Consensus Statement on the Use of Contingent Electric Skin Shock in the Treatment of Severe and Dangerous Behavior


We, Autism Learning Partners, Center for Autism and Related Disorders, Hopebridge, and LEARN Behavioral, unequivocally condemn the use of painful aversive procedures, including the use of contingent electric skin shock (CESS), under the scope of practice of applied behavior analysis (ABA) based treatment for challenging behaviors. Our organizations do not and never will employ the use of CESS under any circumstance.

Who we are: 

We are providers of therapeutic ABA-based autism services across 33 states within the United States, representing care that is provided to thousands of clients across all age ranges (infant to adult) and levels of autism severity.


In 2013, in a special report to the United Nations, the United States Government was called upon to investigate human rights abuses, in violation of UN Convention against Torture, against students at the Judge Rotenberg Educational Center (JRC); these actions included use of contingent electric shock and prolonged physical restraint (Mendez, 2013, p. 83-84).

In March 2020, the U.S Food and Drug Administration (FDA) issued a ban on the use of CESS in the treatment of severely harmful behavior in individuals with disabilities, including autistic children and adults (Banned Devices, 2020). 

The FDA’s ban was subsequently overturned by the Washington D.C. Circuit Court of Appeals, in July 2021. The ruling was not based on whether the practice is inhumane but rather on the grounds that the FDA does not have the authority to ban specific uses of a medical device, which was declared the responsibility of each state (Judge Rotenberg Educational Center v. FDA, 2021). 

In October 2021, Massachusetts Association for Applied Behavior Analysis (MassABA), a regional chapter of ABA professionals practicing in the same state where the JRC practices, condemned the use of CESS in ABA due to ethical and scope-of-practice concerns. 

In November 2021, the Association for Behavior Analysis International, the largest professional membership group in behavior analysis, announced a task force to investigate the use of CESS in ABA-based practice and to issue a formal statement. As of this date, the task force’s work is underway, but a formal statement has not yet been published.

Purpose of Issuing a Position:

In light of the ongoing legal battles at the federal level to ban and subsequently allow use of CESS in ABA services, in adherence to the updated Ethics Code for Behavior Analysts (Behavior Analyst Certification Board ®, BACB(R), 2020, effective January 2022), and because of our large representation of ABA-based autism services across the U.S., we feel a clear multi-organizational stance on this issue is warranted.

ABA is a compassionate science; ABA-based autism services help individuals access their full potential through sustainable, client-centered, meaningful outcomes. Based on condemnation by the United Nations that have not been resolved by permanent legal action, as well as significant ethical and scope of practice concerns disseminated by multiple groups of experts who have engaged in thoughtful and extensive review (e.g., MassABA, 2021; Zarcone et al., 2020), we wish to address this issue as providers. By advocating for the discontinuation of this concerning practice, and by clarifying its place outside of the scope of ethical practice, we hope to open space for the continued evolution of contemporary ABA.


Evidence does not support the use of CESS. In a review of evidence-based practices for the treatment of individuals with ASD, the National Autism Center (2015) determined CESS had an unestablished level of evidence (National Autism Center, 2015). Furthermore, the International Association for the Scientific Study of Intellectual and Developmental Disabilities (IASSIDD), an international group of researchers, clinicians, students, parents, and self-advocates, provided a literature review to support their opposition to the use of CESS to target severe aggression and self-injury. Their review identified methodological concerns, insufficient evidence of long-term effectiveness, ethical concerns, and adverse side effects including physical and psychological injury (Zarcone et al., 2020). 

As behavior analysts, we are also bound by a code of ethics. The core principles from the Ethics Code for Behavior Analysts (BACB, 2020) state that behavior analysts are to:

  • Core Principle #1 – Behavior analysts work to maximize benefits and do no harm
  • Core Principle #2 – Behavior analysts behave toward others with compassion, dignity, and respect
  • 2.01 – Behavior analysts prioritize clients’ rights and needs in service delivery
  • 2.11 – [Behavior Analysts] are responsible for obtaining assent from clients 
  • 2.15 – Behavior analysts must continually evaluate and document the effectiveness of restrictive or punishment-based procedures and modify or discontinue the behavior-change intervention in a timely manner if it is ineffective

It is our consensus that these guiding principles are in direct opposition to the use of CESS in the population we serve. Furthermore, the consideration of individual assent was introduced to the latest revision of the ethics code, which is indicative of progress in our field to incorporate client feedback into treatment planning, building trust between client and practitioner. 

If it is appropriate to reduce a behavior, there are many other evidence-based practices available without severe ethical implications. Strategies including antecedent-based interventions, augmentative and alternative communication, behavioral momentum, differential reinforcement, functional behavior assessment, functional communication training, and reinforcement have been determined to meet evidence-based practice criteria (Hume et al., 2021). Practitioners have a wealth of options to treat severe challenging behaviors while also showing compassion and upholding their client’s dignity. 

