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Autism Spectrum Disorders (ASD) Community
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627816 tn?1349241716

Stories of Seclusion and Restraint

http://ravingmotherfromhell.blogspot.com/

I began to see the similarities in the other children in the waiting room. While many of these children were not verbal, the behaviors were so familiar. One day, our son had such an explosive episode another Mom said to me, "Asperger's Syndrome"? And I said in a pleading voice, "I don't know".

That day, I got online and went to town on my research. Suddenly I had found it. Asperger's Syndrome. THAT was exactly our kid. I called up the Developmental Pediatrician who squeezed us in for a full Psychological Evaluation. We walked out with the diagnosis.

By this time, Preschool was well aware that we were trying to find answers. He, of course, was having behavioral issues there. But the teachers were really patient and understanding since they knew we were doing all we could. We were in the process of getting him some one on one supports when a new parent threatened to pull funds from the program if our son was allowed to continue there. I received a call that day from the teacher who was mortified. Her boss (an administrator who had never even met us) told her to call us and tell us we couldn't come back. I was sick.

We found another preschool, which was very accepting and accommodating. By this time, our local education system was getting him into an early intervention program. He continued in private preschool for three half days per week. He attended Early Intervention 2 days per week for a couple hours at a time. It was all going pretty well.

Enter the local school district.

In the Spring of 2004, we had a formal meeting to transition our son from Early Intervention to School Aged. At the time, we thought this was going to be our IEP meeting. Upon arrival, we were told that it was not an IEP meeting - but a transition meeting. We were given papers to sign him out of Early Intervention and a paper which stated our intention to enroll him in the district Kindergarten program. Assuming this was the process, we signed papers and went on our merry way.

In the summer of 2004, our local district offered us a summer school program that would allow him to become familiar with the Kindergarten rooms and school in general. We jumped at that chance knowing that familiarity was good. We couldn't have been more wrong. It was a horrendous disaster. The program was called "Success by Six" but it was really "Weed out by Six". The program was a sly way for administration to figure out which kids were going to be "problems". The goal was to break the wild ponies before fall. The summer teacher, who was a regular kindergarten teacher, was not allowing our son any accommodations. There was no tolerance for his quirks.

With the problems ensuing, I contacted the school district to find out about an IEP meeting. The district administrator told me that we didn't need any meetings - his Early Intervention IEP would carry through and we should "wait and see". BUT...she slipped and said he was not getting Physical Therapy. I hung up the phone and it dawned on me. I was very green on educational law. But I knew that they couldn't change the IEP without a meeting - which is what she insinuated had happened by removing PT.

I contacted our state's educational consult line first to find out if I was right. What I found out was MUCH more than I had expected. You see, that meeting where he was removed from Early Intervention was also supposed to be an IEP meeting for his school aged IEP. The school just ignored that and thus took him out of special education with no intention of ever telling us. I supposed they figured we'd be "none the wiser".

Talk about feeling bamboozled. BUT, we thought, okay...maybe they are just really screwed up and didn't KNOW what to do. We took the high road.

I formally called an IEP meeting in writing. Two weeks before the start of school, and IEP document was written. I was still fairly green, but had done enough research to make sure that we wrote something based on needs. Since there were no school evaluations done, I provided outside psychological reports, OT reports, you name it, I included it. I found a really nice document outline to give teachers about your child and customized it. I emailed and mailed copies to the team members in advance and had copies to give everyone at the meeting. The documents were never even so much as opened or glanced at.

Despite this, we walked out feeling pretty ok with things. Everyone seemed so nice. They assured us things would be great. Talk about being naive.

By the second week of school, the principal sent our son home for "behaviors". By the third week, he was threatening to expel our 5 year old. By week four, I was being told they were going to change his placement. I hired an advocate.

We found out that his IEP was not being followed because it was not a legal IEP. Our son never had a school evaluation to show a need so therefore, it was just a dummy document to shut us up. There was a plot to transfer our son out of the Autistic Support and into a emotionally disturbed classroom which was just full of problems.

Our Autism therapist (who works at a notorious Autism clinic) received a call from the school psychologist who attempted to persuade her into turning against us. The therapist questioned the school psych as to why they felt he wasn't on the spectrum. The school psychologist started rattling off behaviors that our Therapist advised were indeed indicative and quite common for Asperger's. The school psych, unhappy with that answer, said "We don't see it that way" and hung up on her. I was told this first hand by our therapist.
In the meantime, our son's anxiety was off the charts and he was becoming dark and withdrawn. He started talking about wanting to die. Finally, we had to have him admitted for his own safety.

We called the school to the plate. Do a Multidisciplinary evaluation and get this kid some supports. The school complied, although missed time lines. But in the meantime, his current teacher was really taking the high road and working with us, despite her administration. We also had a private one on one who made the rest of that year tolerable.


Summer was somewhat non eventful until two weeks before school start. We received a call that his one on one was taken off our case. The explanation was given that she wanted off. In the meantime, she and I had become close. I called her and she had no idea that they pulled her off the case. She put in a call and was told she'd lose her job if she pursued it. We soon figured out the school had "gotten" to our one on one's agency. He started first grade alone.

Within a few weeks, we found a new one on one via a new agency. It was going "okay" as far as we knew. By December, we had a different story. He came home with bruises from an Aide assisted by the Principal. We soon found out he had been put in seclusion and restrained while there in a very illegal prone restraint almost every day that year.

We pulled him out immediately, filed due process and enrolled him in Cyber School. He's been in Cyber for two years now and just flourishing. But in March of 2007 he had to do another inpatient stay due to depression.

It's been a ridiculous saga to get our child an education. But we've finally found a home with our Cyber Charter School. I've since learned what special education "should" look like. His school granted him extended year services this summer and sent him to an 8 week day camp to work on social skills. He made friends there. We are so thrilled.

