The Perils of Restraints: Stop Now

by Kristina Chew

category: safety

Published May 08, 2009 @ 12:41AM PT

A while back I put up an action to end the use of aversives, restraints and seclusion for students with disabilities and students in general. Yesterday WAPT.com (Jackson, Mississippi) reported that the parents of Samuel Wilkinson, who is on the autism spectrum and cannot talk, say that their son was "held down and beaten by teachers" in the Millcreek school district after he had a tantrum:

“My son can't talk but he's smarter than everyone else in this room,” Wilkinson said.

The Wilkinsons said the abuse happened two years ago when Samuel was attending school at Millcreek Behavioral Health Services in Magee.

Therapists at the Children's Advocacy Center used sign language and dolls to help Samuel explain what happened.

The Wilkinsons said no one at the school was ever held accountable.

Do you know if restraints have been used, or are being used, in your school district? If you're not sure, or just don't know, have you tried to find out?

It's hardly the sort of question to ask a special ed director outright. It's the kind of thing I've only found out about after the fact---after my own son was restrained without our consent in a previous school district, and from chance interchanges with other parents and some professionals who've seen the sad and lasting effects of children physically restrained. In my son's case (this was when he was about 7-8 years ikd in, again, another school district in New Jersey), the restraints must certainly have hurt---the basket hold, which involves the arms of a child being crossed in front of his or her body and twisted behind his or her back---was used. The staff was trying to stop him from banging his head; the teaching staff were, frankly, dealing with a situation that was more than they could handle and were trained for. But rather than admit this, the school district's response was for us to have some really terrible meetings with the out-of-district consultant (who was a friend of one of the administrators, as we later discovered).

Particularly disturbing to me was the fact that Jim and I had never agreed that restraints be used on Charlie. They were used and were told of them after the fact, and in a matter of fact way that made it sound like this was just "business as usual."

Um, no.

The May 4th Boston Globe notes that "since 2001, when school districts were required to start reporting the most extreme cases, schools have reported more than 900 cases of restraining students that resulted in injury or lasted for an extended period of time."

Rules adopted by the Massachusetts state education board in 2001 require that "school districts must receive parental permission before restraining students, unless they pose an imminent threat of harming themselves or others"; only physical restraints may be used, "except in cases where a physician has explicitly authorized a chemical or mechanical restraint and a parent approves the use in writing."

An example of a mechanical restraint is a Rifton chair, which was "designed to help children sit still"; in Racine, Wisconsin, a Rifton chair with a belt was used "inappropriately with certain students." The Boston Globe reports on what happened to a then 3-year-old autistic student whose being strapped into a chair was just one "procedure" used to address his behavior:

North Reading is embroiled in a dispute over the restraining of a 3-year-old autistic boy three years ago. On Feb. 8, 2006, a North Reading elementary school teacher thought he was too disruptive in a preschool classroom. As the boy cried hysterically, she strapped him into a chair designed to help special-needs children sit still and put him into a dark closet-sized room, according to a lawsuit filed this winter by the parents in Middlesex Superior Court. Then she walked away, shutting the door behind her, leaving the boy alone.

The boy's parents did not give permission for the J.T. Hood School to restrain their child, their lawyer said. They do not know how long their child was restrained in a Rifton chair. Another teacher freed him from the closet-sized room, according to the lawyer.

"He's had night terrors," said Sean T. Goguen, a Woburn lawyer representing the family, who asked that their son not be identified. "At the time the incident happened, he couldn't talk and couldn't convey the experience to his parents. . . . It doesn't seem right to me that a 3-year-old boy has to go to a therapist because of someone else's actions."

The state education department ultimately found that the teacher inappropriately restrained the child after the boy's parents - and not the school district - notified the department about the incident, according to an Aug. 22, 2006, letter the state sent to the school superintendent. The teacher never received training on restraining because she had a medically excused absence on the day it took place and should have made up the training before returning to the classroom, according to the letter.

The fact that the teacher was allowed to (a) miss training in how to restrain a child and (b) allowed to use some very improper and inappropriate methods on a young child---a 3-year-old; a young preschooler?---suggests how widespread misunderstanding and inadequate training regarding restraints is. It's been reported that the use of restraints is on the rise in public schools; whether this is because, as the Boston Globe suggests, there are more students with behavioral issues in public schools, it is not clear. What is clear is that very few are properly trained in crisis management techniques, and that the safety of students is potentially at stake. There are ways to address "difficult behaviors" but these require serious attention, careful training, and a thoroughgoing and compassionate understanding of why a student with disabilities is upset, anxious, and trying to communicate this in the ways that he or she can.

Restraints are short-term, stop-gap measures. They're never solutions, and we need to make sure that they are never seen as such and, further, that school districts stop using them---and start teaching, first and foremost.