Mommy, I Wish I Could Tell You What They Did To Me In School Today

Everyday Atrocities Faced by Special Needs Children

By Richard S. Stripp, Sr.

IN LOVING MEMORY OF NOAH V. VARCADIPANE
8/4/1996 – 11/14/2009 “MOMMY’S SUPERMAN”

The children and adult characters in this book are based on students and individuals that the author has interacted with and/or worked with directly.

The majority of children who “speak” in this book are non-verbal. Their words which you will read are fictitious and were never spoken by them but are based on actual events that occurred in their lives. It is the author’s belief that if the non-verbal children in this book could speak, what you are about to read is what they might have said.

Any conversations between the author and anyone in the book are based on actual events and conversations.

“Never, never be afraid to do what’s right, especially if the well-being of a person or animal is at stake. Society’s punishments are small compared to the wounds we inflict on our soul when we look the other way.” ~ Dr. Martin Luther King, Jr.

ADAM

I can’t believe that Mom is making me go to school again today. Doesn’t she know what they do to me there? Doesn’t she love me anymore? “Adam, you hid your shoes again. This isn’t funny. It’s time for school.” Yeah, I know it’s time for school; I don’t want to go, that’s why I hid my shoes.

Man, I wish I could speak. I wish I could tell Mommy what they did to me at school yesterday. I wish I could tell Mommy how it makes me feel to be treated like that. If she only knew, there is no way she’d make me go there today. I bet Daddy would beat them up.

The day started like most days. They took me off of the school bus and strapped me into that stupid wooden chair. My pull-up was soaked with pee but they didn’t even check. I just had to sit in it until I wet through. Then, the yelling began. Like it’s my fault I had to go to the bathroom again. I was trying to tell them. Kept on touching my private area; what did they think I was saying? “That’s disgusting, Adam. Knock it off!” Knock what off? I’m soaked. I’d change myself if I could, but I can’t.

Three hours stuck in this chair without being able to move and now they want me to stand up. My legs are so sore and stiff. I know my cerebral palsy isn’t as bad as Jimmy’s but I wish I didn’t have it at all. There’s no way I can stand right now but they’re pulling me, yanking me by my arms out of the chair. Yelling, yelling, more yelling. Sorry teacher, I can’t do it. The yelling hurts my ears. The chair is kicked away by the teacher and I get thrown to the ground. All of the aides and assistants just watch, listen and do nothing to help me. How can they just stand there? Why won’t someone help me? I need help. I can’t stand, I’m sorry. I’m trying, but I can’t. Now, when all the other kids are watching television during free time, I’ll have to sit in the corner again, facing the wall. I hate that.

Strapped back in the chair and being yelled at now because I’m waving my arms and moving my head from side to side. I don’t know why I do this; I just do. I don’t mean to do it; I just do. I’m not doing it to make you angry; I just do. Another kid in the class with autism does it too. How come they don’t yell at him? Why don’t they grab him? Is it because he can talk and I can’t? I don’t get it. I wish I could ask him. He’d tell me. He’s my friend. Now the classroom assistant is really mad at me. She says that she is not gonna let go of my head until I stop. I wish I could tell her that I want to stop, that I don’t mean to do it, but she just keeps grabbing me. It hurts. She is squeezing soooo hard. I’m going to try to stop. I’m going to try and keep it together. I remember that time on the field trip when we went to pick pumpkins. She got really mad at me for doing this. She grabbed me by the head that time too. When I got upset and started kicking, she sat on me. I was in my wheel chair. I couldn’t move. She was so heavy. It hurt my legs. Please don’t do that again. Mommy, I want to go home.

Sitting in the cafeteria and they want me to eat my lunch, but I can’t concentrate on that. Can’t anyone smell that? I have poop in my pants. It’s disgusting. I’ll eat after someone changes me. Please someone change me, it’s making my rash burn. Stop trying to stuff that sandwich in my mouth. I’ll eat after you change me. No, no, don’t throw my lunch in the garbage again. I’m hungry.

