Shock Therapy Is at Issue In Two Michigan Lawsuits
In a pair of cases attracting national attention, the families of two severely handicapped Michigan children are trying to force their local school districts to permit the youngsters to wear a controversial electric-shock device to curb their head-banging behavior.
The school districts have, thus far, been reluctant, citing concerns about the device's effectiveness and raising the broader question of the use of techniques that use physical punishment to correct behavior.
The device at issue is known as the Self-Injurious Behavior Modification System, or sibis. Worn on the head, it administers a shock of up to 84.4 volts when the wearer bangs his head.
The children's families contend that sibis is their last, best hope for curbing the youngsters' head-banging behavior. They say that gentler behavior-modification techniques have failed and that the children are in danger of seriously injuring--or even killing--themselves.
But the school systems claim that the effectiveness of the device is still unproved. Moreover, they contend that a new state law banning corporal punishment in schools also prohibits them from allowing students to receive electric shocks.
And, until all other behavior-modification methods have been exhausted, school officials say, they will not permit the device to be worn in school.
"The question philosophically," said George Bell, superintendent of the Northville school district, which is involved in one of the cases, "is whether you inflict that kind of punishment on any developmentally disabled child--or any other person or animal, for that matter."
The cases are thought to be the first to explore the use of sibis in a public school. Marketed since 1987, only 33 of the devices are in use around the country, according to a lawyer for the children.
More important, a number of special educators and mental-health experts note, the cases spotlight a larger national debate raging over the use of a wide range of "aversive therapy" techniques that use physical punishment to modify behavior. Such methods include the use of such noxious fumes as ammonia, the force-feeding of such substances as Tabasco sauce, and the use of painfully loud noises.
"Symbolically, sibis has come to stand for whether or not aversives can be used with very serious and, in some cases, life-threatening behaviors," said Martha Snell, president of The Association for Severely Handicapped Persons (tash). "I think these cases have a lot of significance nationally."
"This debate," Mr. Bell concluded, "is as big as the abortion debate."
Decision Expected Soon
The more active of the two Michigan cases involves Terry Phelan, a 15-year-old Northville boy who bangs his head more than twice a second.
Richard Landau, the lawyer who represents both children, said that school special educators and therapists have tried a variety of means to curb the boy's head-banging.
They have used medication, positive-reinforcement techniques, and restraining splints--all with limited success.
In clinical trials with sibis, the boy's head-banging behavior was slowed to a rate of no more than twice a minute, according to Mr. Landau. He speculated that prolonged use of the device could reduce the rate further.
Special educators at the Bryant Center, where Terry attends school, initially agreed to a request by the boy's mother to try sibis, and wrote a behavioral plan for using the device. But they were overruled by another school committee set up to review human-rights matters.
The Phelans sued. But a federal judge dismissed the lawsuit and directed the family to first exhaust other administrative remedies before appealing to the federal court.
As a result, the case has been in a state administrative hearing since November, and lawyers on both sides said they do not expect a decision until next month.
In the meantime, Mr. Landau said he plans to ask a federal judge this week for a preliminary injunction permitting the boy to wear the device in school until the case is settled.
The second case, which is pending in federal court, paints the issue in much starker terms. In that case, Mr. Landau says, 7-year-old Amber Van Duser of Flint could die if she hits her head the wrong way.
Amber has hydrocephalus, and has a shunt in her brain to drain excess fluid. If the shunt is dislodged by a blow to the head, the child could die within hours without emergency surgery, according to Mr. Landau.
For now, the Genesee Independent School District, where Amber attends school, has agreed to allow the girl to wear the device. But Mr. Landau said he plans to press school officials for a permanent guarantee.
Beyond the human-rights questions involved, a much-debated topic in the proceedings has been the device's effectiveness.
Experts such as Ms. Snell said studies so far have shown only that sibis works for short periods of time.
But that claim is disputed by both sibis's manufacturer, Human Technologies Inc., and Mr. Landau.
Michael Hazel, the company president, said the electrical stimulations given off by sibis, which he likened to the feeling induced by the snap of a rubber band, have helped "100 percent of the wearers reduce their self-destructive behaviors by greater than 90 percent."
"I would call that successful," he added.
Mr. Hazel said an upcoming report in the reputable Journal of Applied Behavior Analysis will also document five cases in which the device has helped young people curb self-injurious behavior.
Ms. Snell, who is also a professor of education at the University of Virginia's Curry School of Education, also raised concerns about the safety of sibis.
"You can't really tell when the child is being shocked, whether the child could be receiving shocks for other behaviors, or if the device is malfunctioning," she said.
Ms. Snell's group was among a coalition of national special-education and advocacy groups that unsuccessfully lobbied the U.S. Food and Drug Administration in 1988 to take the device off the market.