Wednesday, February 1, 2012

Restraint and Seclusion: In Your Child's School and Nationally

Mary Brandenburg and Tony Brandenburg

Trigger warning: discussion of aversives, restraint and seclusion; mistreatment of disabled people

Recently, a story that has been in the headlines regarding treatment of students with disabilities concerned an autistic 4th grade boy in Kentucky. Reportedly, the boy smirked and threw a ball in class.  The teachers' response to this behavior was to stuff him in a duffel bag and tie the drawstring so he couldn't get out. His mom was called to the school to deal with his behavior. She discovered him when she heard a voice calling from the army bag. Thankfully, he didn't suffocate, but who can measure the emotional trauma he suffered?

Another school in the news, the Judge Rotenberg Center, uses painful electrical shocks, restraint chairs, shackles and seclusion to control the behavior of people with disabilities. This center, which charges $200,000 yearly tuition, has lobbied extensively in Washington against legislation establishing regulations to protect students in schools. The Rotenberg Center is a $200,000 per year crime -- a "therapeutic" torture center conducting behavioral experiments on people with disabilities that has to be seen to be believed. Photojournalist Rick Friedman published a photoessay about the Center in January 2011.

The current headlines make it clear that all schoolchildren are at risk for seclusion and restraint in private and public schools across America, but it is also becoming clear that students with disabilities are disproportionately subjected to these abuses. It happens nationally; it happens locally; and it may be happening in your school district as it is in ours. Students with disabilities are often vulnerable to such abuses due not only to manifestations of their disabilities being viewed as "misbehavior" -- but also due to their ability to understand and then follow through on directions given to them. Aversive interventions are often used to force "compliance," as well as simply for the convenience of staff working with them -- to make their jobs easier.

On May 27, 2009, The Council of Parent Attorneys and Advocates (COPAA) issued a report, “Unsafe in the Schoolhouse: Abuse of Children with Disabilities”  on the use of aversive seclusion and restraints on children with disabilities.  The statistic that caught our eye was that  that 68% of the students who were subject to seclusion or restraints were diagnosed with Autism or Asperger syndrome. As this particular sub-group in the population becomes more focused, both in their civil rights and their sheer numbers -- as of the 2008-2009 school year about 0.7%  of the population of all students enrolled in US public schools -- they become more of an active political force to be recognized. They are increasingly mobile and vocal about abuses leveled at their peers. The use of aversives against this sub-group has not gone unnoticed.

There is very little research showing therapeutic or educational value for restraint or seclusion in the classroom. Further, aversives frequently trigger the fight/flight response, as well as long term psychological trauma. There are numerous documented cases of injury and death attributed to these practices. A report issued by the U.S. Government Accountability Office (GAO) in 2009  estimated that over 200 students have died as a result of school based seclusion and restraints between 1999 and 2009. Two hundred children, murdered in American schools. Indiscriminate use of aversives, by people untrained to provide the supports necessary to teach this population, is not an acceptable substitute for planned, positive, systematic behavioral support.

We, as parents, have seen first hand the lasting effects of the indiscriminate use of aversive interventions. This includes seclusion and/or restraints at school used on our own children. These are not isolated occurrences. The school district our children attend had had a track record of alienating autism parents. When  a new Director of Special Education was hired in 2010, she commissioned an audit of the district's Autism Education Program, which was finalized during 2010-2011 school year.  It may come as no surprise to families with experiences similar to ours that an area found to be in need of improvement involved behavioral planning and programming. This includes the necessity for intensive behavioral training for all District staff.

It has been months since the audit in our children's school district was finalized.  Only now is there a task force being formed to address the deficits found in the audit. In the meantime, there is again turnover in leadership; our district will be hiring a new Director of Special Education. My question is: what is happening to special education students in our district in the meantime?

On December 16, 2011, US Senator Tom Harkin (D-IA) introduced a new bill, the Keeping All Students Safe Act (S.2020). This important piece of legislation seeks to establish minimum nationwide standards to protect schoolchildren from physical and psychological harm resulting from aversive behavioral interventions, including restraints and seclusion.