Back in the classroom again. Still got this poop in my pants. The other kids are watching cartoons. I’m in the corner. I can’t take this sitting in my poop anymore. I reach into the back of my pants, dig some out and throw it on the floor. That got their attention. Boy, are they mad but what else could I do? Hey! Ow! That hurts! Four people pull me out of the chair and stand me up. Dragged into the bathroom and the teacher starts to clean my mess. She wipes way too hard. It hurts. Can’t she see the blood on the paper? You’re all squeezing way too hard, all four of you. Don’t you remember that time you broke the bones in my hand doing that? At least I got cleaned up a little. Boy, am I hungry!

Just thirty more minutes and I’m back on the bus to go home. I can’t wait to get out of here. I used to like coming to school. I try not to listen to the bad things everyone is saying about me. It hurts my feelings. I wish I could tell them to stop. It’s so frustrating not be able to talk. If I could pick just one, walking or talking, I’d pick talking.

As I get put on the bus, the teacher tells me to do them all a favor and stay home tomorrow. Sounds like a great idea. I’ll try but Mom always finds my shoes.

About Adam

Like so many special needs children, whose disabilities aren’t understood by the people who work with them, Adam was thought to be difficult, a “pain in the ass.” In a school where the opinion of one can become “fact” to all, this meant that Adam’s stay there was going to be less than enjoyable for him, to say the least. Throughout this time, he would be subjected to both physical and emotional abuse. He would have his most basic needs neglected. Adam would be deprived of the education that he is entitled to by the very people that are paid to provide it to him. Unfortunately, in the school that Adam attended for that time period, he was not alone.

When I first met Adam, I was employed as a personal aide to another child that attended the same school. The school serviced individuals with various types of disabilities. There were no “mainstream” students that attended the school. All students enrolled were sent by their home school districts. A large number of schools that are attended by your “average” child are not equipped to meet the various needs of individuals with disabilities. Many of the students that attended Adam’s school required personal aides that were assigned to them for the entire school day. There were students ranging from three years of age through twenty-one years. These students not only had physical and developmental disabilities, such as Cerebral Palsy and Autism, but many had medical issues as well. Numerous students were confined to wheelchairs. Numerous students suffered from seizure disorders. Some were verbal, some were not. Some had behavioral issues, most did not. The cognitive abilities of the students varied greatly. Some students’ medical needs necessitated them to be accompanied by a nurse at all times. A small number of students would not live long enough to participate in their graduation from the school. All of the students had “special needs.”

Schools that service the special needs population are in most communities. You may have one in yours and not even realize it. The sad reality is that the history of special education is one of seclusion. These types of students and schools are typically tucked away and not talked about. I believe this to be one of the many contributing factors that allow students such as Adam to be treated the way that they are.

Adam and I bonded immediately. The first time we met he was strapped in his wooden Rifton chair being pushed down the hallway by his teacher. A tray was attached to the chair that Adam was leaning on. He seemed sad to me. I stopped to say hello and introduce myself. “Hi, buddy, my name is Mr. Rick. Give me a high five.” My smile and raised hand were met with the same. The teacher told me that his name was Adam. I told Adam that it was nice to meet him and wished him a great day. Adam became very excited and happy. He began to sway from side to side in his chair while laughing and flapping his arms. His head was now constantly in motion. Although Adam was unable to verbalize his thoughts and feelings in the way that I can, I understood exactly what he was saying to me. The teacher told him to knock it off and continued to push him down the hall.

I initially thought that Adam must not be ambulatory. He was strapped in this Rifton chair being pushed down the hall. He must not be able to walk. I would soon learn that that was not the case at all. Adam, while sometimes had difficulty walking and standing, was in this wooden chair for other reasons. He was placed in this chair to contain him. He was placed in this chair to restrict his movements. He was strapped in this chair and he was being restrained. This was certainly easier than having to deal with Adam’s tendencies to walk away. This was certainly easier than having to try to explain to Adam that we’re not going there right now, we have to go here. The few moments it took to strap Adam into this chair was a whole lot easier than having to deal with him all day. If Adam can’t get up and wander away, the people that are employed to teach him and work with him throughout the day don’t have to pay much attention to him at all. They don’t have to do their jobs. They can get their paychecks without earning them.

