Speaking Up for Students and Schools An SLP challenges the use of forced seclusion and restraint in schools. From My Perspective
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From My Perspective  |   December 01, 2016
Speaking Up for Students and Schools
Author Notes
  • Anastasia Reisinger, MS, CCC-SLP, is a speech-language pathologist in Madison, Wisconsin. anaspeechpath@gmail
    Anastasia Reisinger, MS, CCC-SLP, is a speech-language pathologist in Madison, Wisconsin. anaspeechpath@gmail×
Article Information
School-Based Settings / From My Perspective
From My Perspective   |   December 01, 2016
Speaking Up for Students and Schools
The ASHA Leader, December 2016, Vol. 21, 6-7. doi:10.1044/leader.FMP.21122016.6
The ASHA Leader, December 2016, Vol. 21, 6-7. doi:10.1044/leader.FMP.21122016.6
I have seen, in my work in the schools, cases in which students have been forced into isolation or seclusion rooms against their will and have screamed, pounded on the door, and cried out for some kind of support or control.
After their seclusions, the students—one in pre-K and two in elementary school—exhibited fight-or-flight responses and a lack of trust for teachers and the school community. One child ran away from staff in the days immediately thereafter and acted stunned and dissociated, trying to avoid the painful reminders of the trauma. Another child exhibited extreme anxiety—her body was hyper-aroused and her voice quivered. A third child cried and displayed more defiant behavior toward staff in the weeks afterward.
Forced seclusion and physical restraint are not effective behavior management techniques. They are aversive punishments that escalate fear and violence. Rather than creating a peaceful, positive learning environment, seclusion and restraint create a school culture of fear, dysfunction and negative mental and physical states of being.
Involuntary confinement—or what is commonly called seclusion— is inhumane. It is abusive. It is physically and mentally harmful to those who experience and witness it. Children who are secluded or physically restrained may suffer psychological harm, including depression, anxiety and post-traumatic stress disorder (see sources).
Seclusion is not, however, the same as allowing children to isolate themselves to self-calm. According to the Civil Rights Data Collection (see sources), “seclusion should not be confused with a timeout, which is a behavior management technique that is implemented for the purpose of calming.” In the timeout room, the child feels safe in a nonthreatening environment. In a seclusion room, the child is confined in an environment, perhaps with an angry or threatening adult blocking the exit.
Seclusion and restraint do not increase a child’s dignity, functional life skills or positive behavior. According to a report compiled by three disability rights groups in Wisconsin from 2013 to 2014, restraint and seclusion not only fail to teach children appropriate behaviors, but they also escalate and exacerbate challenging behaviors. According to social worker Barry K. Morris, “There should always be a focus on humane changes in the child’s life to learn better behavior, instead of using coercion or punishment to manage behavior.”
Research and reports
In school and psychiatric care settings, seclusion has not shown to be an evidence-based practice, nor has it demonstrated a decrease in angry, destructive behaviors. In fact, it may increase deviant behavior.
Recent research shows seclusion may have severe and tragic effects. Jessica Butler, an attorney and mother of a child with autism, wrote an analysis for the Autism National Committee that summarizes state seclusion and restraint laws and policies in effect as of 2015. In “How Safe Is the Schoolhouse?” she reports, “Children confined in closets or other isolation rooms and spaces unobserved have been killed, injured, and traumatized.” She contends that “most states forbid seclusion only when children are unsupervised,” but more important, they do not restrict supervised seclusion. She emphasizes that “restraint and seclusion expose children to danger, escalate difficult behaviors and create a cycle of violence.”
Physical restraint can also be dangerous. In her report, Butler demonstrated that like seclusion, restraint may cause death, injuries and trauma, and should be limited to only emergencies that threaten serious physical danger. According to Wanda Mohr and Jeffrey Anderson in their 2001 Journal of Child and Adolescent Psychiatric Nursing article, there is no research evidence that demonstrates the use of restraints to be therapeutically effective.
The U.S. Department of Education has also tried to address seclusion and restraint. “The use of restraint and seclusion can have very serious consequences, including, most tragically, death,” according to Arne Duncan, then secretary of education, in the introduction to a 2012 federal resource document on restraint and seclusion. “Furthermore, there continues to be no evidence that using restraint or seclusion is effective in reducing the occurrence of problem behaviors that frequently precipitate the use of such techniques.”
In February 2014, a U.S. Senate committee generated a report with recommendations for proposed federal legislation. The report, “Dangerous Use of Seclusion and Restraint in Schools Remains Widespread and Difficult to Remedy: A Review of Ten Cases,” noted that the lack of federal regulations for restraint and seclusion in schools leaves families little recourse when seclusion or restraints are used.
Proposed legislation (S. 2036), which essentially prohibits seclusion and restraint in any state or local education agency receiving federal funds, did not gain the momentum to pass in the 113th (2013–2015)Congress. A similar bill (H.R. 927), introduced in the current Congress, needs a great deal of support to avoid a similar fate.