We direct the reader to the excellent rationales and resources provided by MassABA in their position statement (2021). 


Banned Devices: Electrical Stimulation Devices for Self- Injurious or Aggressive Behavior, 85 FR 13312 (March 6, 2020).

Behavior Analyst Certification Board. (2020). Ethics code for behavior analysts.

Hume, K., Steinbrenner, J. R., Odom, S. L., Morin, K. L., Nowell, S. W., Tomaszewski, B., Szendrey, S., McIntyre, N. S., Yücesoy‑Özkan, S., & Savage, M. N. (2021). Evidence-based practices for children, youth, and young adults with autism: Third generation review. Journal of Autism and Developmental Disorders, 51(11), 4013-4032.

Judge Rotenberg Educational Center v. FDA, No. 20-1087 (D.C. Cir. 2021).

Massachusetts Association for Applied Behavior Analysis. (2021). Massachusetts Association for Applied Behavior Analysis (MassABA) position statement on the use of electric shock as an intervention in the treatment of individuals with disabilities.

Méndez, J. E. (2013). Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment (A/HRC/22/53/Add.4). Human Rights Council.

National Autism Center. (2015). Findings and conclusions: National standards project, phase 2. Zarcone, J. R., Mullane, M. P., Langdon, P. E., & Brown, I. (2020). Contingent electric shock as a treatment for challenging behavior for people with intellectual and developmental disabilities: Support for the IASSIDD policy statement opposing its use. Journal of Policy and Practice in Intellectual Disabilities, 17(4), 291-296.

LEARN Behavioral Appoints Marissa Mata as Director of New Hire Training Operations


LEARN Behavioral, a national organization of providers serving children with autism and other special needs, has recently appointed Marissa Mata as Director of New Hire Training Operations.

Mata brings over a decade of organizational behavioral management experience to LEARN Behavioral. In her new role, Mata will be based in the company’s Chicago, IL, office and oversee new hire training operations, while building and implementing scalable training strategies across the organization.

Marissa Mata

LEARN Behavioral’s providers are located throughout the U.S. and include Wisconsin Early Autism Project (WEAP), Autism Spectrum Therapies (AST), Behavioral Analysis Center for Autism (BACA), Behavioral Concepts (BCI), Total Spectrum, Trellis, and SPARKS.

Prior to joining the company, Mata was the Director of Strategic Initiatives for G6 Hospitality (Motel 6) based in Carrollton, Texas, where she oversaw the Program Management Office and led a team of experts dedicated to creating a better and safer guest and employee experience enterprise wide. Her career includes a 12-year (combined) tenure as Director of Solution Center Services for Rent-A-Center of Plano, Texas, and as Director of Revenue Operations for LQ Management of Irving, Texas.

Mata is a member of the Association for Talent Development (ATD). Mata and her teams have been recognized with training awards, including Training & Development Magazine’s “Outstanding Training Initiatives” award and their “Training Top 125” award over six years. She has also been honored by ATD with the ATD BEST Award.

Mata holds a bachelor of arts in economics from University of North Texas in Denton, Texas. She is a resident of Dallas, TX.

About LEARN Behavioral

LEARN Behavioral specializes in using contemporary applied behavior analysis (ABA) to nurture the unique potential of children and young adults with autism. With clinical insights and best practices refined through our decades of service to the autism community, we support more than 5,000 clients through brands that include WEAP, AST, BACA, BCI, Total Spectrum, Trellis, and SPARKS. Our team consists of more than 30 doctoral-level clinicians, 450 Board Certified Behavior Analysts®, and 4,000 behavior technicians who share a common mission: to find success for every child with autism in our care.

“Connecting the Autism Community One Podcast at a Time”

LEARN Behavioral provides valuable insight and information from inspiring individuals in the autism community through their unique All Autism Talk podcast found on Spotify and on their website at

Black History Month: LEARN Continues to Push Diversity, Equity, and Inclusion Plan Forward



Creating a more diverse workplace, raising awareness about unconscious biases, providing advancement opportunities for everyone—these initiatives have long been part of LEARN’s DNA. But in 2020, with heightened awareness around social disparities in our country, the company’s employees, supported by leadership, decided to formalize and flesh out these goals with the launch of LEARN’s Diversity, Equity, and Inclusion (DEI) Plan. While DEI committees formed and started working in the summer of 2020, LEARN chose February to announce the plan publicly in honor of Black History Month and the United Nation’s World Day of Social Justice on February 20.

“We’re in a unique moment in this country,” says Justin Funches, the president of LEARN Autism Services and chair of the DEI Leadership Committee. “As a black man and as a leader in an organization with incredible diversity, I recognize the great opportunity and responsibility our initiative presents. And I know that better outcomes—for both our clients and our teams—come when we include more voices and better understand each other’s experiences.”