The chair that Adam, and many other students, was placed in on a regular basis is made by a company called “Rifton.” When utilized properly, the chair is a helpful piece of adaptive equipment, providing body support when needed. There are individuals that benefit from their use. In Adam’s case, the chair was misused on a daily basis. Adam was, and is, more than capable to sit in a regular chair at a desk. He was placed in the Rifton chair to contain him.

The Rifton Company addressed this issue on their website (www.rifton.com). “Using straps, trays or supports to restrict a child’s movement is considered behavioral restraint, which may raise ethical and legal issues for your facility. Rifton Equipment is not intended for this use.”

Adam often exhibited behavioral issues while strapped in the Rifton chair. He would throw things that were placed in front of him. He would reach and grab things that were near him, only to throw them on the ground. If he got hold of paper, books or magazines, he would tear them. I believe, the majority of the time, Adam was reacting to how he was being treated or to things that he heard that were being said about him; sometimes directly to him, other times to others around him.

I remember seeing Adam in the hall one day. He was being pushed down the hall by the teacher assistant assigned to his class. As soon as Adam saw me, he began to smile and rock back and forth. Adam was acknowledging my presence and expressing his happiness in seeing me. I said, “Hi Adam. I love your smile. You have such a beautiful smile.” The assistant immediately replied, “There is absolutely nothing beautiful about this child.” She had a look of disgust on her face. She pushed him further down the hall.

Adam understood everything he heard. Adam has feelings just like you or I. One of the many innocent mistakes made by some of the people that work with individuals with disabilities is they forget that. They fall into the trap of assuming that if a person can’t speak, he or she must not be able to understand things as well. Often the behavior that teachers, administrators, aides or assistants find so disturbing is behavior that is a direct result of their actions and/or words. The student is reacting to how they are being treated or what they are hearing. Other times, the behavior may be a result of some sort of physical discomfort the student is experiencing but is unable to verbally express. I have a son who is a teacher with his Master’s Degree in Special Education. One of his professors in college told him that, “All behavior is communicative.” How true this is, yet so many “educators” are so quick to dismiss behavior that they witness as nothing more than a child acting out because they’re “spoiled”; their parents let them get away with things that they wouldn’t let a non-disabled child get away with. As was the case with Adam, the child is labeled a “pain in the ass” and is dealt with accordingly. They fail to understand what the child is attempting to tell them.

I was not in Adam’s classroom but, for a time period, visited him often. I was welcome by the teacher to do so. Adam always behaved while I was there. He looked forward to my visits. The teacher began to use me as a reward for Adam. He was told that if he did his work and behaved himself that Mr. Rick would come to see him. I was told this was a helpful tool in getting Adam to do the things that he was supposed to do. Sometimes, however, when I went to visit Adam, I was told that I could not see him. I was told he had lost that privilege that day because he hadn’t done what he was supposed to do.

My visits to Adam’s classroom ended entirely when I witnessed Adam being physically abused. I walked into the classroom to find the teacher attempting to pull Adam out of his chair. She was grabbing and pulling Adam by his wrists. She was yelling at him very loudly. Adam was pulled out of the chair but would not stand on his own. The teacher kicked the chair away from him. Adam would still not stand on his own. The teacher threw him to the ground. Adam landed on his backside and remained on the ground as the teacher walked away from him.

I immediately expressed my concerns to the teacher as to what I had just witnessed. I cited the possible consequences of injury that could result in throwing a child to the ground. The teacher justified her actions by telling me that Adam’s diaper had cushioned his fall so there was not a possibility of injury. A brief argument ensued. The teacher was not interested in my opinion that a head or back injury could have resulted from her actions. I informed her that if I ever witnessed such abuse again, that I would report it to the appropriate authorities. I was asked to leave the classroom.

