Poland

Radical Behaviorists spreading the "gospel" according to Darwin and B.F. Skinner Mothers Defeat Behaviorists in Polish Rebellion

Group Against Violence in Autistic People Therapy Aversive treatment is under seige at Poland's autism centers thanks to a dedicated group of mothers and professionals seeking humane treatment for autistic children. The group, which is affiliated with the Gdansk branch of KTA (National Autism Society) published an appeal against aversive procedures at a 1999 Warsaw conference. In 2001 they organized a scientific session "violence in therapy of autistic people" in Gdynia. ------The following is an excerpt from an email we received from one of these courageous mothers: "We are also prepared for press publications concerned with this subject and we presented the problem to the authorities coordinating work of the centers for autistic people in Gdansk and Gdynia, which resulted in control of both centers and prohibition of the use of aversion procedures. -------------We introduced this subject to the only one internet discussion/autism forum in Poland. We hope that people using violence in therapy do not feel untouchable any more."

Too Tied Corset--The Voice in the Discussion with Applying the Aversive Procedure at Autistic Children Therapy ----------by Ewa Szmytkowska and Anna Dobrowolska (Translated from Polish by Joanna Mieczkowska) 1. Kuba----------------Kuba is a nice 12 -years old boy. He has been student integrity class in regular school.---------------------------------------------------------------------------------------------------------------------- This is really important reason to be proud for him and his parents. Kuba is an autistic child. Hanka, Kuba's mother, shows teacher's opinion: "During past semester boy participated (with all other children) in fine-art, callisthenic and sport activities. His works were esthetic, rich in details, colorful. With teachers help he was singing and memorizing short poems. He willingly took part in motorial activities, exercising correctly. He reached full level of educational tasks (talking, listening, math, science). We noticed no aggressive behavior, neither towards adults nor his friends. He never hit, spit at or scratched anybody. However, he was afraid of people wearing white hospital uniforms, reacted with cry when he saw a school nurse. During breaks (pauses) he sometimes jumped, walked around the classroom or sat in the corner with a book (usually it was the same book with big, colorful illustrations)

There where days when Kuba got tired more easily and it was harder for him to concentrate - more frequent but shorter breaks in activities were then introduced. After such break it was enough to say "the break is over" and Kuba obediently came back to his bench.

I saw some pictures taken during school play - Kuba played little frog. His while class felt responsible for Kuba and Arek, another boy suffering from autism, but as Hanka said, both boys kept to their places on stage and remembered their parts.

The beginning of school year was difficult for Kuba. In October he still kept asking "are we at school?" but after affirmative answer, he calmed down and came back to his activities.

Kuba's school achievements did not surprise psychologists from clinic for autism patients, who examined the boy in February 2000. In psychologists's opinion relianced on methods Wechsler's Intelligence Scale WISC - R and Brain Mature Columbia Scale we can read: "During examination the boy was calm, willingly cooperated with examiners, tried exercise the best he could. when the tasks were too difficult, the boy was frustrated, his concentration wasn't so strong. After stimulation, he continued his efforts. There was no aggressive behavior.."

Examination using Wordless Intelligence Scale WISC - R Method showed that no-verbal intelligence of this boy is on a little lower level than average. The most mature function is noticing (over average). There are some functions below average level: visual analysis and synthesis, the ability to organize two-dimentional space, visual-motion learning (probably it is result of less graph motion skills and the tendency to a very precise execution of given task.

Specialists for psychologist-pedagogic clinic, wrote similar opinion in February 2000. There are sentences about boy's skills, his positive motivation to corrrect exercising and about his pro-social behavior.

2. Therapeutic Center for Autistic Children Kuba had been attended to well-know in all country therapeutic center since 1994. This place has been existed since 1990. Each child has personal teacher/therapeutics, what makes possible to get good knowledge about patients and create the program compatible to their individual skills, needs and abilities.

At the start of existence, the center used in its work all positive experiences of science for autistic, slow - learned, rough development children with special needs. Kuba willingly attended to Center in that time and - in his teacher's opinion - made progress.

The program's conception of Center became to change in the middle of 90'. Center became the place where behavioral methods started to be practiced in 1997.

In Kuba's case this change meant very often exercises reconstruction, manual contact (boy is oversensitive for touch - than he really hates this contacts!) and - obedience practice.

I remember the situation happening in the Center's hall. This situation involved Kuba (important here is that Kuba has good orientation in his city's topography.) The therapeutic asked him: "where are you?" - silence. Therapeutics asks him once again - and Kuba leaves this question without answer again. "It's too difficult for him" I hear the Center's principal's comment..

Another time I was watching other boy calmly walking through the hall who received order "lay down" and he is getting lay with his face toward not so clean floor. After next order he is standing up, walking and the situation repeats. When he resists, he is put to lay down violently and kept by few therapeutics. And this is called the obedience practice...

"Are you going to take the sun bath?" I asked the therapeutics, when I saw her carrying the blanket and going out with her student during the sunny day. "No, I bring the blanket, because we will practice getting lay down on the sidewalk" she answered.

In this Center children's scream is permanent part of the activities - it is especially painful for oversensitive for noise children.

Kuba riots. His individual program still is changing. There are more and more techniques, which are going to break his character. He used to be cheerful and open to cooperation, but he becomes "difficult patient." There are notes about his aggressive (kicking, biting, hitting the therapeutic, falling the furniture down) and self aggressive (biting and hitting himself) behavior. And there is only one "therapeutic" reaction: bodily force.