That pretty much summarizes our story, leaving out a lot of gory details. I hope you take away something from it. Amy C.



13 Responses
627816 tn?1349241716
An Interview with Reece L. Peterson: About Restraints

An Interview with Reece L. Peterson: About Restraints
Michael F. Shaughnessy
Senior Columnist EducationNews.org
Eastern New Mexico University

Reece L. Peterson is in the Department of Special Education and Communication Disorders of the University of Nebraska-Lincoln, Lincoln, Nebraska. In this interview he responds to questions about the use of "restraint" and also provides some reference materials for those seeking further information or clarification.

1) First of all, let's be clear about terms---how do YOU define restraint and seclusion?

"Restraint" is defined as a method of restricting an individual's freedom of movement, physical activity or normal access to his or her body. The term is often used to address three different types of restraint strategies: using mechanical devices or objects to restraint a person's movement (handcuffs as one example), using chemicals which have the effect of restraining movement (for example psychotropic medications), or having one or more other person prevent movementby holding another (often called physical restraint).

All three types of restraint might occur in school settings.Mechanical devices have historically been used as assistive devices for children with disabilities. The use of these devices has become controversial when it has appeared that they may have been used to manage behavior rather than compensate for lack of orthopedic control. Although schools do not have a direct role in prescribing medications, they have been criticized for advocating to parents that they seek medication for their children as a tool for controlling their behavior. The use of medications prescribed for behavior problems such as Ritalin have become relatively widespread among school aged children. And finally, schools have also used physical or manual restraint procedures to hold down or restrain children who are out of control. Usually this entails one or more adults using their bodies to hold or control the body of a student, usually when the student has become agitated or "out of control".Most, but not all, of the discussion about restraint centers on the use of physical restraint by adults in the school environment using their bodies to restrain the bodies of students.

"Seclusion" occurs in schools when a student is sent from their normal educational setting to an environment where they are isolated from their peers, and prevented from seeing or hearing normal educational programming. Often this occurs in a small room or booth where the student is alone. The term seclusion is generally not applied to situations where students are sent to a hall, the school office, detention rooms or in-school suspension as these environments often do not prevent access to other people even though they may have some of the characteristics of seclusion such as lack of access to normal educational programming.

2) Is there any data as to how often they are used in the public schools?

Unfortunately, there is no scientifically sound data to know how often restraint or seclusion are used in public school settings. There is anecdotal evidence (newspaper reports, non-scientific survey data, individual teacher reports, etc.) however that both restraint and seclusion are quite widely used in public schools at the present time.

Both of these procedures have a long history of being discussed in professional literature related to the education of students with disabilities as well as in medicine and psychology. As students with more severe disabilities have been "included" in public schools within general education classrooms, it has been speculated that the use of seclusion and restraint has followed into these settings.It has also been speculated that fears about school violence, and school's efforts to take every possible action to reduce violence, or manage it when it does occur, have also fueled the use of these procedures in general public school settings for students who are, or who might become, violent or aggressive.

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3) Should not all possible other interventions be tried before seclusions? I would think positive reinforcement, (both primary and secondary) and a token economy, and a myriad of other strategies should be implemented before schools resort to restraint and seclusion?

When asked, virtually all professionals agree that restraint should never be used except in "emergency situations" where there is threat of injury to the student restrained or to others in the environment. A very few guidelines have also included the threat of serious property damage as a justification for its use, but only in emergencies. Unfortunately, there are hints in anecdotal data we have that it is used when emergencies are not occurring, such as to address non compliance.

Seclusion has been viewed as a behavior reduction strategy which is used for more than emergency situations, but has always been regarded in the literature as a consequence which should only be used when other less drastic measure have been tried.

Generally, the professional community would view the use of both restraint and seclusion as a "last resort" when other interventions including those mentioned in the question have been tried and have not been successful. There are long standing and detailed guidelines for the use of each of these procedures which have detailed how they should be used "appropriately" in school settings. There are numerous anecdotal reports (such as newspaper reports of incidents at schools) which would seem to indicate that both restraint and seclusion are not always being used in accord with guidelines. Indications are that they are being used more frequently than might be required if guidelines were being followed.

4) In your mind, how does time out differ from seclusion?

Seclusion can be used as one way to removea student from their access to the reinforcing stimuli for an in appropriate behavior.Thus the phrase "time out from positive reinforcement". However, seclusion can also be used as an environment to "cool down"to think and reflect on behavior, do problem solving, etc., or simply as a punishment in itself. These other motivations for using seclusion have probably become far more widely used in schools than the more behaviorist use of "time out from positive reinforcement".

There are also forms of "time out from positive reinforcement" which can be used without seclusion. In these types of "time out" the student remains in the classroom environment such as a using a time out necklace or time out chair within the classroom environment.

Because of the original association, the term "time out" is often applied to the use of seclusion whether or not the seclusion is designed to address removal from positive reinforcement. It has become a generic term for seclusion in some places. However, a wide array of euphemisms or other terms are used for "seclusion" is various schools, with equally many explanations about why this strategy is being employed.

5) What legal challenges do schools face in trying to use physical restraint in the schools?

Numerous deaths and injuries have occurred when restraints have been used in schools and other types of treatment programs. Given this, schools may very likely have liability for the deaths or injuries that might occur, especially if they were not following appropriate procedures for their use.

Conversely schools that have custody of students in school and serve in loco parentis may also have liability if they do not restrain students who are violent or who might injure themselves or others.

I often refer to two newspaper articles which appeared not long ago in Iowa as an example of how schools can be liable if they do restrain and the student is injured (in this incident, the student died while being restrained), or if they do not restrain and the student is injured (in this incident the student who was not restrained fell in a river and drowned). My conclusion in the NY Times article was that they will be criticized and may have liability either way.