The next day, I was informed by Adam’s teacher that I was no longer allowed in the classroom. I was told that my presence was a distraction to Adam and caused him to act out. A speech therapist who worked at the school approached me and warned me to “watch my back.” She stated that, following the incident with Adam and his teacher, there was a conspiracy among a group of the staff to discredit me.

Florida - Aide charged with abusing autistic boy

By ANDREW GANT, Staff Writer
December 4, 2010

http://www.news-journalonline.com/news/local/southeast-volusia/2010/12/04/aide-charged-with-abusing-autistic-boy.html

Florida - A 72-year-old school bus attendant was arrested Friday on charges she grabbed at an autistic boy's limbs, slapped him and threatened to break his wrists if he didn't behave on the bus, police said.

Marilyn Talford Onie was charged with child abuse after Edgewater police watched the incident on school-bus video, according to her arrest report.
Onie -- who was sitting in a seat at the front of the bus, across the aisle from a 14-year-old student with autism -- began yelling at him during a Nov. 8 bus ride home from New Smyrna Beach High School, police said.

Investigators said the boy does not speak and only understands some of what is said to him.

When he began to bite at his arm and reached out to touch Onie with his finger, police said, she grabbed his wrists and squeezed them, then pointed her finger in the boy's face. When he reached out again, she grabbed his fingers and squeezed those, too, according to the report.

When the boy tried to touch another child leaving the bus, Onie yelled, "You're gonna get it, buddy," police said. She grabbed his wrists again, bent them downward and asked, "Want me to break them on ya?" according to the report.

"You like that?" she asked later as she pressed on his wrists, "causing the child to lunge his body forward toward Onie's face," police said.

The boy's mother later told investigators her son likely was agitated because a new driver was taking the bus on an unfamiliar route.

Onie also grabbed the boy by the back of the neck, slapped him on the shoulder and pushed his head against the bus window as he tried to touch her with his finger.

"We are not bringing you to school anymore. You're a bad boy," police quoted her as saying.

Onie could not be reached for comment Friday, but in a Wednesday interview with police, she said she "had been having problems with (the boy) for several months but never reported any incidents to anyone."

After watching and listening to the school-bus video, she said her comment about breaking the boy's hands was "said out of frustration."

"Mrs. Onie stated that she has seen the video tape and has no other explanation for her actions other than she is 'only human,' " police wrote.

A fellow student who uses a wheelchair opened the investigation by telling her mother about what she saw. She told investigators she felt Onie was "very mean" and "showed no mercy or sympathy" for the boy, according to the report.

Onie was not fired or suspended, but she was reassigned to duties away from children -- cleaning the buses, for example -- after the Nov. 8 incident, school district spokeswoman Nancy Wait said.

The district won't investigate and will wait for Onie's case to be resolved before taking any further action in her employment, Wait said.

Onie works 6.5 hours per day -- considered full-time by the district -- at $11.73 per hour.

She posted $1,000 bail and was released from the Volusia County Branch Jail on Friday.

America's Forgotten Children

Florida Lawsuit: Footage shows school abuse

Thursday, 13 Aug 2009 Peter Linton-Smith

http://www.myfoxtampabay.com/dpp/news/local/nature_coast/autism_abuse_lawsuit_081309

LECANTO, Florida - A grainy surveillance tape will likely become 'Exhibit A' in a forthcoming lawsuit against the Citrus County School District. "I don't have the slightest doubt that it's child abuse," said Mark Kamleiter, an attorney representing a 14-year-old autistic boy seen in the video. Kamleiter says the videotape shows a teacher at the Crest School in Lecanto and an aide abusing the child. "They grab him by his arms and drag him on his knees out of the classroom, down the open school hallway and literally throw him into a dark room." The boy's father, Vikas Kamat, reluctantly watched the tape. "It's devastating. I have nightmares from that day 'til now." Kamat became suspicious when his son came home with this ripped clothing. Because of autism his son cannot speak and couldn't explain how his pants were being repeatedly torn.

