Life Without Restraint: Problems and Solutions Regarding Restraint Use

Last month the nation reacted to a video showing a school resource officer putting an eight year-old child's biceps in handcuffs . There was an outpouring of dismay, outrage and disbelief all across the country.

As the mother of a young man with high-functioning autism, my mission each school year has been to make sure my son avoids being restrained. With my son being in the general education population since first grade, this has been a special challenge.

My son looks like every other child in his class, much of the time acts like every other child in his class and consequently is expected to behave like every other child in his class. But the truth is that my son is very, very different from every other child in his class. A crowded cafeteria or a misspelled word can cause him to lose his ability to communicate verbally. When that happens, he uses behaviors to communicate, like running out of a room or injuring himself or others. Often, general education teachers haven't received the kind of training to effectively understand behaviors as a form of communication. Instead, behaviors like these can become situations that lead a child being placed in a restraint.

People think that restraints keep a child and those around him safe. But the sad truth is that restraints often have a much different outcome.

Here are some reasons for schools to avoid restraint use, and solutions to use instead:

Problem: Restraints can and do cause injury...and death.

According to a statistical estimate commissioned by The Courant and conducted by the Harvard Center for Risk Analysis, between 50 and 150 restraint- or seclusion-related deaths occur every year across the country. Restraints cause injuries to those doing the restraint too. In Paula Johnson's 2012 study it was found that the majority of staff injuries happen during the restraint process.

Solution: Use a proactive mindset.

A focus on proactive strategies and keeping students engaged can prevent aggressive behaviors. Knowing the why behind the behavior and making the necessary modifications to the environment or to the assigned tasks can help minimize aggression.

Problem: Restraints are disproportionately used for children with disabilities.

In 2012, the U.S. Department of Education released data showing that during the 2009-2010 academic year, 38,792 of students in the survey were physically restrained by an adult at school and 26,766 of these children had disabilities.

Solution: Learn and use the child's preferences.

It is important for us to learn what helps a child return to a calm state when they become upset, like being given space or using a certain manipulative to self-soothe. Providing comfort and calm is far preferable to letting aggressive behavior escalate.

Problem: Restraints can (re)traumatize and damage the brain.

Did you know that people who experienced trauma have brains are physiologically different? A study done by Karestan Koenen (2003) studied twins where only one had a trauma history, and found that the twin who had experienced trauma had an eight-point reduction in IQ scores on average.

People who have been restrained express feeling anger, fear and humiliation. And for the thousands of children who have been abused or neglected, being restrained can trigger a post-traumatic response. A child with a trauma history may experience restraint or seclusion as a reminder of past traumatic events, which could activate the fight, flight, or freeze response system (van der Kolk 2005).

Solution: Create a physically and emotionally safe environment.

While restraint and seclusion adversely affects the child being controlled, it also impacts those witnessing the event. A child must be made to feel safe in their environment. This fosters healthy, trusting relationships and allows the child to learn new skills.

Problem: Restraints cost time and money.

One study showed that a one-hour restraint took up nearly 12 hours of staff time to manage and process (LeBel & Goldstein, 2005). Restraints also cost tax dollars. An extremely conservative estimate is that restraints in schools in 2009 cost nearly $12 million. One analysis estimated the cost of one restraint to be between $302 and $354 (LeBel & Goldstein, 2005). This does not include the cost of training staff, worker's compensation insurance, staff turnover, lost time, substitutes and healthcare premiums.

Solution: Reduce restraints to reduce costs.

With the high emotional, physical and fiscal cost of restraints, we must look for alternatives! As more states mandate the reduction of restraint and seclusion in public schools, the question becomes; What is the alternative that keeps everyone safe?

Most schools struggle to find this answer after decades of restraint use.

Yet studies of schools that have reduced or eliminated the use of restraint and seclusion show a significant reduction in injury rates to staff. A document issued in 2013 by the Commonwealth Council on Developmental Disabilities and Kentucky Protection & AdvocacyRestraint and Seclusion FACT Sheet Proposed Regulation 704 KAR 7:160: Use of Restraint and Seclusion in Public Schools points out that Grafton Integrated Health Network, located in Virginia, has reduced restraint use by 99.8 percent and yet reduced staff injuries by 41.2 percent.

Costs have gone down as well. Grafton saved over $500,000 in staff turnover costs while reducing worker's compensation claims and liability premiums. How did they accomplish this? Through the development of the only crisis approach that provides a physical alternative to restraints, called Ukeru .

As shared by the Commonwealth Council on Developmental Disabilities and Kentucky Protection & Advocacy, restraint and seclusion are not evidence based practices . Data shows that these practices reinforce and maintain challenging behaviors. Yet more than 30 years of data exist that supports using alternate interventions which helps teachers reduce the amount of time spent managing behaviors and more time teaching. This, in turn, results in better academic outcomes for all students.

As we enter into the new school year, let's work towards these solutions in order to provide the best and safest learning environment possible for our children.