CHICAGO - Bradley Bernstein's parents say an electric cattle prod is the only thing that stops him from banging his head and violently punching his eyes, nearly blinding himself.
The Illinois couple's fight to continue shock treatment on their severely autistic 48-year-old son and the uproar over a Massachusetts school that uses similar treatment, have pulled back the curtain on this extreme form of behavior modification. Critics call it outmoded, barbaric and unethical.
Even a leading supporter of the technique, Harvard-educated psychologist Matthew Israel, acknowledges, "The natural reaction is to be horrified."
"It always has been very controversial and is not politically correct, and if you want to advance your career, you try to stay away from it," said Israel, founder and director of the Judge Rotenberg Center, a residential school in Canton, Mass. The institution houses children and adults with autism, mental retardation and other behavioral and psychiatric disorders.
The school is under legislative and regulatory scrutiny for routinely using skin shocks on about half its 230 students to stop serious behavior problems, including self-injury.
Electric shocks and other painful or unpleasant treatments known as "aversive conditioning" were accepted more a generation ago. But mainstream psychiatry relies on new drugs and other methods that have proven effective.
Using this form of shock therapy is "cruel and unusual punishment," said Dr. Louis Kraus, an associate professor of psychiatry at Chicago's Rush University Medical Center. "The concept of doing that is frightening."
Some states, including Illinois last year, have banned or severely restricted use of electric shocks in mental health treatment.
But Israel favors the technique over psychiatric drugs that he says make students too drowsy to learn and says most critics "have never seen children who have blinded themselves, or banged their head to the point of brain injury, or bit a hole in their cheek."
Israel developed a device he calls a graduated electronic decelerator. It's carried in backpacks students at his school wear, and elicits shocks through electrodes strapped on their arms and legs.
"The beauty of it is there's no side effects," Israel said. "It's a temporary painful experience for two seconds."
His school's techniques are the subject of a bill pending in the Massachusetts Legislature and complaints including a lawsuit by a New York mother who says the shocks traumatized her now 18-year-old son.
The device used on Bradley Bernstein is a cattle prod. It used to be a long electrified rod, but the newer model is a handheld shocker about the size of a portable phone, with two short metal prongs.
Fran Bernstein, his mother, says it delivers a shock about as painful as a bee sting. Critics say it's considerably stronger, akin to sticking a finger in an electric socket.
Often just seeing the device was enough to make Bradley stop hurting himself, Mrs. Bernstein said.
Bradley Bernstein only says a few words and sometimes hurts himself in frustration or opposition to his caretakers' demands, his mother said. He is allergic to several drugs that could calm his behavior, she said.
The Bernsteins are fighting a Cook County judge's March 2 ruling that said Bradley's shock treatment violates an amendment to state law passed last May.
"Now we're not going to be able to control him and we don't know what's going to happen," said Mrs. Bernstein, of suburban Lincolnshire, Ill.
A therapist recommended the shocks when Bradley was a boy and he got the treatment routinely in group homes where he lived until the state law was enacted last year, his mother said.
Specialists at Trinity Services Inc., which took over the agency that used to care for Bradley, oppose shock treatment and helped change the law so it and other painful techniques are banned from group homes.
"This is something that our professional staff doesn't believe is ethical," said Trinity's president, Art Dykstra.
Bradley Bernstein is the only group home patient in Illinois known to have received shock treatment in recent years. His parents agreed to a compromise to gradually stop the treatment, but sued when Trinity officials abruptly stopped it after the law changed, according to the their attorney, Robert O'Donnell.
The judge's recent ruling said the change in Illinois law makes the Bernsteins' complaint moot. O'Donnell is appealing and has enlisted Matthew Israel to help evaluate Bradley and determine whether his shock treatment should resume.
"Anything that causes pain isn't necessarily cruel and inhumane," Israel said. "If you go to a dentist or a surgeon, you're going to be involved in temporary pain but have long-term hope of improvement."
Trinity officials dispute the Bernsteins' claim that their son's behavior has grown worse without the shocks.
Bradley looked away and did not respond to questions during an attempt to interview him this week at his group home in suburban Des Plaines. Wearing a maroon sweat shirt and khaki pants, the gray-haired man wasn't violent during the half-hour visit and had no visible bruises.
His mother said he started "beating himself up" during a recent visit home, however, and that his eye doctor worries he'll do permanent damage.
"The judge and the legislature are taking my son's life away," Mrs. Bernstein said. "If he doesn't stop hitting his head he's going to go blind."
