“Some educators hold to the idea that you can replace a destructive behavior with a skill without having to first eliminate the destructive behavior, but, quite frankly, in some real difficult cases, I think this is simply pie-in-the-sky rhetoric. As I said, in an ideal world there would be no techniques that we call punishment used to decrease unwanted behaviors,” he continues, “but we aren’t there yet for serious self-injurious behaviors-at least I’m not aware that we are in Arkansas.”
I look at the satisfied expression on Jill’s angular face and realize that she has slashed the odds against making her case.
By going with a conventional psychologist who condones aversive techniques of behavior management (albeit allegedly in a judicious manner) she has slipped from my hand a weapon I would have been happy to use against her. So far as I can tell from the admittedly limited research I have been able to do in the last three days, the case for strictly non aversive means to eliminate self-injurious behavior is a matter of much debate. By not turning this case into a propaganda film in which outside experts will be trooped into the state to show our backwardness, she has strengthened her hand immeasurably. I realize now that my friend Amy exaggerated Jill’s zeal to reform the system. Jill will be content to show that Andy hasn’t met the professional standards for psychologists in Arkansas, a much easier task, since it is clear that he ignored the hell out of the usual protocol.
Jill takes Holditch through Pam’s records. It is appalling how little had been done for her since she began to hurt herself when she was twelve. As Holditch drones on about the restraints and the drugs that had been an inseparable part of Pam’s adolescent years, Andy writes on the legal pad and shoves it at me: “The turnover and vacancies on the staff makes it impossible to do anything but keep kids like Pam in restraints or on drugs.”
Holditch says that one of “Dr. Chapman’s” major errors was the failure to obtain the approval of a “human rights committee,” standard procedure in institutions before highly aversive techniques are tried with a retarded individual. Andy whispers loudly that it was “moribund” at the Blackwell County HDC and hadn’t met in months. I make a note to work on somehow minimizing this. It seems it would have been a simple matter to arrange to have his ass covered by a group. Holditch says there is no indication from his review of the records that any committee was consulted.
Jill runs Holditch through a number of recognized behavior-modification programs that he says Andy should have tried before shock: “Extinction,” which, according to him, simply means ignoring the behavior (Holditch concedes this would have been dangerous, given the fact that as soon as she came out of the restraints Pam began to hit herself);
“Timeout,” which would have placed Pam in a room by herself with a one-way mirror for a few minutes at most;
“Overcorrection,” a procedure in which the teacher or trainer may actually guide with his hands the offender’s body in movements that “overcorrect” the maladaptive behavior (Holditch explains, as the judge scratches his head, that, as an example, when Pam began to hit herself, she would have been required to fill a bag with ice and hold it against her head). Finally, he says that forms of punishment other than shock should have been tried first. For example, Pam could have been required to do exercises each time she hit herself.
Andy shakes his head as if Holditch has suggested aspirin to cure cancer, but this seems like such common sense I make a note to ask him about it later.
Jill, who has been appropriately unobtrusive in her questioning on direct examination, asks Holditch about the use of a cattle prod, and it is the introduction of this subject that at a jury trial will do the most damage. Average Arkansans may be skeptical of all the psychological mumbo jumbo but talk about electrocution will wake them up, no matter how bored or confused they have become. Bruton thrusts his chin forward as if now we are getting to an area he can under stand.
“If shock can ever be said to be appropriate as a method of behavior control, and it is still used by some professionals, according to the literature,” Holditch says, tapping his fingers together prissily, ‘one thing is for certain: using a cattle prod to administer the electric current never is. Anyone who familiarizes himself with the literature knows that.”
Again, I feel Andy’s breath on my right ear.
“The man who pioneered the use of shock in this area used a cattle prod.”
But would he use one today? I wonder, as I listen to Hoiditch name a number of commercial products that have been specifically designed for use on humans.
“As far back as 1975, an article was published in the journal Behavior Therapy warning against the use of cattle prods. In fact, my research shows that the hand-held shock apparatus is probably rare today. Remote-control devices are more widely used because they don’t have the generalization problems that are encountered with hand-held products.”
Ramrod straight behind the podium, Jill asks, “What is a generalization problem, Dr. Holditch?”
Holditch, increasingly comfortable in the courtroom, nods patiently.
“It is not at all unusual that unwanted behaviors which have disappeared in one setting, for example, the treatment room, reappear in another. If shock is going to have any meaningful application, the child must be able to live in a normal environment. It is nothing short of cruelty to a child if the behavior soon resumes. In other words, children learn to associate the individual who shocks him or her with the stimulus. According to the literature, and in my own experience, when that person is not present, the self-injurious behavior will typically recur. For that reason remote-control devices have been developed which help prevent this problem from developing.”
Jill asks softly, “Is there evidence that any other apparatus or device was used to shock Pam Le Master other than a cattle prod?”
Holditch shakes his head.
“Not from the records I’ve been given to review.”
Jill asks, “What, if anything, is wrong with using a cattle prod?”
Cattle prod. Cattle prod. If Jill is beating it to death today, wait until she has a jury. Holditch frowns, as if the question pains him.
“According to the literature,” he says, “the type of device used on an animal may not regulate the voltage or current. This type of apparatus can deliver more than eighty microamperes, which, if the current travels through the heart, can produce ventricular fibrillation. By the way, the pain produced has been likened to having a dentist drill your teeth without benefit of anesthesia. Before coming here, I applied a shock to myself, and in my opinion, the pain is worse than that.”
Instinctively, I rise to object, but realize once I get to my feet that the severe pain produced by the shock of a cattle prod is intentional. While I am standing, Jill chooses this moment to ask, “Do you have an opinion concerning Dr.
Chapman’s use of shock on Pamela Le Master?”
I can make objections here, but they will do no good at this hearing, and I pop back down in my seat like a jack-in-the-box in reverse, while he says, of course, that he does, and then proceeds to say how reckless Andy’s actions were and more or less repeats his earlier testimony. It is recklessness that the jury will decide this case on, and the room is hushed when Holditch finishes, and Jill says tonelessly, “Your witness.”
There are weaknesses in this testimony, and I have to bite my tongue when I decline to crossexamine him. Even Bruton’s eyes bulge in disbelief when I say, “No questions.”
I call Olivia as my only witness. I had talked with her briefly on Friday (she surprised me by declining to meet with me again before the hearing), but she seemed as resolute on the phone as she had after the plea and arraignment hearing.
Despite my urging, she has made no public statement and has refused all comment to the press. Andy, who has accepted the inevitable outcome of the probable cause hearing with his customary aplomb, had not wanted me to put Olivia through a court appearance any sooner than we had to, and argued as late as last night that she would not waver from the story she had given to the prosecutor’s office and to me in my office. Perhaps, she won’t, but I think I know better than Andy the pressure she will endure between this hearing and the trial. Getting her on the record now will remove the worry once and for all.