Abstract
In an effort to address the controversy regarding the use of aversive interventions in the treatment of individuals with developmental disabilities, this paper presents a review of the literature on the efficacy of such interventions, along with brief reviews of the ethical and legal issues involved. In general, there appears to be empirical, ethical, and legal support for the continued availability of aversive interventions as treatment options, but only if sufficient safeguards are in place.
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References
American Association on Mental Retardation. (1966).Position statement on aversive therapy. Washington, DC: Author.
American Psychological Association Division 33. (1989). Guidelines on the effective behavioral treatment for persions with mental retardation and developmental disabilities.Psychology in Mental Retardation, 14, 3–4.
Association of Retarded Citizens/United States. (1985).Resolution on use of aversives. Washington, DC: Author.
Association for Persons with Severe Handicaps. (1986).TASH resolution on the cessation of intrusive interventions. Alexandria, VA: Author.
Autism Society of America (1988).Resolution on abusive treatment and neglect. Washington, DC: Author.
Azrin, N. H., & Holz, W. C. (1966). Punishment. In W. K. Honig (Ed.),Operant behavior: Areas of research and application. New York: Appleton-Century-Crofts.
Bailey, J. S., & Pyles, D. A. M. (1989). Behavioral Diagnostics. In E. Cipani (Ed.),The treatment of severe behavior disorders: Behavioral analysis approaches (pp. 85–107). Washington, DC: American Association on Mental Retardation.
Bailey, S. L. (1983). Extraneous aversives. In S. Axelrod & J. Apsche (Eds.),The effects of punishment on human behavior (pp. 247–284). New York: Academic Press.
Beyer, H. A. (1983). Litigation with the mentally retarded. In J. L. Matson & J. A. Mulick (Eds.).The handbook of mental retardation (pp. 79–96). New York: Pergamon.
Carr, E. G., Robinson, S., Taylor, J. C., & Carlson, J. I. (1990).Positive approaches to the treatment of severe behavior problems in persons with developmental disabilities: A review and analysis of reinforcement and stimulus based procedures. Seattle, WA: Association for Persons with Severe Handicaps.
DiLorenzo, T. M., & Ollendick, T. H. (1986). Behavior modification: Punishment. In R. P. Barrett (Ed.),Severe behavior disorders in the mentally retarded: Nondrug approaches to treatment (pp. 27–60). New York: Plenum Press.
Dunlap, G., & Plienis, A. J. (1988). Generalization and maintenance of unsupervised responding via remote contingencies. In R. H. Homer, G. Dunlap, & R. L. Koegel (Eds.),Generalization and maintenance: Life-style changes in applied settings (pp. 121–142). Baltimore: Paul H. Brookes.
Ellis, J. W. (1982). The supreme court and institutions: A comment on Youngberg v. Romeo.Mental Retardation, 20, 197–200.
Favell, J. E., & Reid, D. H. (1988). Generalizing and maintaining improvement in problem behavior. In R. H. Horner, G. Dunlap, & R. L. Koegel (Eds.),Generalization and maintenance: Life-style changes in applied settings (pp. 171–196). Baltimore: Paul H. Brookes.
Favell, J. E., Azrin, N. H., Baumeister, A. A., Carr, E. G., Dorsey, M. F., Forehand, R., Foxx, R. M., Lovass, I. O., Rincover, A., Risley, T. R., Romanczyk, R. G., Russo, D. C., Schroeder, S. R., & Solnick, J. V. (1982). Association for Advancement of Behavior Therapy Task Force Report: The treatment of self injurious behavior (Monograph).Behavior Therapy, 13, 529–554.
Foxx, R. M., (1988, April).A reconceptualization of the least restrictive model: Moving from aversive to nonaversive. Paper presented at the AuClair Conference, Valley Forge, PA.
Foxx, R. M., & Livesay, J. (1984). Maintenance of response suppression following overcorrection: A 10-year retrospective examination of eight cases.Analysis and Intervention in Developmental Disabilities, 4, 65–69.
Freidman, P. R. (1975). Legal regulation of applied behavior analysis in mental institutions and prisons.Arizona Law Review, 17, 39–104.
Gardner, W. I. (1989). But in the meantime: A client perspective of the debate over the use of aversive/intrusive therapy procedures.Behavior Therapist, 12, 179–181.
Gerhardt, P. F., & Holmes, D. L. (1990).The Eden Decision Model: A theoretical model with practical applications for the development of behavior declerative strategies. Unpublished manuscript.
Griffith, R. G. (1983). The administrative issues: An ethical and legal perspective. In S. Axelrod & J. Apsche (Eds.),The effects of punishment on human behavior (pp. 317–338). New York: Academic Press.
Groden, G. (1989). A guide for conducting a comprehensive behavior analysis of a target behavior.Journal of Behavior Therapy and Experimental Psychiatry, 20, 163–169.
Guess, D., Helmstetter, E., Turnbull, R. E., & Knowlton, S. (1987).Use of aversive procedures with individuals who are disabled: A historical review and critical analysis. Seattle, WA: Association for Persons with Severe Handicaps.
Handleman, J. S., & Harris, S. L. (1986).Educating the developmentally disabled: Meeting the needs of children and families. San Diego, CA: College Hill.
Handleman, J. S., Gill, M. J., & Alessandri, M. (1988). Generalization by severely developmentally disabled children: Issues, advances and future directions. Behavior Therapist, 11, 221–223.
