Aversive therapy is the most controversial treatment available for individuals with autism. This therapy involves the use of electric shock as a response to mal-adaptive behaviors. When the individual with autism is plagued with behaviors which hinder their safety and the safety of others, aversive therapy is sometimes recommended as a last resort treatment. The aggressive nature of the treatment has drawn the criticism of many reputable treatment centers and professionals, as well as parents and other community members. Despite these criticisms, there are parents and professionals who stand by aversive therapy as their treatment lifeline.
There are far fewer centers which offer aversion therapy than those which offer more widely accepted behavioral intervention services. One reason for this is that it is reserved for only the most severe cases. The ethical standard of treating any person, physically or psychologically, is that the treatment benefits must not harm the person, and it must improve their quality of life. It must not be merely experimental with risk of these things. In some very severe cases, behaviors associated with autism may hinder not only the quality of life or the person with autism, but also his or her physical safety and that of others. Self-injuring behaviors, such as biting or head-banging can seriously injure a person with impulsive tendencies to do them. These behaviors can also be assaultive, which can endanger others. In these extreme cases, when all other interventions have failed to improve these behaviors, aversion therapy treatment may be sought as a solution. When the person is exposed to a light shock, an aversion to the mal-adaptive behavior associated with the shock is developed.
Many treatment centers have stalled their programs in the last year as the leading center for aversion therapy for students with autism has fallen under scrutiny. The Judge Rotenberg Educational Center in Massachusetts was the leading center for aversion therapy until 2011 when they were accused of abusing students and misusing the therapy. Other centers have quietly halted treatment and only a few reserve it for extreme cases. These centers are only available with a medical referral, typically by a neurologist and psychiatrist. In California, UCLA provides this therapy under strict medical supervision.
Aversion Therapy Costs
Costs associated with aversion therapy for individuals with autism can be as high as $220,000 per year. This is determined by the involvement of external programs, frequency of treatment and other factors. Currently, costs are not covered under major insurance carriers. The major reason for the high cost is level of physician expertise and liability coverage.
Those who do advocate the validity of autism aversion therapy maintain that it should only be administered in a clinical setting. The Judge Rotenberg Educational Center is deemed by nearly all credible experts as an inappropriate setting for aversion therapy. In this case, staff was not properly trained and students did not receive proper administration of the treatment. The incidents prompted an internationally raised eyebrow, as well as a UN investigation and ultimate call for banning the procedure altogether. Several states took up litigation causes to attempt to ban the practice of aversion therapy for individuals with autism. It should be noted that aversion therapy is considered a viable treatment for behavioral disorders not related to autism, such as addiction. There is little social resistance to the use of these methods to treat addiction, whereas it is nearly a consensus opinion that it is abuse for those with autism.
Aversion therapy for individuals with autism should be considered as a last resort. If this is the case, a team of medical professionals provide the best consultants to find a center for treatment. Despite the high cost and controversy, aversion therapy is extremely effective in addressing dangerous behaviors.
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I’d disagree that aversives are occasionally appropriate, or that the JRC was a rotten apple somehow distinct from “good” aversive programs.
The UN has classified _all_ painful aversives as torture, and urged a federal ban.
Human nature is, unfortunately, such, that any such programs will invariably result in abuse. The grim credo of behaviorism excludes all thoughts and feelings, and focuses exclusively on actions. This has the inevitable result of causing horrendous psychological damage (as staff are not allowed to care), not to mention the physical damage due to shocks more powerful than Tasers.
It is worth mentioning that many more behaviours are punished than simply the harmful behaviours, as these are seen as “pre-cursors” to the harmful behaviour (in the JRC’s case: speaking at the wrong time, nagging, failing to answer questions quickly and using an inappropriate tone of voice are all punished).
“Patients” on such programs live in constant fear of debilitating pain for very minor infractions. And that is if it is done right. No civilised society can condone such a thing.
Paul You are 100% right. Our job is to educate people for advantages and disadvantages of a particular therapy.