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ASPartOfMe
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16 Nov 2022, 10:06 pm

Association for Behavioral Analysis International

Quote:
Position Statement on the Use of CESS
The following position statement was approved by the ABAI Executive Council in November 2022. After a two-week period of commentary by ABAI members, the ABAI Executive Council agreed to offer two position statements for a vote by the Full members, consistent with the ABAI bylaws. Both statements were informed by the CESS Task Force’s report and members’ commentary. Position A opposed the use of CESS except under extraordinary circumstances; Position B opposed the use of CESS under any condition. The two statements were put before the Full membership for a vote in fall 2022. At the end of the three-week voting period, 65% of voting Full members had voted to approve Position B (the statement below). As of November 2022, it is an official position of ABAI

The Association for Behavior Analysis International (ABAI) and its members respect the personal dignity and worth of every human being and affirm each individual’s right to effective behavioral treatment and to freedom from inappropriate, unnecessary, and/or intrusive interventions. Behavior analytic principles constitute the foundation of the professional practice of applied behavior analysis and are essential to ethically sound and effective treatment programs. In accordance with these values, we strongly oppose the use of contingent electric skin shock (CESS) under any condition.

 Our concerns center upon human rights, insufficient evidence demonstrating the efficacy of CESS compared to alternative treatments, a lack of social validity, and consistent cultural considerations being raised by individuals and organizations worldwide. Practices related to the use of CESS have the potential to harm individuals who receive it. The potential for harm is critical to consider when the procedure is applied to vulnerable populations and in a variety of cultural contexts, inside and outside of the United States. We are committed to promoting human rights, creating equitable and safe environments for all individuals, and respecting individual diversity and autonomy of all. As an international membership organization, this position statement is critical and necessary for upholding our commitment to sound ethical practice. This position and rationale are based on a careful review of the relevant evidence, ethical standards, and commentary received regarding the cultural implications, particularly for countries where CESS is illegal.

Limited Supporting Evidence
The science of applied behavior analysis has evolved sufficiently to where the current scientific literature base suggests that function-based interventions, as inspired by functional analysis methodology, are effective in treating severe challenging behaviors.

CESS can suppress behavior; however, as a treatment, it does not address the function of a behavior, and does not support the acquisition of prosocial or adaptive behavioral repertoires. In fact, the short- and long-term emotional side effects and likelihood of trauma produced by the procedure may interfere with the acquisition of such repertoires. The published literature based in applied behavior analysis does not support CESS as an evidence-based treatment. There is limited evidence that the treatment produces long-term maintenance of behavior change, promotes generalization of behavior change to naturalistic conditions, or enhances important quality of life outcomes during or after treatment. Moreover, there are limited studies published on CESS in behavior analytic journals, limited replication studies across multiple sites, and limited studies published by leading researchers with expertise in the assessment and treatment of challenging behavior. Finally, relatively few of those studies were methodologically rigorous or published after the year 2000, given that CESS is not a commonly accepted or socially valid practice. In short, behavior analysts must select interventions based on the current scientific literature.

Other concerning aspects with the implementation of CESS include the fact that its intensity must be increased in order for it to be effective, a technology has not yet been established for the effective withdrawal of treatment, the intervention may produce unwanted emotional side effects that jeopardize clients’ well-being, and contingencies may support misuse by staff. In addition, with a delay intervening between the occurrence of a behavior and the delivery of shock, it is likely that prosocial or adaptive behaviors may be punished.

Relevant Ethical Standards
 There are many ethical issues germane to the use of CESS. A number of professional organizations have articulated such ethical concerns to the ABAI Executive Council and developed position statements regarding the use of CESS. Members of ABAI are bound to the code of ethics for their respective professional disciplines. Common ethical considerations include the following: Do no harm, minimize risks and maximize benefits, protect the welfare of clients, provide treatment within one’s scope of competence, obtain consent and assent for treatment, and implement practices that are based on scientific evidence. Based on these ethical considerations, it is the position of ABAI that CESS is an ethically questionable practice.

Cultural Implications
ABAI supports the growth of behavior science worldwide and commits to including international members. As an international organization, it is essential for ABAI to consider the impact of behavior analytic interventions for different cultures, both within the United States and internationally. ABAI as an organization bears the responsibility to represent international views and standards.

