Lauded School for Autism Draws Charges of Abuse

RANDOLPH, Mass. -- During a weekend visit home in early July 2000, Scott Tedeman took off his shirt to get ready to shower. His father, John, immediately saw bloody abrasions on his son's back. John Tedeman says Scott, then 18, had similar injuries on his forehead and elbow, and looked as if he had been on the "losing end of a vicious fight."

A state and local police investigation determined that an instructor at Scott's school had dragged Scott by the ankles across rough institutional carpeting when he balked at repeatedly making his bed as part of a drill, according to a police report. The instructor was charged with assault and battery on a disabled person but returned to his native Japan before he could stand trial.

Scott Tedeman is autistic. The school he attended, Boston Higashi, is known and widely respected world-wide for treating a disorder that afflicts as many as 1.5 million Americans and has no known cause or cure. But Boston Higashi's success comes amid a number of complaints that the school's treatment practices have led to abuse. Since 1995, police and various Massachusetts agencies have received at least 17 abuse complaints against school staff.

Boston Higashi is one of several autism-treatment centers to face allegations of abuse recently. Last month, a Pennsylvania woman claimed that her autistic son died at a Bancroft Neurohealth Inc. facility in New Jersey after his immune system was weakened through excessive use of arm restraints and overmedication. The Camden County Prosecutor's Office is investigating the case, a spokesman says. A spokesman for Bancroft Neurohealth denies the family's charge. Also last month, the chairwoman of a South Carolina autism-treatment facility quit, saying the facility failed to investigate complaints of abuse. The facility, the Babcock Center Inc., has denied her accusations.

Array of Therapies

Autism comprises a spectrum of mystifying developmental deficits, often including obsessiveness, profound withdrawal, self-abuse and striking out at others. Diagnoses of autism have risen nearly threefold in the past decade, and an increasing number of families -- forced to choose from a bewildering array of therapies -- are in an often-desperate search for help. Some treatments seem bizarre or even cruel, such as the use of restraints and electric shocks. A current fad calls for feeding autistic children a diet consisting solely of wild game.

The Higashi approach, which a Japanese elementary-school teacher developed in the 1960s, shuns medication and restraining devices. It emphasizes repetition of tasks, strict schedules and intense physical exercise.

In recent years, doctors, educators and researchers have lauded the Higashi philosophy as pioneering and humane. At Boston Higashi, students have been trained to curb their dangerous behavior, sit attentively in class and even perform in a jazz band. There are now five Higashi schools -- in the U.S., Japan, South Korea, Uruguay and England -- and elements of the approach have been adopted elsewhere. Boston Higashi, which enrolled 143 students from around the world this year, turned away dozens of applicants.

But two separate incidents on July 7 resulted in the school firing two instructors and in pending police charges against one of them. Randolph Police Det. James Hayward said the instructor who will be criminally charged was caught on a school surveillance tape pulling a student by the hair on three occasions for five to six seconds each time. The second incident involved an instructor forcing a student to do push-ups for inappropriate behavior, in violation of school policy. Mr. Hayward said there were several instructors in the room when the student was made to do push-ups and none appeared "shocked," leading him to believe it was a common practice. He said he didn't view the push-up incident as a criminal matter. The school reported the incidents after a staff person saw them on the surveillance tape.

Another teacher was charged with assault last year for punching a student in the stomach and for beating another student with a hairbrush. The teacher was found not guilty but was fired after an internal school investigation concluded she had abused at least one of the students. Two years ago, still another teacher, Masataka Kunihiro, was charged with assault and battery on a disabled person for allegedly dragging Scott Tedeman by his ankles, leaving wounds on the student's back. Mr. Kunihiro resigned under pressure three months after the incident and returned to Japan. Scott's parents are suing Boston Higashi, which denies wrongdoing. Mr. Kunihiro couldn't be reached for comment.

Robert Fantasia, director of Boston Higashi, says "cases of abuse have been isolated" in the school's 15 years of operation, during which it has educated 350 students. "In almost all of the cases," he says, "the school itself has been the one to report the problem to the proper authorities and to initiate disciplinary and corrective procedures." The school conducts thorough background checks on employees, he says, but "can never guarantee that a human being won't falter under the best of circumstances." He says the school is safe for students because the few staff members who have been abusive were fired and no instructor "has injured a student twice."

Mr. Fantasia, 60 years old, says the school "balances the highest expectations for students to reach their full potential" with "an environment of caring and love" and that students "are absolutely safe" there.

Passionate Defenders

Many parents remain passionate defenders of Boston Higashi. Miriam Hurwitz of Brooklyn, N.Y., says the school is "superior to anything in the entire world." Her 19-year-old daughter, Sarah, was struck on the hand, arms and head with a brush and punched twice in the stomach by a Boston Higashi teacher in May 2001, according to the Disabled Persons Protection Commission, which investigated after two Boston Higashi staff members reported the abuse to the administration. Mrs. Hurwitz says she found the incident "very worrisome" but says it was the fault of one bad employee and doesn't reflect a systemic problem. She says Sarah, who has been a Boston Higashi student for 10 years, no longer needs tranquilizers to sleep and can go for walks without throwing tantrums.