The use of seclusion entails somewhat different issues, there may be legal liability for the inappropriate use of this procedure or when students spend extended time periods in seclusion, thus preventing access to education.

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6) I believe there is training for individuals who are dealing with violent, aggressive, assaultive children. Are you aware of these programs?

There are a wide variety of programs which provide training intended for human service professionals for dealing with aggressive or assaultive persons. These now focus primarily on conflict de-escalation but often include some training on physical restraint holds and procedures as well. Many schools obtain and use this training, but there is no requirement that they do so, nor data about the effect of this training on the use or non-use of restraints or seclusion. While I have provided a representative list of some examples of these training programs, no endorsement of these programs should be implied.

7) Can schools suggest parents take their child to a psychiatrist for medication rather than resorting to restraints and seclusion?

While schools can suggest that parents have their children medically evaluated as a part of a comprehensive assessment, and will provide behavioral data to physicians when requested by the parents, when using good professional practice schools should not advocate for parents to obtain medications. Federal and state regulation may also prescribe schools from advocating that parents seek medications for their children related to their behavior. These are viewed as medical decisions between family and physicians in which schools should not interfere.

8) Should not some type of FBA (Functional Behavior Assessment) be done before restraints and seclusion?

Appropriate professional practice would require that a Functional Behavioral Assessment be conducted as soon as there is potential for serious inappropriate behavior, particularly behavior which might be aggressive or violent. However, FBAs are only required by federal policy when a student with a disability has behavior which might violate the school's discipline policies. Most schools only do FBAs for students with disabilities, even though both seclusion and restraint might be used also with non-disabled students.

9) I understand that the NY Times and perhaps also the CEC site either misunderstood or misquoted you. Here it a chance to set the record straight. What did you say and how were you misquoted?

The New York Times article (July 15, 2008) did an adequate job of distilling information from an approximately two hour telephone interview and did not misquote me. The company which provides the CEC email news service which apparently was abstracting the New York Times article attributed statements to me which I did not make and which were not in the New York Times article. Although I have not seen it, I understand that at my request a retraction of that original CEC email announcement has been sent out to the CEC email news recipients.

10) Last tough question, but in my mind, if a school has to resort to physical restraint, should not the child perhaps be in a residential treatment facility or be receiving one to one graduated guidance or some other option?

Public schools have been asked to serve more and more students with serious behavioral disorders and mental health challenges. Many times as students have moved to or been identified in schools as having these challenges,the resources (smaller class sizes, specialized teachers, support staff, and counselors) have not been available to the extent required to be successful with them. For many of these students, we do not have effective treatment options, under the best of circumstances. Unfortunately, we are not under the best of circumstances in schools.

There is a special education teacher shortage, and a lack of highly trained educators to work with these types of students which exacerbates the problem. Poorly trained and under resourced programs may be more likely to use restraint and seclusion as basic behavior management strategies rather than the way they are intended to be used.

It is certainly true that a student with a disability whose behavior cannot be managed in a particular setting effectively, and whose behavior might regularly require the use of seclusion or restraint, should be referred to a more restrictive setting (such as self contained classroom, day or residential treatment, or even hospitalization). At the same time parents and the principle of "least restrictive environment" expect that students should be given the chance to be educated in the most normal environment possible. The guidelines for predicting student behavior and making placement decisions are not clear-cut and whichever way schools go in making these decisions they may be criticized and "second guessed".

Very challenging behaviors by students, lack of resources and training, lack of effective treatment options all make this an increasingly difficult situation.

11) What question have I neglected to ask?

What are parent and advocacy positions on this topic?

Several parent advocacy and disability organizations have gone on record as opposing the use of restraint and seclusion, and have vowed to work for the total elimination of their use with children. (For example see the website of the APRAIS coalition at http://aprais.tash.org/ ) In addition, one federal governmental agency SAMHSA has taken a similar position (http://www.samhsa.gov/matrix2/seclusion_SAP.aspx). These organizations would argue that the risks associated with the use of these interventions do not merit their continued use, that these procedures do not have good evidence for their effectiveness, and that these procedures should be opposed because they attack basic human rights and dignity.

Does the federal government have any laws or guidelines which address the use of restraint or seclusion in school settings? What about individual states?

No, the federal government does not have any policy addressing the use of these procedures in schools or educational settings. The federal government does have a law requiring reporting of these procedures in certain hospital and residential treatment settings. States vary tremendously on this issue.Some have policies or regulations, andothers have guidelines or technical assistance documents on these topics for the school use of these procedures.. Several states are in the process of developing or modifying their policy on these topics in response to various incidents of abuse of these procedures or as a result of parent advocacy organizations requests. (I have contributed to two journal articles on this topic recently- see the attached reference list). Given the problems with the apparent over use and abuse of restraint and seclusion which have been emerging over the past few years in schools across the country, more strict and uniform policy requirements for schools on these topics may be needed. More data about and attention to how these procedures are used is certainly warranted.