 
The field is evolving towards a compassionate application of behavior analysis, one that endorses humane and dignified practices. In addition to supporting effective and scientifically based interventions, ABAI must support interventions that are ethical, compassionate, and do no harm. Ensuring the protection of the most vulnerable, oppressed, and marginalized populations is paramount for behavior analysts. All practices should consider cultural variables (e.g., race, ethnicity, disability, nationality, gender identity/expression, sexual orientation, socioeconomic status), as well as potential privileges and power dynamics. Not considering these factors may contribute to inequitable or unethical interventions or practices.



ASAN Statement
Quote:
After a vote by the membership of Applied Behavioral Analysis International (ABAI), the governing body of ABA practitioners, ABAI has reversed their position on the use of electric skin shocks for behavior modification. As of today, “[ABAI] strongly oppose[s] the use of contingent electric skin shock (CESS) under any condition.” This is the result of years and decades of advocacy from the autistic community and our allies, bringing attention to ABAI’s continued support of the Judge Rotenberg Center and its use of electric shock torture. 

For years, ABAI has allowed the Judge Rotenberg Center to sponsor their conference and to present on the use of electric shocks. Despite claiming that ABAI does not endorse the practices exhibited at their own conferences, ABAI continued to demonstrate clear support and endorsement for the Judge Rotenberg Center. Last May, ASAN and our grassroots, online and off, protested ABAI and their continued endorsement of torture. An ABAI taskforce looking into the use of electric shocks at the JRC presented their findings and final recommendations in September. The taskforce interviewed four people institutionalized at the JRC who are or were subjected to electric shocks. Despite three out of four people saying that they did not want to be shocked and all four saying that the shocks were painful, the final recommendation of the taskforce was not to oppose electric shocks. This recommendation continued ABAI’s decades-long disregard for the opinions, views and wants of JRC survivors, autistic people, and people with disabilities. While we are glad that the report’s recommendation was not adopted by ABAI, it’s clear that the new position statement is thanks to ABAI’s members, not its leadership. This change in position is too little, too late.

It has taken ABAI decades to oppose the use of torture in their field, decades where they continued to support and air the views of the JRC. In 2012, the United Nations Special Rappoteur on Torture condemned the use of electric shocks, determining that “the rights of the students of the JRC subjected to…electric shock and physical means of restraints have been violated under the UN Convention against Torture and other international standards.” In 2016, the FDA “determined that these devices present an unreasonable and substantial risk of illness or injury.” The disability community has said for decades that this device is harmful and that its use is never justified. It cannot be overstated how delayed this is, how much pain and suffering was experienced at the JRC over the decades that ABAI tacitly endorsed electric shock torture. 

Now that ABAI has finally condemned the use of electric shocks, ASAN asks: What’s next? Will ABAI join us in fighting for a ban on the JRC’s electric shock devices? Will they stop letting the JRC use their conferences to promote torture? Will they confront the use of other aversives, from withholding food to “planned ignoring,” that are common within ABA? Will they change their position that restraint and seclusion may be used as punishments when “necessary or needed”? Will they grapple with ABA’s blatantly abusive origins? Will ABAI meaningfully listen to autistic people and our concerns, and take action?

ABAI’s new position does not change ASAN’s opposition to ABA, or to ABAI, but if ABAI is willing to act, they could assist us in the effort to finally ban electric shock torture. It is important that we apply as much pressure to Congress to ban the device as possible. We hope that now that ABAI has joined the disability community and other major professional organizations including the American Academy of Pediatrics, American Association on Intellectual and Developmental Disabilities, American Academy of Developmental Medicine and Dentistry, International Association for the Scientific Study of Intellectual and Developmental Disabilities, National Association of State Directors of Developmental Disabilities Services, National Association of State Directors of Special Education, and National Association for the Dually Diagnosed in opposing the use of electric shocks, it will take concrete action, as these other groups have. ABAI claims in their statement that “ensuring the protection of the most vulnerable, oppressed, and marginalized populations” is part of their duty. We call on them to take steps to live up to those values by fighting right now to ban electric shock torture.


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CockneyRebel
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16 Nov 2022, 11:10 pm

It's about bloody time.


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