Jean Bowden of Barnstable, Mass., credits Boston Higashi with producing a dramatic improvement in her 15-year-old daughter, Abbie, who she says had been pinned face-down to the floor while in a public-school program. Boston Higashi "saved her life," Mrs. Bowden says.

Virtually all parents interviewed for this article said they were unaware of most of the complaints of abuse at Boston Higashi. The school says confidentiality laws barred it from disclosing complaints to any parents other than those of the children directly involved, although Boston Higashi sent a letter in August to all parents notifying them of the Tedemans' lawsuit and asking for their support. The school says no one has pulled out their children as a result of the disclosure.

The nonprofit school is situated on a 55-acre suburban campus outside Boston. It charges $100,000 a year for residential students. Federal law requires that public-school districts pay the full cost of educating a handicapped child if they don't offer an adequate program.

Boston Higashi was first investigated for claims of abuse shortly after its 1987 founding, when the school's first special-education director quit after a month on the job, saying that some employees were abusive. An investigation by the state Department of Social Services found no abuse. In 1989, the agency conducted another investigation, this time into allegations from students that staffers had punched them and hit them with hairbrushes and sticks, and from parents that they had been denied visits and that food was withheld from their children for misbehavior. The agency said its investigators "concluded that there was reasonable cause to believe" that five children had been abused at the school.

Also in 1989, the Massachusetts Office of Child Care Services, which licenses Boston Higashi, conducted its own investigation and found 29 violations of state code. They included an unspecified number of "unexplained injuries" such as broken bones, bruises and bites, in addition to force-feeding and the use of forced kneeling as punishment. A monitor was assigned to the school until 1990, when the state was satisfied the situation had been corrected.

Karen Tedeman, Scott's mother, acknowledges that when some parents began complaining of abuse in the late 1980s, she was part of an effort to discredit them. As president of the parents association, she wrote letters attacking state officials who investigated the abuse complaints. "It became like a cult for parents," Mrs. Tedeman says.

Gina Green, research director for the Institute for Effective Education in San Diego, which runs programs for autistic children, says the Higashi method has never been subjected to meaningful assessment, such as published, peer-reviewed studies comparing the development of Higashi and non-Higashi autistic students over time. If the Higashi approach works, Dr. Green says, "that should stand up to scientific scrutiny." Dr. Green has produced research showing that one formerly popular treatment, Facilitated Communication, didn't work. Under that approach, a parent or teacher was supposed to hold a child's hand and "facilitate" pointing at letters on a screen to make words. Dr. Green and other researchers have shown that the facilitator was actually leading the child.

But Mr. Fantasia and the school's educational advisers argue that ordinary scientific and educational measurements don't apply to the kinds of improvements made by autistic children, such as the ability to perform proper bathroom hygiene or to eat with utensils. "I don't mind saying we don't have data," said Mr. Fantasia. "We have videos of before and after, parents talking of the history of their child and hopes for the future."

"The judge is the parents," says Jerome Kagan, a Harvard University professor of psychology who helped import the Higashi method from Japan and is a member of Boston Higashi's educational advisory board. "If they were unhappy, they would draw people out."

Some have, including Rosemary Kane, who pulled her son Matthew in 1997 after a decade at the school. She says Matthew, who was aggressive and often self-abusive, suffered an increasing number of serious injuries in his last year there. She asked school officials to consider medication for him, but they refused, in keeping with Higashi's policy against using drugs. Since entering a new program and taking medication, Mrs. Kane says, Matthew has had only one injury, a sprained foot, and holds a landscaping job.

To control students' behavior, instructors at Boston Higashi frequently use physical "prompts," given with a "light to a firm touch," according to a school teaching manual. Although the school says the prompts aren't physical restraints, one state report noted that an acceptable prompt was holding children's arms to their sides. The school's guidelines note that "if an upset student cannot regain self-control within the group, the teachers may limit the student's movement in order to prevent aggressive or self-injurious behaviors."

The Higashi approach doesn't allow corporal punishment, but some former Boston Higashi staff members, including several who left the school on good terms, blame incidents of slapping, punching and dragging either on inadequate training or on the school's rigid structure and the influence of Japanese culture. They say the Japanese instructors -- who make up more than a third of the staff of 185 -- tend to be the most aggressive and to use such harsh techniques as the bending of fingers to induce pain.

In a letter to The Wall Street Journal, Mr. Fantasia says he believes that some former Boston Higashi staff members who criticize the school "harbor hidden but deep-seated resentments and biases against existing Japanese staff members." He adds that "the work ethic of most of our Japanese staff is 10 on a scale of 1 to 10," and "the same would never have been said of the disgruntled former employees."