627816 tn?1349241716
Web Links Related to Restraint and Seclusion

Alliance for the Safe, Therapeutic & Appropriate Use of Residential Treatment http://cfs.fmhi.usf.edu/cfsnews/2005news/A_START.html,or http://astart.fmhi.usf.edu/AStartDocs/family.pdf

Alliance to Prevent Restraint, Aversive Interventions and Seclusion, www.aprais.org  

American Psychiatric Association.Behavioral Health Groups- Publish
"Learning From Each Other: Success Stories and Ideas for Reducing Restraint/Seclusion in Behavioral Health". This Resource Guide Provides Practical Help in Creating a Culture of Safety, Respect, and Dignity.
http://www.psych.org/Departments/QIPS/PatientSafety/SeclusionandRestraint.aspx

Child Welfare League of America. (2002). Advocacy: Seclusion and restraints: Fact sheet, http://www.cwla.org/advocacy/seclusionrestraints.htm

Coalition Against Institutional Child Abuse, www.caica.org  

Federation of Families for Children's Mental Health, www.ffcmh.org

National Association of Psychiatric Health Systems.Guiding Principles on Restraint and Seclusion for Behavioral Health Services, February 25, 1999.
http://www.naphs.org/News/guidingprinc.html

National Association of State Mental Health Program Directors.(2001). Position statement on seclusion and restraint [On-line]. Available:
http://www.nasmhpd.org/general_files/position_statement/S&R%20position%20statement.Forensic%20Div.%20prop.%20approved%20by%20NASMHPD.07.07.final.pdf.

Substance Abuse Mental Health Services Administration, www.samhsa.gov and specifically http://www.samhsa.gov/Matrix/SAP_seclusion.aspx



Representative Examples of Training Programs that include a component on Physical Restraint

Program
Contact Information

Handle With Care Behavior Management System, Inc.
Handle with Care
Crisis Intervention & Behavior Management
184 McKinstry Road
Gardiner, NY 12525
845-255-4031
http://www.handlewithcare.com

JKM Training, Inc.
JKM Training, Inc.
36 South Pitt Street
Carlisle, PA 17013
717-960-0458
http://www.jkmtraining.com

Mandt System
David Mandt & Associates
P.O. Box 831790
Richardson, TX 75083-1790
800-810-0755
http://www.mandtsystem.com/

NAPPI International
NAPPI International
1-800-358-6277
http://www.nappi-training.com/

Nonviolent Crisis Intervention
Crisis Prevention Institute, Inc. (CPI)
3315-K North 124th Street
Brookfield, WI 53005
800-558-8976
http://www.crisisprevention.com

ProACT

Professional Assault Crisis Training
P.O. Box 5979
San Clemente, CA 92674-5979
949-489-5700;
www.parttraining.com

Response
Response Training Programs
Shutesbury, MA 01072
413-367-2485
http://www.responsetrainings.com/

Therapeutic Crisis Intervention (TCI)
Residential Child Care Project
Family Life Development Center
College of Human Ecology
Cornell University, Ithaca, NY 14853
607-254-5210

Therapeutic Options
Therapeutic Options, Inc.
100 Delaplane Avenue
Newark, Delaware 19711
302-753-7115;http://www.therops.com/



Selected References Related to Restraint and Seclusion

American Academy of Child and Adolescent Psychiatry (2002). Practice parameter for the prevention and management of aggressive behavior in child and adolescent psychiatric institutions, with special reference to seclusion and restraint. Journal of the American Academy of Child and Adolescent Psychiatry, 41(2), 4S-25s.

Day (2002). Examining the Therapeutic Utility of Physical Restraint and Seclusions and Seclusion with Student and Youth: The role of theory and research in practice. American Journal of Orthopsychiatry, 72, 266-278.

Fogt, J.B., & Piripavel, C.M.D. (2002).Positive school-wide interventions for eliminating physical restraint and exclusion.Reclaiming Children and Youth: The Journal of Strength-Based Interventions, 10 (4), 227-232.

George, M.P. (2000) Establishing and promoting disciplinary practices at the building level that ensure safe, effective, and nurturing school environments. In L.M. Bullock & R.A. Gable (Eds.), Positive academic and behavioral supports:Creating safe, effective, and nurturing schools for all students.Reston, VA: Council for Exceptional Children, 11–15.

George, M.P., & George, N.L. (2000). A culture of hope: Fostering success in alternative day school settings. Reaching Today's Youth, 4, 23–27.

George, M.P., White, G.P., & Schlaffer, J.J. (2006). Implementing school-wide change: Lessons from the field.Psychology in the Schools, 44, 41-51.

Haimowitz, S., Urff, J. & Huckshorn, K.(2006) Restraint and Seclusion - A Risk Management Guide.Available: http://www.nasmhpd.org/general_files/publications/ntac_pubs/R-S%20RISK%20MGMT%2010-10-06.pdf

Nelson, C.M. & Rutherford, R. (1983).Timeout revisited: Guidelines for its use in special education. Exceptional Education Quarterly,3, 56-67.

Miller, D.N., George, M.P. & Julie B. Fogt, J. B. (2005).Establishing And Sustaining Research-Based Practices At Centennial School: A Descriptive Case Study Of Systemic Change. Psychology in the Schools, 42(5), 553-557.

Peterson, R.(2002).Physical restraint.Lincoln, NE: Safe and Responsive Schools Project, University of Nebraska-Lincoln.Available: http://www.unl.edu/srs/facts.html

Rozalski, M. E., Yell, M. L., & Boreson, L. A. (2006). Using seclusion timeout and physical restraint: An analysis of state policy, research, and the law. Journal of Special Education Leadership, 19(2), 13-29.
Ryan, J.B., Sanders, S., Katsiyannis, A. & Yell, M.L. (2007). Using timeout effectively in the classroom. Teaching Exceptional Children, 39(4), 60-67

Ryan, J.B. & Peterson, R.L.(2004).Physical restraints in school.Behavioral Disorders, 29(2), 155-169

Ryan, J.B., Peterson, R. & Rozalski, M. (2007). State policies concerning the use of seclusion timeout in schools.Education and Treatment of Children, 30(3), 1-25

Ryan, J.B., Robbins, K., Peterson, R. & Rozalski, M.(2008).Review of State Policies concerning the use of restraint in schools.Manuscript in preparation.