Herr, S. S. (1990). The law on aversive and nonaversive behavioral interventions. In S. L. Harris & J. S. Handleman (Eds.),Aversive and nonaversive interventions: Controlling life threatening behavior by the developmentally disabled (pp. 80–118). New York: Springer.
Holmes, D. L. (1990). In re: Aversive procedures [Letter to the editor].Behavior Therapist, 13, 30, 32.
Holmes, D. L., & Gerhardt, P. F. (1989). Association of private schools supports the controlled use of therapeutic punishment.Links, 14, 8–9.
Horner, R. (1990). Ideology, technology, and typical community settings: Use of severe aversive stimuli.American Journal on Mental Retardation, 95, 166–168.
Konarski, E. A., Jr. (1990). Science as an ineffective white knight.American Journal on Mental Retardation, 95, 169–171.
Lavigna, G. W., & Donnellan, A. M. (1986).Alternatives to punishment: Solving behavior problems with nonaversive strategies. Los Angeles, CA: Irvington.
Lovaas, O. I., & Favell, J. E. (1987). Protection for clients undergoing aversive/restrictive interventions.Education and Treatment of Children, 10, 311–325.
Lovaas, O. I., Koegel, R., Simmons, J. Q., & Long, J. S. (1973). Some generalization and follow up measures on autistic children in behavior therapy.Journal of Applied Behavior Analysis, 6, 131–166.
Matson, J. M., & DiLorenzo, T. M. (1984).Punishment and its alternatives: New perspectives for behavior modification. New York: Springer.
Matson, J. E., & Taras, M. E. (1989). A 20 year review of punishment and alternative methods to treat problem behaviors in developmentally delayed persons.Research in Developmental Disabilities, 10, 85–104.
Meinhold, P. M., & Mulick, J. A. (1990). Risks, choices and behavioral treatment.Behavioral Residential Treatment, 5, 29–44.
Meyer, L. (1989, May). Settlement reached in BRI case.TASH Newsletter, pp. 1–2.
Meyer, L. H., & Evans, I. M. (1989).Nonaversive intervention for behavior problems: A manual for home and community. Baltimore: Paul H. Brookes.
Mulick, J. A. (1990). The ideology and science of punishment in mental retardation.American Journal of Retardation, 95, 142–156.
National Institutes of Health. (1989). Treatment of Destructive behaviors in persons with developmental disabilities.NIH Consensus Development Conference Statement, 7, 9.
Newsome, C., Favell, J., & Rincover, A. (1983). The side effects of punishment. In S. Axelrod & J. Apsche (Eds.),The effects of punishment on human behavior (pp. 285–316). New York: Academic Press.
Powers, M. D., & Handleman, J. S. (1984).Behavioral assessment of severe developmental disabilities. Rockville, MD: Aspen.
Rush, F. R., & Schutz, R. P. (1981). Vocational and social work behavior: An evaluative review. In J. L. Matson & J. R. McCartney (Eds.),Handbook of behavior modification with the mentally retarded (pp. 247–280). New York: Plenum Press.
Scibak, P. (1983). Behavioral treatment. In J. M. Matson & J. A. Mulick (Eds.),Handbook of Mental Retardation (pp. 339–350). New York: Pergamon.
Seiden, S. B., & Zirkel, P. A. (1988). Commentary: Aversive therapy for handicapped students.West's Education Law Reporter, 48, 1029–1044.
Stokes, T. F., & Baer, D. M. (1977). An implicit technology of generalization.Journal of Applied Behavior Analysis, 10, 349–367.
Touchette, P. E., MacDonald, R. F., & Langer, S. N. (1985). A scatter plot for identifying stimulus control of a problem behavior.Journal of Applied Behavior Analysis, 18, 343–351.
Turnbull, H. R., Guess, D., Backus, L. H., Barber, P. A., Fiedler, C. R., Helmstetter, E., & Summers, J. A. (1986). A model for analyzing the moral aspects of special education and behavioral interventions: The moral aspects of aversive procedures. In P. R. Dokecki & R. M. Zanner (Eds.),Ethics of dealing with persons with severe handicaps: toward a research agenda (pp. 167–210). Baltimore, MD: Paul H. Brookes.
Van Houten, R., Axelrod, S., Bailey, J. S., Favell, J. E., Foxx, R. E., Iwata, B. A., & Lovaas, O. I. (1988). The right to effective behavioral treatment.Journal of Applied Behavior Analysis, 21, 381–384.
Wyatt v. Stickney, 344 F. Supp. 373, 344 F. Supp. 387 (M.D. Ala. 1972) aff'd sub nom. Wyatt v. Aderholt, 503 F.2d. 1305 (5th Cir. 1974).
Youngberg v. Romeo, 102 S.Ct. 2452 (1982).
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The authors acknowledge Thomas Boyle for his insightful contributions to this manuscript. In addition, a special thanks is extended to the Eden Family of Programs' staff and participants and their families.
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Gerhardt, P., Holmes, D.L., Alessandri, M. et al. Social policy on the use of aversive interventions: Empirical, ethical, and legal considerations. J Autism Dev Disord 21, 265–277 (1991). https://doi.org/10.1007/BF02207323
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DOI: https://doi.org/10.1007/BF02207323