The recent uproar over the use of “scream rooms” at the Farm Hill Elementary School in Middletown, Conn. has sparked a conversation about the use of seclusion and restraint to manage behavioral problems in an academic setting. This situation has prompted the Connecticut legislature to file a bill (HB 5347) that would require the State Board of Education to submit an annual report on the frequency of physical restraint and seclusion episodes to the Select Committee on Children.
While widespread anecdotal evidence exists, no hard data has been kept that confirms the practice of seclusion and restraint in the school system, according to Mickey Kramer, MS, RN, Office of the Child Advocate in Connecticut. Because of a pending investigation of the situation in Middletown, she is unable to discuss that particular case, but offered her thoughts on the general use of seclusion in the schools.
Kramer agrees with a 2009 report from the General Accounting Office (GAO), which finds that seclusion and restraint has no therapeutic value, but rather is more likely to create resentment, fear and anger. “We learned that laying on of hands for people in a state of dis-control leads to staff getting hurt. When a child is out of control, it’s heartbreaking. He is emotional, flailing and kicking. To try to collect that child is challenging,” she says. “Teachers are not prepared for this. It’s not part of basic education or special education training.”
The law does allow for seclusion when written into a student’s Individualized Education Plan (IEP), Kramer notes, but she is concerned about children not identified as having behavioral issues that are subjected to “time-outs” or “taking a break.” She says, “Different people call it different things. But if a child is removed from the classroom and not allowed to leave, that’s seclusion. In a mental health setting, that would have to be counted as seclusion, but not in the schools.”
Additionally, children who witness the removal or restraint of a classmate can be traumatized, according to Kramer. “It’s scary watching a child being dragged out of the classroom and into a separate room. It’s like listening to a domestic violence episode,” she says.
The University of Connecticut has been working with schools to promote positive behavioral interventions. George Sugai, Ph.D., Carole J. Neag Endowed Chair in the Neag School of Education at the University of Connecticut and co-director, OSEP Center on Positive Behavioral Interventions & Supports, emphasizes seclusion is not an intervention and should be viewed as a rarely used and well-prepared crisis/emergency response to protect children and adults from being injured.
Although schools tend to view seclusion as “a safety response,” this practice often fails to decrease the behaviors that precipitated the reaction, says Sugai. “To reduce the need for such safeguards, we advocate that the best alternative is a carefully crafted and – more important – fluently implemented preventive behavior intervention plan,” he says. Such a plan would include an educational component, i.e., students would learn better responses and staff would learn how to intervene successfully before a situation reaches crisis stage. He attributes the continued use of seclusion and restraint to lack of resources and knowledge of effective preventative alternatives and limited implementation capacity and access to useful supports.
Kramer says, “We need to ensure that resources are embedded in the community and within the schools to help figure out this issue. We’d love to see a tighter alliance between schools and community resources.”
On May 1, the Connecticut House passed HB 5347 and sent it to the Senate where it has been tabled until the next session. Kramer anticipates passage of the bill by the entire legislature. “With required reporting, we’ll be able to know how prevalent this problem is,” she says. “I’m optimistic that people will feel it’s important and necessary to look at what’s the bigger issue, instead of waiting for another incident to appear in the media.”
By Phyllis Hanlon