627816 tn?1349241716
Guest Commentary: Corporal punishment has no place in our public schools
by Phyllis Walters, Naples school psychologist
6:15 p.m., Saturday, August 30, 2008



    
Despite evidence of the ineffectiveness of corporal punishment, many school districts in Florida continue to allow this practice.

A recent joint report from the American Civil Liberties Union and “Human Rights Watch” says more than 200,000 children were spanked or paddled in U.S. schools last year.

The groups also say African-American students and students with mental or physical disabilities get a disproportionately high number of spankings. Corporal punishment discourages learning and even provokes misbehavior in kids. According to the U.S. Department of Education, 21 states permit corporal punishment. Most states leave it up to individual districts to decide whether corporal punishment should be allowed, and many districts allow parents to opt out of it by signing a waiver stating they don’t want their child spanked.

The Mobile County School District in Alabama and districts in Dallas, Memphis, Houston and Atlanta have all banned the practice.

Schools are the only institutions in America in which striking another person is legally sanctioned. It is not allowed in prisons, in the military or in mental hospitals. In a society that is already marred by appalling rates of physical violence, schools should not be condoning a practice that contributes to the cycle of child abuse and the pro-violence attitudes of American youth.

Corporal punishment has been found to be associated with higher levels of violence and aggression, decreased self-control and symptoms of depression and anxiety. Bruises and broken bones are not unusual consequences of corporal punishment; tragically, children have even died as a result of corporal punishment.

The Florida Association of School Psychologists recognizes that discipline is necessary for effective schooling but encourages schools and teachers to utilize one of the numerous empirically-supported alternatives to corporal punishment, including positive behavioral support, behavioral contracting, positive reinforcement of appropriate behavior, social skills training, disciplinary consequences with instructional or reflective components programs that emphasize early diagnosis and intervention, student recognition programs, peer mediation and providing parent training and classes on effective discipline.

School psychologists, social workers, guidance counselors and other mental-health professionals can provide many direct and indirect services to improve the discipline of individual children, as well as services to improve classroom and schoolwide discipline.

As a current school psychologist practicing privately, as well as an employee of Collier County Public Schools, I challenge our state Legislature to adopt more effective and constructive alternatives to school discipline and to draft bills that will lead to the abolishment of corporal punishment in Florida.

Phyllis Walters, Ph.D., is a licensed and nationally certified school psychologist who provides psychological services in both her private practice in Bonita Springs as well as Collier schools. Walters has served on the executive board of the Florida Association of School Psychologists for seven years
627816 tn?1349241716
Treasure Coast Homeroom
By Colleen Wixon
Are teachers trained well enough to deal with autistic kids?
Posted August 15, 2008

I'm working on a story about whether teachers of autistic children get enough training. There are a lot of complaints from parents throughout the state and country on how their children with special needs are treated in classrooms. Many parents claim their children are being unnecessarily restrained or placed in seclusion rooms as a behavior management technique.

Please post comments

http://www.tcpalm.com/blogs/treasure-coast-homeroom/2008/aug/15/autism/

627816 tn?1349241716
Here is the article at:
http://www.projo.com/education/content/BLOCK_ISLAND_SCHOOL_ROOM_06-14-08_H0A
FVHL_v43.3734e71.html


It is admirable how schools will take every opportunity to comply with
confidentially.

-- When it suits their needs.

-----
Block Island officials defend room in school basement

08:40 AM EDT on Saturday, June 14, 2008

By Katie Mulvaney

Journal Staff Writer

NEW SHOREHAM - Room 20 in the basement of the Block Island School is
small and bare. Its concrete floor is painted green, its ceiling sky
blue with white clouds, its main window covered with plywood. And,
until earlier this week, its knob-less door had double bolts on the
outside.

An anonymous letter raising questions about the room and a DVD showing
it arrived at The Providence Journal, three television stations, and
the attorney general's office last week. In the brief video, a camera
silently pans the room, showing the locks. It also shows pillows and
blankets in a jumble on the floor, an open utility outlet, chipped
paint and fingerprints smudging the walls. The letter makes no
allegations, but raises questions about whether unruly children might
have been sent there.

On Tuesday, Davida Irving, principal of the two-story school since last
July, acknowledged that there might be such a room, but didn't know its
location. She said she had been told it was developed in consultation
with Bradley Hospital as a space for a child "to chill out." Asked if
there were external locks, she went to look, returning perplexed. "I've
never seen a student locked in there since I've been here," she said.

During the interview, she placed a call to Supt. Leslie A. Ryan, who
was off island. Ryan told her not to let a reporter see the room.

When the superintendent, who doubles as special-education director,
returned on the 3 p.m. ferry, she said the school lawyer would issue a
statement the next day as she stormed to her car.

Calls that evening to all five School Committee members were not
returned. Teachers reached for comment said they knew nothing of the
room, or were reluctant to talk. One said it was a special-education
issue and she didn't have the authority to discuss it.

Jack Lyle, the school's previous superintendent, said there was no such
room when he led the district from 2004 until Ryan took over in 2006.
"That wouldn't have happened on my watch," Lyle, now a practicing
lawyer, said. "That would go against every fabric of my being."

An official at Bradley Hospital denied any involvement. "There is not a
chance. Nobody would have worked on a room like that," said Dr. Dale
Radka, director of Bradley School who oversees all consultation with
school districts. "Bradley doesn't consult anybody about these kinds of
locked facilities."

It is common, he said, to have focus rooms in which students can
quietly calm down, but a locked seclusion room would only be used as a
last resort to prevent a very disturbed child from endangering him or
herself or others. But, he added, there should be stringent policies
and a highly trained staff in place first.

He speculated that more districts would turn to such approaches as
budget cutbacks sway them to integrate high-needs children into public
schools.