There are a lot of hurts, bruises and scratches on the boys body. The Kuba's parents received the report entitled " The methods involved with working on the difficult behavior of Kuba during the school year. THERE IS IT WRITTEN: "WE USE ONLY NECESSARY AMOUNT OF THE FORCE." There is also written (authors seem to be convinced of being in the right): "We state that procedure showed above 9 it means: keeping the laying on his stomach child having hands tied on his back) is only one successful and safe for the child and therapeutics procedure of work with aggresssive and self aggressive behaviors and it will be always used in cases like that in the future."

The parents were not pleased for release to use these methods. They might only find out what happened with their child. They are also blamed that these methods did not give wanted effects: "Center's methods of work are not present at Kuba's home. The boy does not have clear rules."

Both, Kuba's mother and father, are sure that all these methods treated their son in the Center are bad. However, there were a lot of negotiates, but they did not get an agreement with the Center. "We are using behavioral methods here and if someone does not like it, can pick the child out of here" the parents hear these words in this only one Center in northern Poland .

Hanka noticed that her child became more nervous, boy started to have nightmares and scream during the dream that he "does not want to go to the Center." He refused taking evening bath, going to bed, repeated "does not want tomorrow," he couldn't wait until weekend. He was screaming through 4 hours (all time he spent in the class) in the Center.

His mother tries once again. She writes the letter to the therapeutics. She hopes that introducing her point of view will be useful to find the compromising solution...

III A letter that has never been sent This is my first letter to therapist. I am writing it because I want you to understand why I do not agree with the way you are working with my child in the Center.

A year ago I was convinced that the Center was the best place for Kuba. For five years he was provided with therapy that was bringing positive results, not invasive, based solely on positive enforcements.

Last year everything changed. Decision was made to put more emphasis on correction of so called "therapy interfering behavior." Nobody even bothered to inform me exactly what kind of behavior will be regarded as "interfering." Aversive procedures, negative enforcements and obedience training took place of education. Step by step, all other elements of therapy disappeared. Newly introduced methods (a "sit down - stand up" procedure, continuous reconstruction of tasks) did not influence Kuba's psychics positively. Instead, they resulted in his growing aversion to the Center as a place, studying and aggression towards therapists. My requests for change of the therapy method did not work. Therapeutic techniques turned out to be more important than my child.

I cannot accept such treatment of my child. Nobody paid attention that new procedures did not bring positive effects, that child's well-being was not achieved. Soon "sit down-stand up" procedure became insufficient and stronger methods were applied: holding with force and putting facedown, lifting up by arms twisted backward. Such treatment was humiliating for my child and I was not allowed to intervene. This was a real torture for Kuba and me.

In my opinion that was the best way to annihilate many of my child's achievements and to bury many hopes.

Before a decision is made to apply this aversion therapy one must be sure that this is in the best patients interest. If I were a desperate mother, who had serious problem with her child and could not handle them by herself, perhaps I would agree to such a drastic approach. But that was not the case. It turned out that I had no right to decide of what is best for my child. The therapists, who knew one method but who did not even try to get to know my boy, made this decision for me.

I think that my trust has been misused. I am constantly scared with "the worst scenario" of Kuba's future, but it will be me, who will be with my son to the very end. I want my son to as open to the world as possible and most self-efficient. I do not want him to be stripped off his own will and personality. Such bad treatment makes my child aggressive.

Wouldn't you be upset if your child was in such a position?

I do not want these aversive methods to be applied to Kuba again. I am against such procedures and I oppose introducing them as elements of therapy used in the Center.

I had to write to you about all this. I hope than now you will be able to better understand me. Only then our cooperation would bring positive outcomes for Kuba.

IV The End Hanka never sent this letter to the therapist. She gave up her fight for keeping Kuba in the Center after she received his six-month therapy result report. On this elaborated three-page document, describing difficulties in working with the boy, his parents were once again presented as a source of Kuba's troublesome behavior. This reported ends with the following conclusion: "In my opinion, from my own experience with many autistic children, Kuba's behavior may in future lead to less progress in studying and worse functioning within family and society."

Second semester of school year 1999/2000 Kuba spend in special "life-class" in school for special care children. He calmed down and did not cause any problems. Encouraged by his success, in the following school year Kuba's mother enrolled him to special integration class that was formed as a part of a regular school. Only this summer he succeeded in completing his first year of study and proudly received promotion to the next class.

In years 1999/2000 seven other autistic children left the Center - this a 25% of its total students number. Reasons in all these cases were similar: parents did not agree for aversion methods to be applied in their children's treatment. For some of the parents the decision was connected with the need to give up their professional occupations (as it was in Hanka's case), all of them had to look for a new place where their autistic children could continue their education.

The Center still has the opinion of one of the best Polish facilities for autistic children - new patients are on waiting list to be admitted.

We told Kuba's story because we have the impression that people who discuss the idea of using physical force as an element of treatment of autistic children do not know what they are talking about. How else can one understand the words of M. Rybicka ("Autistic child," vol. VIII (2), p. 156): "It is easy to criticize therapies that include elements of enforcement. One tend to forget that enforcement or limiting once freedom, are very often elements of rehabilitation process. A child with altered teeth wears correction braces although it is very uncomfortable. A child with posture defects often is forced to wear correction corset, which is often painful. Of course, one can let child decide whether he/she wants to wear it (the right of hutch-back to grow), but this is the best way to make our child a cripple."

This was a true story. And this is not an isolated case. We decided to write about it to make both parents and teachers more sensitive to use of aversion methods in therapy and teaching. All cited documents are original and are kept in Hanka's, Kuba's mother, family archive. Hanka is also a co-author of this article.

We do not give the name and place of the Center location. Our purpose is not to brand but to make people think about the problem.