On January 23, his son wound up in the emergency room with a broken finger and Kamat began demanding answers. "Everybody was telling me, 'Things are going well,' and that teacher could not tell me in the emergency room how the injury happened," he recalled. Kamat's attorney said the injury may have been an accident, but maintains the boy never should have been touched or placed in an isolation room in the first place. "We have laws in this state that make it a special crime to hurt disabled people and the abuse was the dragging and the placing in a seclusion room," Kamat said. A spokesman from the Citrus County School District refused to comment about the forthcoming lawsuit but did point out the teacher in the videotape was fired. According to the Department of Children and Family Services, the isolation room is no longer in use.

Report from the National Disability Rights Network - School is Not Supposed to Hurt

The National Disability Rights Network Releases Shocking Report on Restraint and Seclusion in U.S. Schools.

Please click on the link below "School is not Supposed to Hurt" to review the report that was released to the press on 01/13/2009.

School is Not Supposed to Hurt: Investigative Report on Abusive Restraint and Seclusion in Schools.

REPORT : School is Not Supposed to Hurt (pdf)

03/12/2009
Why is the school staff restraining my child? He can't help the way he is and what they are doing to him is only making his behaviors worse. Don't they understand this? They are breaking his spirit! These are the words of so many parents.

'Pattern of abuse of autistic children in Florida schools'
08/22/2008 Miami, FL
There is a pattern of abuse, neglect and humiliation. That's what more than 100 parents of autistic children in Florida are telling the state attorney general's office and anyone who will listen.The parents and others claim children with autism are being mistreated — in some cases physically harmed — by teachers and staff who are supposed to be helping them. On the Treasure Coast alone, there are two potential lawsuits against the St. Lucie County School District by parents of autistic children."These aren't isolated incidents. This is an epidemic," said one Port St. Lucie parent, Anna Moore, who says her then-7-year-old autistic son was mistreated by staff at his school in 2007. "It's time it stopped."
Click on the link below to read the complete story.
http://www.autismconnect.org/news.asp?section=00010001&itemtype=news&id=6450

Please visit our National Blog site Families Against Restraint and Seclusion http://familiesagainstrestraintandseclusion.blogspot.com/

Advocate Contact Information

1. File a written complaint with the FLDOE about your situation in regards to your child being restrained or put in seclusion. This may not do much but at least it will be documented and on file. This will create a paper trail that you may need in the future. Click on this link to get the form. State Complaint Request Form
2. File a complete with your Department of Children and Families Services (DCF) if your child has been injured physically or mentally. The Welfare of Children Act (HB 7173) amended the definition of "other person responsible for the child's welfare" to include school personnel. Parents can now report suspected abuse by school personnel to DCF. Florida Child Abuse Hot Line 1-800-962-2873
3. 
   
   File a complaint with your local police department if your child has been injured physically or mentally.
4. 
   
   Florida's Positive Behavior Support Project http://cfs.fmhi.usf.edu:80/cfsnews/2006news/PBSupdate8.06.html. This is free program to all Florida schools but they have to be invited in by the school district. Make this request to your ESE Director and your school board. Make this request by phone or in person but always put it in writing also.
5. 
   
   Educate and work with your local and state legislatures about restraint and seclusion in the public school system on children with disabilities. Identify problems and present solutions to help solve the current problems our children are facing. Find your Legislators in the link below by ZIP+4 Code (the 4 extra number can be found on most of your incoming mail next to your zip code) http://www.flsenate.gov/Legislators/index.cfm?Mode=Find%20Your20Legislator&Submenu=3&Tab=legislators&ZipCode=33436
6. 
   
   Work with other parent advocates creating and submitting new bills to your local legislatures. Example of bill subjects: Burden of proof put back on the schools districts, Behavior committee to oversee policies/rules are being followed, State Data system set up by school districts to track restraint, seclusion, suspensions, baker acts and arrests of children with disabilities.
7. 
   