The Journal returned to the Block Island school Wednesday morning, and
Ryan again rebuffed attempts to view the room, saying she had to
protect students. She handed out a statement that read:

"The Block Island School excels in providing support and appropriate
education to all of its students. We have never taken punitive action
involving locked doors or any other archaic practice. Specifics of
behavior plans designed for special-needs students are confidential
and, on this island, can prompt immediate identification of the
student. We have a team of qualified and caring teachers and therapists
who advocate every single day for every single child."

Ryan refused to answer questions. "I've given you a statement and
that's the end."

She referred the reporter to Vincent Carlone, the island's chief of
police.

In his office looking out on Old Harbor, where the ferries come in,
Carlone said that he investigated the room Tuesday after a television
reporter asked about it. He concluded there were no safety concerns,
adding that the two outside locks had already been removed.

The district created the room, he said, as a way to keep a specific
child with violent tendencies on the island, instead of being sent to a
residential facility away from family. A difficulty of living on an
island is having limited access to services readily available on the
mainland, he said.

Asked why a police chief was talking about an education matter, he said
school officials were restricted by "confidentiality laws."

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The superintendent told him, he said, that one or two aides always
accompanied the child. The room was used "infrequently" and had not
been used "recently," he said. He was unable to be more specific. He
said he had heard nothing about any other children being placed in the
room.

"I don't know if they locked that lock," he said. But, he said, the
child enjoys the room.

"No one's in danger," the chief said. School officials "go out of their
way to help the kids."

He emphasized that the superintendent told him the room had been set up
in consultation with Bradley, an East Providence hospital specializing
in children facing emotional, mental and behavioral challenges.

Told that Bradley denied any involvement with the room, the chief said,
"They [school officials] wouldn't lie to me."

Repeated efforts to get the name of the Bradley contact were denied.
School lawyer Denise Myers said, through the chief, that such
disclosure would violate a federal law that protects the privacy of
personal health information.

After getting clearance from Myers, Carlone took The Journal to see the
room. A Journal photographer, however, was barred from taking pictures.

A thin floor mat lay in one corner with a pile of fabric resembling a
blanket on top. The plywood on the window is there to prevent a student
from striking the glass, Carlone said. The door has a small rectangular
window and holes where the locks had been removed.

"If they made a mistake, they made a mistake with the locks," the chief
said. "But they certainly didn't do it to hurt anyone."

The wife of a School Committee member reprimanded the reporter, saying
it was a private matter.

The state police and a prosecutor from the attorney general's office
visited the school Thursday. They will discuss their evaluation with
state education officials, Maj. Steven G. O'Donnell said later.

The investigation is expected to conclude in the next few weeks,
according to Michael J. Healey, spokesman for the attorney general.

"It looks like the room was used as some sort of time-out space,"
Healey said. "I really doubt we're talking about anything of a criminal
nature."

After The Journal inquired about regulations involving locked isolation
rooms, Marvin Abney, the assistant to the education commissioner for
equality and access, called school officials Thursday. He was assured
that the locks had been taken off the room, Elliot Krieger, spokesman
for the Department of Education, said.

Rhode Island regulations do not allow unobserved time-out rooms or
rooms used solely for time-outs. They also do not allow a student to be
confined alone in a room without access to school staff.

"Any kid in a locked room would concern the state - period," Krieger
said. "That seems to be a safety problem."

Yesterday afternoon, the School Committee met in closed session to
discuss the issue. Chairman Bill Padien could not be reached for
comment.

The individual behind the DVD and the letter sought anonymity
yesterday, saying he feared there would be retribution against his
family for blowing the whistle on the locked room in the basement.

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Time-out rooms revisited

BY JOHN HILDEBRAND
STAFF WRITER

January 7, 2006, 9:10 PM EST

It's Thursday afternoon at the Masera Learning Center, a special-
education school in West Islip, and a 7-year-old autistic girl has
just bitten teacher Laura Kearnes on the leg. Keeping calm, Kearnes
sends a terse message over the school's intercom.

"Code C ... Room 107."

Quickly, a team of four adult staff members arrives. The student
backs off temporarily, then flies into another tantrum before she is
taken to a padded room to calm down. Masera averages eight to 10 such
confinements each month in its two "quiet" rooms combined -- and
necessarily so, the staff says, though they add that the rooms are
used as a last resort.

"Students really need some time to regroup, so they can get back to
what they've been doing," said Robert Becker, director of special
education at Eastern Suffolk BOCES, which operates the Masera center,
one of dozens of special-education facilities on the Island. "It's
like anything else -- if used appropriately, it does work."

Use of rooms challenged

Debate is growing over such confinements, however, and not just on
Long Island, where some parents recently objected to use of a cubicle
known as a "time-out" room at a Nassau BOCES school in Wantagh.

Nationwide, long-standing support for special confinement rooms on
the grounds that they help improve students' behavior is under
challenge by psychological researchers and family advocates who say
such rooms often do more harm than good. The debate has spread to
more than a half-dozen states, including big ones such as Texas,
California and New York.

In some states, child advocates have seized policymakers' attention
with reports of disabled students locked for hours on end in rooms
the size of closets and stained with urine.

In New York State last month, education authorities issued a bulletin
to every school superintendent in the state and reminded them of
their obligation to comply with state guidelines governing time-out
rooms.

The advisory was triggered by the complaint of a Hicksville couple,
William and Janet Schafer, who have charged that their
developmentally disabled son was illegally confined more than 20
times over four months in a 5-by-6-foot padded cubicle maintained by
Nassau BOCES.

A civil lawsuit is being prepared in that case. Officials at Nassau's
Board of Cooperative Educational Services, a regional agency based in
Garden City, say the room is used according to state guidelines.

