A Critical Examination of State Agency Investigations into ...

and give positive reinforcement for more desirable behaviors. However, Jonathan’snoncompliant behaviors, such as flopping, aggression, stripping, and urinating on thefloor, increased during the summer of 2004.According to records reviewed by the Inspector General, in response toJonathan’s worsening behavior, on September 23, 2004, a new plan was implemented atthe school that intensified the “ignoring.” Staff members were instructed to placeJonathan in an empty room or in his own room, without his toys, books, or games, whenhe displayed negative behaviors. The modified plan did not have the desired effect, andJonathan’s negative behaviors continued and increased. However, the plan was notabandoned. Over the course of four weeks, the plan escalated into a program of mealmodification and increased isolation in his room. Jonathan was placed in his room forextended periods and was not permitted to attend school or to attend meals at theresidence dining table if he did not comply with verbal instructions to dress. Jonathanalso was not permitted to eat regular meals in his room. After approximately two weeksof missing some of his regular meals and at least one full day with virtually no food at all,a plan was written to provide Jonathan with substitute foods of soy milk, juice, soyyogurt, or ice pops in his room. Several days later, Jonathan’s window was covered witha frosted coating so that he could not look out. Staff had been instructed to change hissheets only once in the morning if they were wet with urine and to leave the bed unmadeif Jonathan wet the bed again. Jonathan’s parents claimed that on two separate weekendvisits before his withdrawal from the school, they found him hungry and bruised, lyingnaked on a urine-soaked mattress. The school’s proposed plans to implement a program24