Key provisions of S.2020:
  • Prohibits seclusion -- in locked, or separate rooms/enclosures that a child cannot exit from.
    • Across the US, schoolchildren have been locked/blocked into closets, storage rooms, and/or isolated for hours at a time in separate rooms, denied access to their education, for often minor infractions, such as protesting, refusing, or even tearing their schoolwork. This practice was commonly used with my own child, without notifying us, and irregardless of whether there was a true emergency situation.
  • Bans physical restraints except in emergency situations where there is an imminent threat of serious bodily injury. Prone restraint is prohibited, as are any restraints restricting breathing.
    • In your child's school or district, what defines threats of serious bodily injury? Does it include "crimes" such as breaking or throwing pencils, tearing papers, pinches, slaps, kicks, screams, etc.? Or does the definition of "serious bodily injury" follow Title 18 of the U.S. Code?
  • Prohibits mechanical restraints such as locking students into chairs/devices, taping or tying them to furniture ... including stuffing students into duffel bags.
  • Bans chemical restraints such as medications used to control behavior that are not administered in accordance with a physician's orders.
  • Prohibits aversive behavioral interventions that compromise health and safety by inflicting physical and/or emotional pain to change behavior. This includes denial of food, water, bathroom use, as well as sensory exploitation such as spraying water or chemicals in the face, forced feeding, bathroom time outs, forced trash pick up, etc.
  • Requires that parents be notified within 24 hours of a child being restrained.
    • Past practices at our child's school, including incidents involving our child, were that parents were notified of restraints and seclusion being employed with students on numerous occasions often months after the fact, if at all.
  • Establishes numerous provisions promoting positive school climate and culture through positive intervention practices emphasizing conflict management and de-escalation, including school wide use of positive behavioral interventions and supports.
Something for all parents, not only parents of students with IEPs, to think about:

Does your local school practice:
  • Disciplinary measures such as: social isolation or public humiliation (such as placing students' names on the board), time-out rooms, guidance rooms, sitting students apart but in view of their peers, confining the student to a bench during recess, trash pick-up, or ridicule based on learning differences?
  • Physical punishment? (Examples: making students run laps, not as a normal PE requirement, but as a consequence of behavior; forcing children to write as punishment; witholding meals and breaks -- even for a few minutes; trash pick-up; or sensory assaults such as blowing a whistle in class in close proximity to students)
  • Over-correction? (Examples: making a student do a task over and over, even if it causes distress, or holding a child accountable for an action for days.)
  • Are these punishments or "consequences" at your child's school approved by the school district? Are the results long-lasting and develop positive outcomes? Do they seem reasonable?
So, parents, while we wait for the legislators, self-study committees, and the revolving door of administrators to figure out what to do, it is our role to start asking ourselves:
  • What is acceptable practice? 
  • Just because it was done before, does it make it good practice now? 
  • Is that the best we can hope for in the future?
  • Are the established schoolwide practices at your child's school educationally, ethically, and socially sound?
  • If it is unacceptable to treat your child this way, is it acceptable to treat another family's children this way? 
  • Do some children 'deserve' to be punished differently and more forcefully because their behavior doesn't meet your standards of conduct? 
  • If your child were to became disabled tomorrow, would you feel the same way? 
  • Would you be OK if they shoved your child into a duffle bag?
Editor's note: In the U.S., all children have a right to education at public expense.  The rights of children with disabilities to be educated is (in part) protected by the national law, the Individuals with Disabilities Education Act (IDEA). What is missing is the students' rights to be protected from abusive disciplinary policies.  

Among professionals, the discussion of "restraint and seclusion" as an ineffective response to students' behavioral challenges has been ongoing for more than a decade, as has research into positive behavioral supports.  However, the discussion has been slow to move into every-day classrooms. 

The "end restraint and seclusion in the classroom" movement started with the founding of  The Alliance to Prevent Restraint, Aversive Interventions and Seclusion (APRAIS) in 2004. A bill, the Preventing Harmful Restraint and Seclusion in Schools Act (HR 4247), was introduced to the House and passed with bipartisan support in 2010, but failed in the Senate. A similar bill, the Keeping All Students Safe Act (S.2020) was introduced in December 2011. 

The following resources will help parents and allies to understand the need for the bill, and how to advocate for the bill's passage.

From the Editor -- Resources: