Monday, November 23, 2009

Education

Students Suffer Abusive Restraint, GAO Says

Struggling to control special-needs students sometimes leads teachers to use risky techniques

Posted July 7, 2009

Clarification added on 07/10/09: The article was expanded to note that since changing to the positive reinforcement system, Centennial School has rarely had to call for police assistance.

Cindy Kilmer will never forget the look of that chair. Worn, leather straps crisscrossed over its high-back, wooden structure—one strap to hold the head and additional straps to restrain the chest, waist, knees, ankles, and wrists. It resembled an electric chair, Kilmer says. The chair is designed to support someone who cannot sit up on his own, but special education teachers at one West Virginia elementary school used it to restrain Kilmer's then 4-year-old daughter, Christy, who has cerebral palsy and autism, for being "uncooperative," according to the findings of an investigation conducted by the Government Accountability Office. Kilmer says she saw the chair in her daughter's classroom while picking her up from school.

Christy attended preschool for only nine days before Kilmer learned of the restraint and removed her daughter from school more than 10 years ago, but the effects of the alleged abuse are still evident today. Doctors diagnosed Christy with post-traumatic stress disorder that causes her to experience extreme bouts of anxiety and anger, GAO investigators found. Though she was fully potty-trained before her teachers restrained her, Kilmer says Christy, at age 15, will wet her pants if she hears her name and the word teacher spoken in the same sentence. Christy becomes agitated when she is driven past her old school, and Kilmer need not look farther than her own home—the broken furniture and the fist-size holes dotting the walls—to see the costly manifestations of her daughter's anger. "We can deal with the beatings and the broken walls," Kilmer says. "But how can we heal her brain? I can't take the abuse out of her."

The Government Accountability Office found that many special education teachers use potentially dangerous restraint practices to control minor student misbehaviors such as speaking out of turn or refusing to remain seated. According to a GAO report released in May, investigators identified hundreds of allegations of abuse that resulted in emotional trauma, physical injury, and even death among special education students across the country. They also found that many of the allegedly abusive teachers are still working in the classroom—at least one of the three teachers responsible for restraining Christy was still teaching at her former school.

Though the GAO report could not statistically quantify the scope of the abuse because no federal agency (or private entity) gathers data on use of the techniques, two other reports released this year call the problem both widespread and underreported. One of these reports, written by the Council of Parent Attorneys and Advocates, discusses a survey the organization conducted in March and April 2009 that identified 155 school-age children from across the country (more than half of whom are 6 to 10 years old) who had allegedly been restrained or secluded in an abusive manner at school. The other report, written by the National Disability Rights Network, highlights accounts of alleged abuse from nearly all the regional offices it operates across the country. The rise of reported abusive incidents is leading some school administrators to use alternative techniques for resolving confrontation, such as positive reinforcement.

The National Disability Rights Network began advocating against abuse of restraint and seclusion techniques in institutions for the mentally and physically disabled 30 years ago, but when executive director Curt Decker realized the abuse had crept into the nation's special education classrooms, he was stunned. The first instance of in-school abuse Decker can recall happened about eight years ago when a girl who has Down syndrome was strapped to a chair and put in a closet by her teacher. NDRN provided legal services for the girl's family. Since then, the protection and advocacy centers NDRN operates in each state have seen steadily increasing numbers of similar cases.

The reports of abuse reached a critical mass last summer: A conference call among NDRN representatives from every state produced "a horrendous litany of five cases of abuse, 10 cases of abuse, injured kids, dead kids," Decker says. So NDRN decided to raise awareness of the problem in a different way. 

In January, the organization released a report on restraint and seclusion that caught the attention of California Rep. George Miller, chairman of the House Education and Labor Committee, who subsequently asked the GAO to investigate the issue. Miller held a committee hearing on the issue in May and has since pledged to propose legislation by summer's end that would protect students against the potential hazards of restraint and seclusion techniques. Secretary of Education Arne Duncan plans to investigate how states are preventing abuse at the state level. "We wrote the report so there would be no more argument about whether this was anecdotal, abhorrent behavior isolated to one school," Decker says. "Now the public knows the problem is deep-seated, pervasive, and growing."

Reader Comments

Centennial School physical restraints

My name is David N. Miller, and I was one of the co-authors mentioned in the article above by U.S. News and World Report. I think its important to provide a piece of clarification regarding this article, specifically in reference to its statements about the use of physical restraints at Centennial School. In the note added on 7/10 that begins the article, it states that "Centennial School has rarely had to call for police assistance". To put this in better perspective, the reader should know that Centennial School almost never calls the police - this occurs perhaps once or twice per year on average(many public schools call the police much more often). Further, on those (extremely rare) cases where the police have been called, it has often been at the request of parents rather than the school. Centennial School is a model program for schools serving students with emotional and behavioral disorders in the nation and attracts visitors from all over the country.

restraints, positive behaviour program, biological causes

I would be much more impressed with George's results, if they weren't calling the police, and telling the child that "they are sorry that their behaviour caused them to have to call the police, and that they will miss them while they are gone."!!!

This is NOT part of a positive behaviour approach! It is just substituting one negative response for another negative response. Are the police restraining them? Putting them in hand-cuffs? Putting them in juvenile detention center, or jail-where they are more likely to learn additional poor behaviours, or, especially if they are on the autism spectrum, to be at risk of being abused (physically, mentally, emotionally, sexually), further traumatized, drugged excessively/inappropriately, and be at a higher risk for suicide.

I am not impressed that suspension rates are down, after hearing this information. It makes me wonder what kind of games may be played with manipulation of the statistics! For example, what happens when you factor in the days missing, due to being placed elsewhere (detention center, jail, hospitalization program, etc.)? Is there an increased drop-out rate?

As a teacher, I know the difficulty of teaching when there are large numbers of children with severe behavioural issues. As an advocate, I am appalled at the number of people with autism, MR, mental/emotional health issues, etc., who end up in jail, instead of getting appropriate treatment! Google Pfeiffer Treatment center, or other studies regarding medical treatment for heavy metals, (such as lead and mercury, which can cause MR, and look at links between metsls and anger/violence), and vitamin supplementation, and how it can affect behaviour. As a parent of a child with autism, I would advise Kilmer to google the Autism Research Institute, the DAN protocol, the Feingold diet, TACA, biomed or alternative interventions, etc.

P.S.-I am NOT trying to minimize the effects of trauma, or to say that the school was making a good choice in placing a 4 year-old in that type of restraint,especially without even discussing it with the parent! I believe that schools should try for a positive approach. However, I also believe that changing the behaviours should begin with healing the body, including the brain, and that it is appalling that our society is not studying these issues in a meaningful way (I believe this is due to the fact that big pharma companies can't make money on these interventions, so there is no reason for them to spend millions of dollars setting up studies- and many reasons for them to discredit these ideas-especially if components of vaccines, such as thimerosal, aluminum, etc., or antibiotics, or commonly used over the counter drugs,or antibiotics, or drugs used to induce or speed up labor, or various psychiatric meds, could possibly be shown to have links to, or be causative factors in autism, or other severe behavioural or cognitive problems).

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