   Work with other parent advocates changing current laws that are outdated and need to be revised.
8. 
   
   Call and order 20 - 30 free booklets "Making Your Case" 1-877-348-0505 (toll free) and pass them out to other parent advocates. This is a beginners guide to teach advocates how to work with legislators.
9. 
   
   Speak at school board meetings about what restraint and seclusion has done to your child, family and other families. Educate school board members about the dangers and trauma of restraint and seclusion. Restraint & Seclusion is NOT a positive behavior treatment, it's a FAILURE to treatment.
10. 
    
    Send a "No Restraint" letter to the school principal and ESE Director. Change the letter to fit your situation. A sample letter can be found here: http://aprais.tash.org/parents.htm 
11. 
    
    Take pictures of any visible injuries your child comes home with. And make sure you document everything.
12. 
    
    Take your child to his/her Pediatrician or the Emergency room for a complete physical examination if needed.
13. 
    
    Contact your local media and ask them if they will do a story to educated the public.
14. 
    
    Restraint and Seclusion - Join the Yahoo group http://groups.yahoo.com/group/RESTRAINT_INFO/ to find information and support.
15. 
    
    Pass this information on to other parents that may need help.
16. 
    
    Educate yourself regarding special education law. Wrightslaw -http://wrightslaw.com/   CHALLENGING YOUR CHILDS PROGRAM DUE PROCESS -  http://aboutspecialeducationlaw.com/Due_Process.html         

Other Contact Numbers

 http://wdcrobcolp01.ed.gov/CFAPPS/OCR/contactus.cfmhttp://wdcrobcolp01.ed.gov/CFAPPS/OCR/complaintform.cfmhttp://www.usdoj.gov/crt/edo/filecomp.htmhttp://www.fddc.org/HOME/index.aspStatewide and Local Advocacy Councils http://www.floridasac.org/

The Florida Developmental Disabilities Council

U.S. Department of Justice

Office of Civil Rights

U.S.Office of Civil Rights Washington office

Exceptional Parent Magazine

Eliminating Restraint, Seclusion, and Aversives in Our Schools: A parent’s thoughts on why we’re stuck and how to move forward By Pat Amos Sep 30, 2007 - 6:10:50 AM
In the small hours of a recent night I found myself in a hospital emergency room waiting for my son’s release after treatment of a seizure. As I sat decompressing, I heard a group of hospital staff assemble in the corridor and then heard the word “restraint.” After a quarter-century as an advocate for people with disabilities, few words get me to my feet faster. I edged closer to the curtain to listen in.

The discussion turned on a hospital credentialing review that was to occur later that day, and I realized with growing satisfaction that it was a model of its kind. Staff reviewed the hospital’s policies that restricted restraint to dire emergencies, and the strict procedures to be followed in the event that such an emergency could not be prevented. Doctors were to be called, permissions obtained, oversight provided, brevity and safety stressed. They talked about the debriefing and extensive documentation that would be required of them should they ever participate in a restraint. It was clear from the hushed tones and careful recitals of these healthcare staff that they understood the gravity of the subject and their medical responsibility to “do no harm.”

How ironic, I thought, that my daylight hours are so often spent with parents whose children who have been harmed by casual and multiple restraint use in their schools, at the hands of the very adults entrusted with their care. It is no longer a secret that every day, across our country, special education students are grabbed and immobilized, tied and strapped to chairs, and held in basket holds and prone restraints that are known to cause asphyxia. Sometimes frightened children are dragged to seclusion rooms, a form of restraint involving forced isolation. Despite the fact that they are known to cause injury, intense psychological trauma, and even death, these extreme methods are justified as education, discipline, or behavior therapy. Under these reassuring guises they tend to be used repeatedly and with impunity. Sometimes they are written into a child’s Behavior Intervention Plan (BIP) or Individualized Education Plan (IEP), and sometimes they fly under the radar, with parents uninformed.

