Hidden camera reveals ABA therapist interacting 'roughly' with autistic 4-year-old boy
'You're just supposed to be neutral and firm,' says autism therapy expert after reviewing nanny-cam video
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When Jennifer noticed her four-year-old son Adam acting strangely after an at-home therapy session to treat his autism last September, she became suspicious.
So her husband installed a hidden camera. What they witnessed on video left them shaken and unsure where to turn for help.
- EXPLAINER:What is ABA therapy for autism?
- MORE IN THESERIES:Why is it so hard for Quebec families to gethelp for their autistic children?
Usually, Adam would greet Jennifer excitedly at the door when she arrived home from work. That September day, he stood with his head bowed, clutching his stomach.
When Jennifer tilted his face up to look at him, she said she noticed a red mark on his cheek that hadn't been there when she left the house that morning.
Jennifer asked his therapist, Stephanie Vernucci, what was wrong with him.
Vernucci said she didn't know how the mark got there.
"She kept saying, 'I don't know, I don't know,'" recalled Jennifer, who asked that their real names not be used to protect her son. "She said, 'He gave me a hard time today.'"
Adam wanted Jennifer to hold him. He then took his mother by the hand and led her to his room for a nap, which Jennifer said was completely out of character.
Vernucci followed them and explained she'd never seen Adam, who is non-verbal, act so badly, Jennifer said.
The therapist also said he'd been a handful for his grandmother, who had been caring for Adam earlier that day.
As soon as Vernucci left, Jennifer called her mother.
"I asked her, 'Did he give you a hard time?'" said Jennifer. "And she said, 'No, he was a little angel. He was happy and playing all morning.'"
Hidden camera
That night, Jennifer asked her husband to set up a hidden camera in the basement, where the therapist worked with Adam, to record the following day's session so they could see what was going on.
The camera was triggered by motion, capturing video but no sound.
When Jennifer and her husband watched the 93 minutes that had been recorded on video the following day, they couldn't believe what they saw.
Both were shocked at the way the therapist physically handled their son that day
- On two occasions, Vernucci is seen on the video pulling the bean-bag chair that Adam is sitting on out from under him.
- She is seen pulling Adam by his arm, three times. During one of those encounters, she roughly leads him to his work table and forces him to sit down.
- At one point, the therapist can be seen following behind Adam as he headed toward toward his bean-bag chair. Before he could reach it, the therapist caught up to him and appeared to push him to the ground. She then appeared to gesture for Adam to sit on the bean-bag chair. As he starts to sit down, she pulls the chair away.
- The video also recorded a moment where the therapist leads Adam by the arm to his bean bag chair. When he turns over onto his stomach, she grabs him by his ankles and pulls him into the middle of the chair.
- The recording also shows there is little actual therapy going on.
By the time Jennifer and her husband finished watching the video, Jennifer was shaking and crying uncontrollably.
"It was the ultimate betrayal," said Jennifer, who had been friendly with the therapist and said she'd treated Vernucci like family.
'High hopes' for Adam
When Adam was diagnosed with autism at two-and-a-half, his psychologist suggested therapy and recommended Alexandra Rothstein.
Rothstein is a behaviour analyst, certified by the Behavior Analyst Certification Board, a non-profit corporation based in the U.S.
Rothstein developed the program Adam would follow, but she, in turn, hired Stephanie Vernucci to execute it.
Jennifer's goal was to get Adam to speak, so she asked Rothstein for the best therapist she had.
"She didn't guarantee that it would happen, but she told me that's what her goals were too and that she had high hopes for my son," said Jennifer.
Vernucci worked with Adam three hours a day, five days a week for 16 months.
Rothstein dropped in every few weeks to monitor her, to make adjustments to Adam's program and consult with her parents.
Jennifer said she was present at most of those meetings and never noticed anything wrong with the therapy she saw or how Vernucci treated Adam.
About six months after the therapy started, Jennifer said Adam began to act aggressively. When he got upset, he'd hit, bite and pull people's hair acting out in ways he'd never done before.
Sometimes, when Vernucci arrived, he would refuse to go downstairs. Jennifer thought her son might be reacting that way because Vernucci was stern with him. At the time, she thought that's the approach Adam needed in order to learn.
Jennifer said Vernucci told her that her son didn't like to work and was lazy.
Increasingly, Jennifer said, she'd reported to Rothstein that she wasn't happy with Adam's progress.
During one of Rothstein's visits to check in on the therapy last summer, Jennifer said Rothstein noted Adam was not smiling or laughing.