In theory, a last resort

While conceding that abuses do occur, school administrators in charge
of time-out rooms nationwide say the vast majority are managed safely
and humanely -- and only after teachers have tried less drastic ways
of dealing with students' outbursts. Typically, such confinements are
said to last 10 to 15 minutes.

On Long Island and elsewhere, many educators defend padded rooms as
essential in restraining out-of-control students who can endanger
teachers, classmates and themselves. Also, some say the isolation
sometimes is therapeutic, in the sense that it may help students calm
down and behave.

Still, some behavioral experts question whether such rooms can
effectively alter behavior for the better -- particularly among
students with disabilities who are the ones most likely to be
forcibly secluded.

Edward Carr, a psychology professor at Stony Brook University who has
worked with thousands of disabled youngsters and their families,
advises teachers to look for early signs of distress in such
students. The students then should be given stress-reducing breaks --
for example, in a room where music is playing -- rather than putting
them in austere rooms with no furniture or decorations.

"Think about it," Carr said. "When you want to relax at home, do you
lock yourself in a padded room? Do you? Don't you just go to a
pleasant, peaceful area?"

Nationwide, confinement rooms are known by a variety of names,
including seclusion rooms, time-out rooms or "stop-and-think" rooms.
Many were first set up in the mid-1970s, when a new federal law
allowed hundreds of thousands of disabled youngsters to get
educational services for the first time. Often, such rooms are bare
of furnishings except padded gym mats that line walls and doors for
safety's sake.

While rare in regular schools, such rooms are common in centers
enrolling students with severe disabilities. A 1995 research study of
156 students at a special-education facility in upstate New York
found they were confined an average of 83 times each over the school
year.

More recently, Minnesota became the scene of a statewide debate after
child advocates issued reports of disabled teenagers repeatedly
handcuffed in front of classmates and shut away by themselves -- in
one case for more than 31/2 hours. Advocates elsewhere point to such
incidents as evidence that such rooms are used routinely and not just
as last resorts.

"It just invites everybody to say, 'Hey, I've got a kid who's
throwing pencils. There's that room -- let's use it,'" said Curt
Decker, executive director of the National Disability Rights Network,
a Washington-based group providing legal advocacy services.

'Quiet room' alternatives

To avoid violent confrontations, educators have been developing
milder strategies.

At the Masera center, lessons typically start with deep-breathing
exercises meant to calm students, many of whom are severely autistic.
Students who refrain from spitting and other misbehavior are rewarded
with breaks and other incentives. And teachers frequently use flash
cards to communicate with those unable to speak.

It's difficult, time-consuming work that doesn't always get the
desired result. Many parents express sympathy for teachers working
under such conditions and say they understand that seclusion rooms
sometimes must be used. They also say they'd rather their children be
isolated than physically restrained, which is another option
sometimes used.

"In a way, what's the alternative?" asked Matt Cody, the father of
three autistic students who attend another BOCES school in Stony
Brook. A retired Wall Street investment executive, Cody has founded a
center at Stony Brook University devoted to research and training in
dealing with autism.

Others disagree. Among them is Deborah Ross of Shelter Island, who is
pursuing a $25 million civil lawsuit against her school district.
Ross contends that school employees traumatized her son in the spring
of 2003, when they shut him inside a padded room without her
permission. The district says its action was legal.

The boy has since transferred to another school, and the room itself
has been converted for instruction. Still, the mother feels
confinement has done lasting damage to her 10-year-old.

Said Ross: "He's still having bad dreams."

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Children forced into cell-like school seclusion rooms
http://www.cnn.com/2008/US/12/17/seclusion.rooms/index.html#cnnSTCVideo  (Click on the link and then click on the word video under the title of the article to see the  interview with Jonathan's parents)

December 17, 2008 - By Ashley Fantz CNN
MURRAYVILLE, Georgia (CNN) -- A few weeks before 13-year-old Jonathan King killed himself, he told his parents that his teachers had put him in "time-out."


The room where Jonathan King hanged himself is shown after his death. It is no longer used, a school official said.

"We thought that meant go sit in the corner and be quiet for a few minutes," Tina King said, tears washing her face as she remembered the child she called "our baby ... a good kid."
But time-out in the boy's north Georgia special education school was spent in something akin to a prison cell -- a concrete room latched from the outside, its tiny window obscured by a piece of paper.

Called a seclusion room, it's where in November 2004, Jonathan hanged himself with a cord a teacher gave him to hold up his pants.  Watch Jonathan's parents on their son's death »

An attorney representing the school has denied any wrongdoing.

Seclusion rooms, sometimes called time-out rooms, are used across the nation, generally for special needs children. Critics say that along with the death of Jonathan, many mentally disabled and autistic children have been injured or traumatized.

Few states have laws on using seclusion rooms, though 24 states have written guidelines, according to a 2007 study conducted by a Clemson University researcher.

Texas, which was included in that study, has stopped using seclusion and restraint. Georgia has just begun to draft guidelines, four years after Jonathan's death.

Based on conversations with officials in 22 states with written guidelines, seclusion is intended as a last resort when other attempts to calm a child have failed or when a student is hurting himself or others.

Michigan requires that a child held in seclusion have constant supervision from an instructor trained specifically in special education, and that confinement not exceed 15 minutes.

Connecticut education spokesman Tom Murphy said "time-out rooms" were used sparingly and were "usually small rooms with padding on the walls."

Only Vermont tracks how many children are kept in seclusion from year to year, though two other states, Minnesota and New Mexico, say they have been using the rooms less frequently in recent years.

Dr. Veronica Garcia, New Mexico's education secretary, said her state had found more sophisticated and better ways to solve behavior problems. Garcia, whose brother is autistic, said, "The idea of confining a child in a room repeatedly and as punishment, that's an ethics violation I would never tolerate."

But researchers say that the rooms, in some cases, are being misused and that children are suffering.