Either way, the easy and reckless use of restraint in our schools stands in stark contrast to the cautious avoidance with which restraint use is now expected to be approached in hospital, rehabilitation, nursing care, mental health, and related medical settings. What many school systems still see as a viable treatment or plan, health care systems increasingly repudiate as a failure of treatment and a failure to plan. How did our nation’s special education system get to a place where school teachers and classroom aides rush in where medical professionals fear to tread? And what is our exit strategy?

The short answer to why children with disabilities remain at unnecessary risk in their schools is a nationwide failure of leadership. While our education system refuses to face the problem, hospitals, nursing homes, and mental health treatment settings have recognized and acted to end the serious risks associated with the use of restraint and seclusion. Federal and state authorities and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) now impose significant restrictions on its use and require specialized staff training, rigorous review of each usage, and detailed data reporting. Advocates and their Congressional allies achieved passage of the Children’s Health Act of 2000, which offers significant protections to children in mental health settings. The President’s New Freedom Commission on Mental Health (2003) set forth a vision for safe, humane services. And the Centers for Medicare and Medicaid Services (CMS) have taken a leadership role in shedding light on the dangers of restraint and seclusion, enforcing higher standards and accountability across the programs they fund.

In contrast, many state education agencies continue to operate without regulating, or with regulations that specifically allow, the use of non-emergency restraint, seclusion, and even aversive “punishers” (which have no justification even as emergency responses) on children with disabilities. In fact, the New York State Department of Vocational and Educational Services recently widened the array of aversives it would permit for use on school children with disabilities. This patchwork of dangerous and inequitable state-level special education regulations, although neither evidence-based nor in sync with the protections children receive in other settings, is quietly accepted by the federal government. This apathy must end. In an education system dedicated to producing lifelong learners, it is time for our leaders to learn new lessons from the successful reduction and elimination of restraint and seclusion in other service systems.

These lessons are turning out to be encouragingly clear and simple. The National Technical Assistance Center (NTAC), National Association of State Mental Health Program Directors, has analyzed the Core Strategies leading to successful restraint/seclusion reduction and elimination in mental health settings and compiled them into a 6-point lesson plan. With a little curriculum modification, I believe we can make this lesson accessible to the education system:

1. Leadership Toward Organizational Change. This first strategy identified by NTAC requires the organizational leader or CEO – for schools read “principal” – to define and articulate “a vision, values and philosophy” resulting in an action plan based on “continuous quality improvement.” That leader must then be present and involved in “witnessing” any time a restraint occurs. “Witnessing” is a surprisingly simple and powerful concept that forces a problem into awareness and demands personal accountability. Imagine how witnessing could change the culture of a school: no hiding restraint and its aftermath behind closed doors, no looking the other way, no deniability. To lead with integrity, those in power would have to become active learners engaged in discovering what happened, why it happened, and how to prevent it from happening again.

2. Use of Data to Inform Practice. Now that evidence-based practices have become part of the common language of the education system, this strategy translates easily. Schools need to follow the example of health care facilities and pay rigorous attention to gathering data on restraint use: by classroom, school, district, characteristics of the individual and situation, and other informative variables. An all-too-common practice in special education has been to bury restraint usage in students’ IEPs or BIPs, reporting data only on “emergency” restraint – an emergency being, for practical purposes, any restraint use that has not been given prior permission in a student’s plan. However, a “planned emergency” is not only an oxymoron but an incentive to write restraint into more students’ plans. State education systems will undoubtedly try other ingenious strategies to avoid facing the data – for example, Pennsylvania’s State Board of Education recently proposed new regulations that would exempt restraints of no more than 30 continuous seconds from being counted as restraints, no matter how many were performed in a row or how much aggregate time a student spent in this way. This is where national-level leadership, from the U.S. Department of Education to Congress, has to get tough. Continuous quality improvement can only build on a foundation of hard data.

