.
  • Mental health promotion
    • There is a need to improve public knowledge and understanding of mental health.
    • There should be better provision and dissemination of information about mental health aimed at children and young people, appropriate to different age ranges. This should include information about what different mental health problems are, how and where to access help and support, what different mental health professionals do, and what treatments entail. Information should be presented in a variety of media that appeal to children and young people, and in different languages.
    • The media should be encouraged to show those with mental health problems in a positive light, including children and young people.
    • There is a need for more and better mental health promotion to BME groups in order to address health inequalities.
    • Current strategies to address stigma and discrimination against those with mental health problems must be fully implemented. They should be monitored to ensure that they are adequate and effective.

Link to the BMA report and to Ms. Hall’s story.

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