Public schools in the United States are now educating more than half a million more students with disabilities than they did a decade ago, according to the National Education Association.

"Teachers aren't trained to handle that," said Dr. Roger Pierangelo, executive director of the National Association of Special Education Teachers.

"When you have an out-of-control student threatening your class -- it's not right and it can be very damaging -- but seclusion is used as a 'quick fix' in many cases."

Former Rhode Island special education superintendent Leslie Ryan told CNN that she thought she was helping a disabled fifth-grader by keeping him in a "chill room" in the basement of a public elementary school that was later deemed a fire hazard.

"All I know is I tried to help this boy, and I had very few options," Ryan said. After the public learned of the room, she resigned from her post with the department but remains with the school.

School records do not indicate why Jonathan King was repeatedly confined to the concrete room or what, if any, positive outcome was expected.

His parents say they don't recognize the boy described in records as one who liked to kick and punch his classmates. They have launched a wrongful death lawsuit against the school -- the Alpine Program in Gainesville -- which has denied any wrongdoing. A Georgia judge is expected to rule soon on whether the case can be brought before a jury.

Jonathan's parents say the boy had been diagnosed since kindergarten with severe depression and attention deficit hyperactivity disorder. But his father remembers him as a boy who was happy when he sang in the church choir.

"He was a hugger, liked to go fishing with me and run after me saying, 'Daddy, when are we going to the lake?' " Don King said.

King said that he wanted to know if there were similar situations in other schools and that critics of seclusion rooms fear there could be.

"Jonathan's case is the worst of the worst, but it should be a warning. It's reasonable to think that it could happen in all the other schools that use seclusion on disabled children -- largely because the use of seclusion goes so unchecked," said Jane Hudson, an attorney with the National Disability Rights Network.

"This is one of those most unregulated, unresearched areas I've come across," said Joseph Ryan, a Clemson University special education researcher who has worked in schools for disabled kids and co-authored a study on the use of seclusion.

"You have very little oversight in schools of these rooms -- first because the general public doesn't really even know they exist," he said.

There is no national database tracking seclusion incidents in schools, though many have been described in media reports, lawsuits, disability advocacy groups' investigations and on blogs catering to parents who say their child had been held in seclusion.

627816 tn?1349241716
Disability Rights California, a federally funded watchdog group, found that teachers dragged children into seclusion rooms they could not leave. In one case, they found a retarded 8-year-old had been locked alone in a seclusion room in a northeast California elementary school for at least 31 days in a year.

"What we found outrageous was that we went to the schools and asked to see the rooms and were denied," said Leslie Morrison, a psychiatric nurse and attorney who led the 2007 investigation that substantiated at least six cases of abuse involving seclusion in public schools.

"It took a lot of fighting to eventually get in to see where these children were held."

CNN asked every school official interviewed if a reporter could visit a seclusion room and was denied every time.

In other instances of alleged abuse:

• A Tennessee mother alleged in a federal suit against the Learn Center in Clinton that her 51-pound 9-year-old autistic son was bruised when school instructors used their body weight on his legs and torso to hold him down before putting him in a "quiet room" for four hours. Principal Gary Houck of the Learn Center, which serves disabled children, said lawyers have advised him not to discuss the case.

• Eight-year-old Isabel Loeffler, who has autism, was held down by her teachers and confined in a storage closet where she pulled out her hair and wet her pants at her Dallas County, Iowa, elementary school. Last year, a judge found that the school had violated the girl's rights. "What we're talking about is trauma," said her father, Doug Loeffler. "She spent hours in wet clothes, crying to be let out." Waukee school district attorney Matt Novak told CNN that the school has denied any wrongdoing.

• A mentally retarded 14-year-old in Killeen, Texas, died from his teachers pressing on his chest in an effort to restrain him in 2001. Texas passed a law to limit both restraint and seclusion in schools because the two methods are often used together.

Federal law requires that schools develop behavioral plans for students with disabilities. These plans are supposed to explicitly explain behavior problems and methods the teacher is allowed to use to stop it, including using music to calm a child or allowing a student to take a break from schoolwork.

A behavioral plan for Jonathan King, provided to CNN by the Kings' attorney, shows that Jonathan was confined in the seclusion room on 15 separate days for infractions ranging from cursing and threatening other students to physically striking classmates.

Howard "Sandy" Addis, the director of the Pioneer education agency which oversees Alpine, said that the room where Jonathan died is no longer in use. Citing the ongoing litigation, he declined to answer questions about the King case but defended the use of seclusion for "an emergency safety situation."

The Alpine Program's attorney, Phil Hartley, said Jonathan's actions leading up to his suicide did not suggest the boy was "serious" about killing himself. Jonathan's actions were an "effort to get attention," Hartley said.

"This is a program designed for students with severe emotional disabilities and problems," he said. "It is a program which frequently deals with students who use various methods of getting attention, avoiding work."

A substitute employee placed in charge of watching the room on the day Jonathan died said in an affidavit that he had no training in the use of seclusion, and didn't know Jonathan had threatened suicide weeks earlier.

The Kings say they would have removed their son from the school if they knew he was being held in seclusion, or that he had expressed a desire to hurt himself.

"We would have home schooled him or taken him to another psychologist," said Don King. "If we would have known, our boy would have never been in that room. He would still be alive."

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The story
A few weeks before 13-year-old Jonathan King killed himself, he told his parents that his teachers had put him in "time-out."

"We thought that meant go sit in the corner and be quiet for a few minutes," Tina King said, tears washing her face as she remembered the child she called "our baby ... a good kid."

But time-out in the boy's north Georgia special education school was spent in something akin to a prison cell -- a concrete room latched from the outside, its tiny window obscured by a piece of paper.  Read full article »

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