As a first item of business, LEARN’s DEI committee drafted an official statement and established five priorities:

The Sum of All Parts:
LEARN knows we’re not all the same. Recognizing differences and tailoring our approach is at the core of what we do. That’s why we’re committed to fostering a culture that embraces what makes us each unique—be it race, ethnicity, gender/gender identity, sexual orientation, religion, national origin, disability/ability, and socioeconomic background. LEARN aims to acknowledge the lived experiences and diversity of perspectives among our staff and the children and families we serve. We pledge to create a community centered around trust, respect, tolerance, and empathy. Together, we’re better.

Our priorities on this journey include:

  1. Positioning LEARN as a diverse, inclusive, and equitable organization.

  2. Creating policies and practices that are culturally sensitive to differences in our staff and clients.

  3. Equipping teams with the tools they need to navigate the myriad inequities in our society.

  4. Actively embracing the diversity of the communities we serve.

  5. Building leadership teams that are diverse and provide opportunities for typically underrepresented populations.

LEARN also created internal communications—a monthly digital newsletter and web portal—for employees to share news related to diversity, equity, and inclusion. With systems and priorities in place, the real work began. Teams of staff from across the country solicited feedback, brainstormed ideas, and asked the hard questions.  

One activity involved a series of forums that brought together Black behavior technicians from across the country to “speak with candor as they shared their stories and experiences of being Black in the field of applied behavior analysis (ABA),” says Brandon Whitfield, Clinical Director of AST’s Learning Center in Beach Cities, California. “Their stories were heartfelt, gut-wrenching, and awe-inspiring.” The next steps, says Whitfield, who serves on a DEI committee and co-hosted the forum, are to analyze the data collected and use it to shape future leadership practices and inform new programs and policies.

One such program was announced to employees last month—a partnership with National University to fully support tuition Black or African American staff members to complete National’s ABA master’s program. In addition to tuition support, LEARN will designate a mentor to help each recipient with coursework, career planning, and the behavior analyst certification process. Once certified, recipients can oversee applied behavior analysis (ABA) therapy to children with autism.

“Right now, the percent of Black behavior analysts working in the ABA field does not reflect the percentage of African Americans in the population of the United States,” says Whitfield, who spearheaded the partnership with National University. “Our new program is a step to change that.”

As LEARN’s DEI committees continue to push forward their goals, employees say they’re thrilled to join the effort and see the organization back these critical initiatives. “As a woman of color, I’ve always been acutely aware and passionate about the ways in which barriers affect education access in minority and low-income communities,” shares Margarita Mesa, Director of Program Quality and Operations for LEARN It System’s Academic Services and a member of a DEI committee. “I’m confident that this committee of intelligent, forward-thinking colleagues will offer creative strategies and purposeful ideas to make strides in this ever-important arena, and I look forward to the thoughtful dialogue as we collectively work to better understand and support the diverse communities in which we work.”

Stay tuned for LEARN’s series of blog posts and podcasts to raise awareness about ABA as a social justice issue and to highlight Black professionals working to make a difference in the lives of children with autism.

LEARN Behavioral announces Telehealth ABA services now available through their network of providers.

Children diagnosed with ASD may continue to receive critical ABA therapy

remotely during COVID-19 pandemic.


BALTIMORE, MD… LEARN Behavioral, the leading network of providers serving children with autism and other special needs, announces the availability of telehealth Applied Behavior Analysis (ABA) services to children diagnosed with Autism Spectrum Disorders (ASD) and their families nationwide through their regional providers.


To continue providing critical ABA services to client families during the coronavirus (COVID-19) pandemic, LEARN has innovated their service delivery model and capabilities to provide telehealth ABA, or “teleABA”, services.


TeleABA provides another option for families who prefer virtual therapy services over in-person therapy, or who have household family members who are at higher risk for severe illness.

It is ABA therapy overseen by a Board-Certified Behavior Analyst (BCBA) that parallels in-person treatment.


“The COVID-19 response requiring nationwide social distancing and other safety guidelines

has left many parents of children on the autism spectrum wondering how to maintain the gains their children have made in ABA therapy,” explained Hanna Rue, Ph.D., BCBA-D, Vice President of Clinical Development for LEARN.  “LEARN is helping parents by providing the option of teleABA therapy which helps ensure that their children are able to continue their forward momentum towards established treatment goals.”


TeleABA Services

Treatment for ASD is in accordance with state and federal emergency guidance regarding medically necessary telehealth services. It is imperative that children with ASD avoid any break in ABA therapy as this may cause distress, disruption and potential behavior regression. TeleABA is the delivery of evidence-based ABA therapy with master level clinicians via HIPAA-compliant videoconferencing, which is accessible by computer, tablet or smartphone.