3. Workforce Development. NTAC calls for the development of “trauma informed systems of care,” a different and broader focus than the mere promotion of physical safety during restraint. Trauma-informed care promotes responsibility for the emotional wellbeing of children. It is based on research from psychology, child development, and neuroscience that shows that children exposed to high stress situations tend to develop challenging behaviors which in turn expose them to further stress. The take-home message—or take-to-school message—is that using restraint, seclusion or other aversives to change the behavior of students with disabilities is the type of stressor that can lead to the development of attentional, motivational, impulse-control, and mental health problems. These problems, in turn, can lead to behavior that is mistakenly blamed on the disability and subjected to further trauma-inducing responses, such as more restraint. An understanding of this vicious cycle and how to stop it must become part of every educator’s skill set.

4. Use of Seclusion/Restraint Prevention Tools. This strategy from mental health settings is paralleled by the requirement under the Individuals with Disabilities Education Improvement Act (IDEIA) that IEP teams approach a child through “positive behavior interventions and strategies,” which in turn should trigger a Functional Behavioral Assessment (FBA) when a Behavior Intervention Plan is needed. What the special education system lacks is comprehensive implementation of those tools. For example, California’s Protection and Advocacy, Inc. (PAI) recently gave that state’s schools an “F” for failure to confront widespread abuses of restraint and seclusion. In the cases PAI investigated, schools failed to utilize the significant preventative tools at their disposal: there were no proactive plans to address known problems, and no meetings were convened after a restraint to discuss changes in the IEP or to arrange for an FBA. NTAC notes that “This strategy relies heavily on the concept of individualized treatment.” Similarly, schools fail their students when they fail to individualize.

5. Consumer Roles in Inpatient Settings. Successful strategies in mental health settings involve “the full and formal inclusion of consumers, children, families and external advocates in various roles and at all levels in the organization to assist in the reduction of seclusion and restraint.” In our schools, this would translate into greatly increased parental involvement, welcoming parents and advocates as resources who have valuable insights and proactive strategies to impart on behalf of individual children. It would also translate into welcoming parents and students to participate in debriefing interviews when problems occur, and encouraging their participation in the development of relevant school and district policies. Operating with this level of openness and transparency has been a frightening prospect for many schools, yet the experiences of the mental health system demonstrate the importance of meaningful inclusion of all stakeholders in achieving successful systems change.

6. Debriefing Techniques. This final Core Strategy insists that every use of restraint or seclusion is meaningful and must be analyzed to avoid repetition. No such event can be accepted as unimportant, unavoidable, or part of someone’s routine plan. In our schools, the student and student’s family must be central to this process. If educators truly believe in the value of critical thinking, they need to put this skill into action instead of unthinkingly making the same dangerous responses over and over.

None of these six Core Strategies involve rocket science, but seeing them implemented will involve leadership at the highest levels of our federal Department of Education and among members of Congress. The mental health community made great strides in restraint and seclusion prevention, despite disbelief and opposition, when visionary national leaders connected with an organized and supportive grassroots constituency. Similarly, parents, families, and self-advocates must insist that our schools stop lurching from tragedy to tragedy and be guided by strong national policies that are proven effective in preventing these dangerous, inhumane practices. Each time the use of restraint, seclusion or other aversives comes to light we must loudly, publicly, and relentlessly “witness”— and insist that our leaders witness with us.

­­­­­­­­­­­NTAC’s “Six Core Strategies to Reduce the Use of Seclusion and Restraint” and related planning tools can be accessed through the web site of The National Association of State Mental Health Program Directors: http://www.nasmhpd.org/ntac.cfm

Pat Amos, M.A., has been an advocate for people with disabilities for over 25 years. She is a founder of Autism Support and Advocacy in Pennsylvania (ASAP) and of The Family Alliance to Stop Abuse and Neglect, past president of the Greater Philadelphia Autism Society, and past president of the Autism National Committee. Currently she is a member of the Board of Directors of TASH, an international organization that promotes equity, opportunity, and inclusion for all individuals with disabilities. Pat's family includes three young adults with significant sensorimotor differences.