Few parents were initially as enthusiastic about the Higashi philosophy as Karen Tedeman, who first enrolled Scott in 1987, when he was five. At home, he had difficulty speaking and often attacked his mother, pulling her hair, pushing her and pinching her in sensitive spots, sometimes 100 times a day. Mrs. Tedeman says she was thrilled when the school taught Scott how to tie his shoes, ride a bike and use eating utensils.

In his last year at Higashi, the Tedemans became concerned about a growing number of injuries that culminated that July weekend when Scott's father saw the injuries on his back. Former school nurse Kelli Silvestro says Mr. Kunihiro told her Scott was hurt when he bent down to tie his shoe in the school van and "brushed his head on the seat's fabric." Ms. Silvestro says she was suspicious because two months earlier, Mr. Kunihiro had brought another student to her with a swollen nose and forehead, saying he had thrown himself into a wall during a tantrum.

Ms. Silvestro says that when she asked the other student what happened, he referred to Mr. Kunihiro and said, "Kuni. Pow! Pow!" When she reported the student's response to the school's head teacher, Akihiro Takamatsu, Ms. Silvestro says, he responded, "You can't believe an autistic child." Mr. Takamatsu denies making the comment. Ms. Silvestro was fired in March 2001. The school cites poor performance; Ms. Silvestro says the school was retaliating against her.

In their lawsuit against Boston Higashi, filed in state court in April, the Tedemans claim that school-injury reports show this was at least the 20th time Scott had been injured at the school in the preceding 10 months -- including a June incident in which he was treated at a local hospital for a gash in his forehead, a black eye and two puncture wounds on his neck. In April 2001, the Tedemans moved Scott to a new program on Cape Cod, where they say he has been injury-free and less aggressive. The suit seeks unspecified money damages.

'Adolescent Physical Activity'

In its response to the suit, Boston Higashi denied that Scott's "alleged injuries were caused by any mistreatment or wrongdoing" by the school. The school said the injuries were a consequence of "adolescent physical activity" combined with Scott's "myriad" disabilities, including autism, hyperactivity and lack of coordination. The school also alleges that some of the injuries could have occurred while Scott was in the care of his parents.

After the Tedeman incident, Mr. Kunihiro was ordered to undergo training in the "different culture of Japan and U.S.A.," according to an internal school report that lists Mr. Fantasia as one of its authors. Mr. Fantasia says he doesn't know why the cultural training was included.

The Tedemans contend in their lawsuit that finger bending is used with impunity, because it doesn't leave marks and nonverbal children are unable to complain about it. The State Police report on the Tedeman case quotes school van driver Kenneth Vanleeuwen as saying he saw Mr. Kunihiro bending students' fingers backward.

Ayumi Gates, a Japanese native who taught at the school from 1994 to 2000, says she was shown how to use finger-bending by another Japanese teacher, who told her it was an acceptable way to control the children. Mrs. Gates says she never used the technique herself. School officials say that finger-bending is not allowed and that they are unaware of any allegations of its use.

In licensing reviews, Massachusetts officials have praised Boston Higashi. In one review, a state regulator said it was "a pleasure" to visit. State regulators say they aggressively monitor the school and frequently review its policies and curriculum. They say that if the school were unsafe, they wouldn't allow it to operate.

In some cases, regulators have failed to interview witnesses to alleged abuse. Connecticut officials say one of their case workers, who was visiting a Boston Higashi student on Feb. 7, saw an instructor scream at the student and was concerned about bruises on the student's face. The worker filed a complaint with the Massachusetts Department of Social Services but says she was never contacted by investigators. A spokesman from the Massachusetts agency says an investigator made several calls to the worker but never made contact. Boston Higashi says the agency found no abuse.

In October 1999, two local women at a playground with their children called police to say they had witnessed a Boston Higashi instructor abuse a boy who was refusing to walk during a school outing there. "She was dragging him by the arm, then she would start kicking his legs, yelling at him to stand up, kicking him harder and harder," says one of the women, Lee Damore. "It disturbed me for a long time." The women also say the instructor and two other staff members repeatedly pulled and pushed other reluctant students while screaming at them.

Local police filed a complaint of alleged abuse with the Department of Social Services, a common route for such allegations. State investigators followed up by interviewing the instructors, who denied kicking or pushing students, according to the investigators' reports. Mrs. Damore and the other woman, Janice Cain, say investigators never contacted them.

Two months later, a state report concluded that the teachers had "utilized appropriate behavior management techniques while intervening with the children." The state says it never interviewed the women because the police indicated they didn't want to be contacted. The police department declines to comment. Mrs. Cain, who spoke to police when they arrived at the park, says she never indicated a reluctance to talk.

The state has also blamed some reports of abuse on ignorance of the Higashi way. The mother of a new Boston Higashi student said she witnessed several incidents of abuse in 1997, including a teacher who grabbed a student by the neck and dragged him into the gym. A state investigation concluded that "visitors to Higashi may misunderstand the regimentation of the program and may consider the treatment of children by staff to be harsh and inappropriate." The parent pulled her child from the school.

Write to David Armstrong at david.armstrong@wsj.com ¹

Updated September 30, 2002