LEARN’s teleABA services include direct treatment and parent consultation. Direct treatment is one-on-one treatment sessions with a child geared towards maintaining and generalizing communication, play skills and behavioral progress. Parent consultation provides an opportunity to discuss daily routines and challenging behaviors, identify targets, and implement a plan.


TeleABA enables families to continue to build upon and reinforce skills including, but not limited to:

– Potty training

– Bedtime/sleep routine

– Screen time

– Personal hygiene routine, including hand-washing


Through teleABA, LEARN providers help children and families in a number of ways. For example: discussing strategies and progress on a desired goal; developing a routine that fits in to your family’s schedule; providing individual reinforcement strategies; setting and explaining clear expectations; and offering “in the moment” parent coaching along with references to help successfully reach your child’s goal.


Parent Webinars

One innovative program being launched through teleABA is Parent Webinars. With COVID-19 changing day-to-day lives, new challenges are presenting and old ones are resurfacing. Parent Webinars, offered on a weekly basis, enable families facing similar challenges to join in virtual presentations to share solutions and helpful info.


The Parent Webinars are led by Ashley Williams, a Clinical Director in the Greater Boston area within the LEARN provider network. Each webinar is guided by a BCBA and will include clinical tips, strategies, and suggestions to help parents in these challenging times.


Dr. Rue continued, “We have received a tremendous response from our families, who are experiencing new successes due to our virtual teleABA services. It is our hope that teleABA treatment will continue to be accepted by insurers beyond COVID-19, as this will enable us to serve a greater number of children and families on the autism spectrum who need services but have limited in-person access to ABA providers.”


In total, LEARN has served over 2,500 families through teleABA, with nearly 1,000 trained providers across the nation who have delivered sessions. LEARN is dedicated to supporting their staff and has developed a comprehensive resource library which enables them to access tools, resources, training and support online.



LEARN is a leading network of prov
iders that serves children with autism and other special learning needs. LEARN specializes in behavioral health treatment based on the science of Applied Behavior Analysis (ABA) and is committed to providing programs and services that are family-focused, community-minded, and delivered with the highest clinical integrity. The LEARN team delivers more than 2.5 million hours of service annually and is comprised of more than 5,000 passionate professionals dedicated to nurturing each child’s personal best. For more information, visit

Autism Spectrum Therapies (AST) Opens New Learning Center in Covington, Lousiana

COVINGTON, LOUISIANA –  Autism Spectrum Therapies (AST), one of the leading providers of Applied Behavior Analysis (ABA) in the country, announced the opening of its new Learning Center in Covington, Lousiana.  The new center will offer services for children ages 18 months to 8 years of age on the Northshore.  AST will continue to offer home-based services across the Greater New Orleans including  parts of Ascension, Jefferson, Orleans, St. Bernard, St. Tammany, Tangipahoa, and Washington Parishes.

AST’s Clinical Director for Louisiana, Dr. Rebecca Mandel-Blasia, PhD, BCBA-D, LABA, shared, “We are excited to open our second center in Louisiana, and bring our services to the Northshore community. AST is committed to providing the highest-quality services to children with autism and their families.”

About AST

Autism Spectrum Therapies (AST) is a leading provider of behavioral health treatment utilizing Applied Behavioral Analysis (ABA). AST’s clinical philosophy is grounded in working collaboratively with families, insurers, and schools to deliver high-integrity, individualized treatment plans that use the latest science to guide interventions. AST is part of the LEARN Provider Network, the leading autism treatment network serving 2,500 families across 9 states.

Autism Spectrum Therapies (AST) Opens New Learning Center in Livonia, Michigan

LIVONIA, MICHIGAN –  Autism Spectrum Therapies (AST), one of the leading providers of Applied Behavior Analysis (ABA), announced the opening of its new Learning Center in Livonia, Michigan.  The new center will offer services for children ages 18 months to 8 years of age.  AST will continue to offer home-based services across the Detroit Metropolitan area including Wayne, McComb, and Oakland Counties. 

AST’s Clinical Director for the Metro-Detroit area, Scott McPhee, MA, BCBA, shared, “We are excited to be able to offer center-based services to children in Livonia and the surrounding communities.  Livonia’s motto of “Families First” resonates with our clinical philosophy at AST; our services are family-focused, our approach collaborative, and our treatment individualized. We are excited to bring our national resources to this vibrant community.”

About AST

Autism Spectrum Therapies (AST) is a leading provider of behavioral health treatment utilizing Applied Behavioral Analysis (ABA). AST’s clinical philosophy is grounded in working collaboratively with families, insurers, and schools to deliver high-integrity, individualized treatment plans that use the latest science to guide interventions. AST is part of the LEARN Provider Network, the leading autism treatment network serving 2,500 families across 9 states. Learn more at