June 1st, 2010

Safety standards passed in school use of restraints, seclusion

The U.S. House of Representatives passed legislation aimed at preventing and reducing the use of physical restraint and seclusion techniques in schools. “The Keeping All Students Safe Act” was passed in March, outlining federal minimum safety standards in schools, similar to protections currently in place for hospitals and other community-based facilities.

Sen. Chris Dodd, (D-Conn.) introduced the Senate version, “Preventing Harmful Restraint and Seclusion in Schools Act,” in December and hopes to move this legislation by the end of this Congressional session, whether as a stand-alone bill or part of a larger piece of legislation. Dodd wrote and helped pass legislation to prevent the misuse of restraint and seclusion in hospitals and residential facilities more than a decade ago.

The legislation has the support of the Bazelon Center for Mental Health Law and the National Alliance on Mental Illness (NAMI).

“We are supporting the legislation because it speaks to a wealth of problems that are happening nationally,” says Laurel Stine, director of federal relations for Bazelon.

Stine says schools are experiencing the same kinds of harmful practices that were taking place in hospitals and psychiatric settings a decade ago.

“In our position, any child that goes to school that is harmed by the use of restraint and seclusion or ends up with serious injury or death is a national shame,” she says. “Parents send children to school to learn. Schools are educational settings. We want to try to foster proactive approaches. We don’t want to use punitive and harmful approaches that really do nothing but mask problems and exacerbate issues.”

A 2009 report by the Government Accountability Office found hundreds of allegations of injury and even death as a result of misuses of restraint and seclusion in schools.

The new legislation covers students in public schools (including special education classes) and any private or special needs school that receives federal education funding.

The bills seek to: prohibit the use of restraint and seclusion in schools unless the student’s behavior poses an immediate danger of physical injury; prohibit the use of any mechanical, chemical or physical restraint that restricts air flow to the lungs; require training for school personnel imposing restraint and seclusion; and require immediate parental notification following each incident of restraint or seclusion. The legislation also seeks to implement positive behavioral supports to prevent restraint and seclusion.

Ron Benner, NCSP, LPC, CAG, treasurer of the Connecticut Association of School Psychologists (CASP) and a public elementary school psychologist in Bridgeport, Conn., is in favor of the legislation. “I would recommend other psychologists be in favor of it,” he says, likening it to the physician’s creed of “First, do no harm.”

One thing Benner would like to see is clarification in the legislation to distinguish the age of a student. “Restraint on a high school student and restraint on a kindergartener are totally different,”

Benner says. “You can have a little kindergartener who wants to run out of the room and so you would restrain him from running out of the room, versus an older student who needs to be restrained because he wants to fight with somebody. How much physical strength do you need to restrain each of those situations in order to control the situation? I think that needs to be clarified more.” Benner says Bridgeport teachers are currently undergoing crisis prevention and intervention (CPI) training. “I think every teacher should have that type training. It gives a starting point so people have a common language to describe the behavior and it gives specific deescalation techniques. It also teaches physical restraint in a responsible way so you are not going to do harm to the student.”

Benner particularly likes the new legislations’ mandate for mandatory contact with parents. “My philosophy has always been if you are aware of a problem, the parents should be aware of a problem.”

Benner advocates positive behavioral supports to help students comply in a learning environment. “If schools start taking care and being more active on the littler problems, then you won’t have as many big problems. That’s the philosophy of positive behavioral support.”

Benner is part of a national group on sharedwork.org working toward positive behavioral supports and mental health. “You have to have classroom management going on before you can get learning going on in the classroom,” he says. “That whole philosophy is the positive behavioral support, the self image of the child, the mental health of the child being seen in a positive way. That comes under the resiliency factors, what factors are there in place and what do you need to try to get in place to have resiliency for the child.”

Stine says Bazelon has long tried to foster and promote the use of cognitive behavioral supports at the federal level. Positive supports are proactive and have years of data that show it improves classroom instruction time. “It’s outcome-based,” she says. “The federal government should be helping foster practices that have evidence based to them and positive outcomes associated.”

“What we are seeing now, not only through restraint and seclusion practices, but also harmful zero tolerance policies is that kids are going to school and they are either ending up in the juvenile justice system or they are not graduating,” she says.

Seclusion and restraint practices don’t teach anything and there’s no research to show the practices are beneficial, she adds.

“(The legislation) effectively declares the use of restraints and seclusion in schools to be an emergency safety measure, not standard practice for dealing with problem behavior,” Stine says. “You aren’t taking away the right, you are just providing guidelines on when it should be used.”

Stine says Bazelon is hailing the legislation because the organization wants to foster schools to look at social and behavioral supports for children, in addition to academics.

“We believe they are connected.”

By Pamela Berard

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