Jennifer said Rothstein asked Vernucci to reduce some of the demands on him and try to make the sessions more fun, by taking him outside or to different parts of the house.
The following day, Vernucci sent Jennifer a video of her tickling Adam on his bed.
Confronting the therapist
After watching the video from that day's therapy session, neither Jennifer nor her husband slept that night. They tried to figure out what to do.
The following morning, Jennifer made a complaint to police, but ultimately the Crown decided not to press charges.
She and her husband then confronted Vernucci with an excerpt from the video, recording the audio from that conversation.
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In the audio tape, Jennifer can be heard bringing up the red mark on Adam's face that initially made her suspicious.
Vernucci denies doing anything to his face and denies physically harming Adam in any way.
She offers to give the family back their money if they will drop the police complaint.
Vernucci's supervisor, Rothstein, showed up at the family's home later that day. Even before she watched the video, Rothstein asked Adam's parents to drop the police complaint, Jennifer said, explaining that Vernucci was scared.
Jennifer refused.
"I told her that if this had happened to your child, you would do the same," said Jennifer.
Rothstein also explained Vernucci had been unwell recently and stressed out. She told Jennifer what happened that day was a one-time thing.
Earlier that month, Vernucci had given her notice and had about two weeks left to work with Adam.
Jennifer told Rothstein that Adam hadn't done anything to warrant a response like Vernucci's.
"He wasn't doing anything wrong. He was actually following orders," said Jennifer.
Jennifer said Rothstein stayed to watch the video then told them she was sorry their family was going through this and left.
With the exception of a text message the following morning asking them if they felt better, Jennifer said they never heard from Rothstein again.
Between Vernucci and Rothstein, Jennifer says they spent more than $23,000 on Adam's therapy over the course of 16 months.
While the money part of it stung, Jennifer said, that isn't what hurt the most rather, the time lost.
ABA shouldn't be 'rough or unkind'
When CBC showed the hidden-camera video to two experts, both were disturbed by what they saw.
Both were clear that what they saw was not applied behaviour analysis, or ABA, therapy. They were also emphatic: ABA does not include any type of rough interaction.
"No, no, no, for sure, we don't want to see any type of this behaviour," said Marc Lanovaz, an autism expert at the Universit de Montral.
Although Lanovaz didn't feel that the interactions between Vernucci and Adam constituted abuse, he categorized them as "rough" and "inappropriate."
As a board-certified behaviour analyst himself, he's supervised dozens of therapists. He said he'd be extremely unhappy if he saw one of his therapists acting in the way he witnessed on the video.
"It's not recommended to scold or seem aggressive or to seem mad, it's not things we're taught to do," said Lanovaz.
"You're not supposed to be mad. You're just supposed to be neutral and firm."
Lisa Reisinger, the second expert who reviewed the video, is a psychologist who works with autistic children at the West Montreal Readaptation Centre. She said any touching between a therapist and a child should be playful or instructional.
"It shouldn't feel rough or unkind in any way," said Reisinger.
Lanovaz and Reisinger were shown the data binder containing the details of Adam's program and noted it was well set out, however, they were struck by how little therapy Vernucci did with Adam in the course of the video.
Of the 93 minutes that was recorded, the therapist appeared to spend a little less than 15 minutes doing three separate exercises with him blocks, stickers and drawing. At least 25 times in that period, she is seen using her smartphone.
Disappointing, said Reisinger, because these sessions are so critical in helping children learn the skills they so badly need.
Vernucci, Rothstein respond
CBC contacted both Vernucci and Rothstein to get their side of the story.
After reviewing the video, Vernucci declined to comment.
Her lawyer, who watched the video with her, questioned the quality and accuracy of the video and said he thought Adam's parents were blowing the video's content out of proportion. He said his client is a good person who did nothing wrong.
When Rothstein was contacted by phone, she told CBC that once she had seen what happened in the video, Vernucci had been "immediately terminated."
She then referred us to her lawyer, who refused an interview on his client's behalf. He told CBC Rothstein was an honourable, hard-working woman with a successful company.
- READ MORE:Why is it so hard for Quebec families to get the help they need for their autistic children?
Following last September's incident, Jennifer decided to take Adam off therapy for a few weeks while she considered her options.
She now sends him to a centre for autism therapy where there are other people around. She said she's no longer comfortable having one-on-one therapy in a home setting.
She said Adam is happy, and his vocabulary has improved.
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