“There continues to be no evidence that using restraint or seclusion is effective in reducing the occurrence of problem behaviors that frequently precipitate the use of such techniques.”

Change the climate
Schools, parents and communities can help address the problems related to seclusion and restraint. To help eliminate the practices, school personnel need to keep some points in mind.
School-wide positive behavior intervention and supports benefit students and teachers. When teaching children who have challenging behaviors, we need to practice nonaversive interventions, such as school-wide positive behavior intervention and supports. This approach establishes a respectful social culture and positive behavior supports that allow all children to experience social and academic success. (Read more information on school-wide behavior programs.)
Schools need resources and counsel. When we fail to provide sufficient funding and trained staff to schools and special education services, we jeopardize access to resources that help teachers and students stay physically and mentally well-balanced.
Schools need to recognize the effects of trauma and support traumatized children. The effects of trauma can alter a child’s physical, emotional, cognitive and social development, according to the Child Trauma Academy. Schools can foster nurturing and caring relationships to promote resiliency and recovery from trauma.
Schools need nonviolent crisis-prevention training. The emergency action plan and discipline policies and procedures need to align with peaceful and humane treatment of all students and personnel. The trained personnel involved in de-escalation must know how to implement alternatives to seclusion and restraint.
Schools can initiate improvement. Small steps can have great impact: strengthening special education and English language-learner programs, providing sufficient recess and break times, enhancing mental health counseling resources, increasing funds for professional development on positive behavior management, and instituting trauma-informed care.
State and national laws can be reformed. We need federal legislation to ban seclusion from schools and prohibit physical restraint except when there is an imminent threat of serious physical danger.
Action steps
If you work in a public school that uses seclusion and restraint, you can help change the climate in several ways:
  • Share information about the traumatic impact of seclusion and restraint with administrators and colleagues.

  • Request staff training on alternative behavior management strategies, the impact of trauma and poverty, and crisis prevention.

  • Help educators understand the causal issues—specifically underlying communication disorders or weaknesses—related to behavior.

  • Contact your state association to advocate for changes in state laws governing restraint and seclusion.

Sources
Butler, J. (2015). How safe is the schoolhouse? An analysis of state seclusion and restraint laws and policies. National Autism Committee. www.autcom.org/pdf/HowSafeSchoolhouse.pdf.
Butler, J. (2015). How safe is the schoolhouse? An analysis of state seclusion and restraint laws and policies. National Autism Committee. www.autcom.org/pdf/HowSafeSchoolhouse.pdf.×
Disability Rights Wisconsin, Wisconsin Family Ties, & Wisconsin Family Assistance Center for Education. (2016). Seclusion and restraint in Wisconsin public school districts 2013–2014: Miles to go. http://www.disabilityrightswi.org/wp-content/uploads/2016/02/SeclusionRestraint-Report-2013-2014.pdf.
Disability Rights Wisconsin, Wisconsin Family Ties, & Wisconsin Family Assistance Center for Education. (2016). Seclusion and restraint in Wisconsin public school districts 2013–2014: Miles to go. http://www.disabilityrightswi.org/wp-content/uploads/2016/02/SeclusionRestraint-Report-2013-2014.pdf.×
Finke, L. M. (2001). The use of seclusion is not evidence-based practice. Journal of Child and Adolescent Psychiatric Nursing, 14(4), 186–190. [Article] [PubMed]
Finke, L. M. (2001). The use of seclusion is not evidence-based practice. Journal of Child and Adolescent Psychiatric Nursing, 14(4), 186–190. [Article] [PubMed]×
Georgetown University Center for Child and Human Development. Center for Early Childhood Mental Health Consultation: Tutorial 7: Trauma in the context of relationships. http://ecmhc.org/tutorials/trauma/mod2_5.html.
Georgetown University Center for Child and Human Development. Center for Early Childhood Mental Health Consultation: Tutorial 7: Trauma in the context of relationships. http://ecmhc.org/tutorials/trauma/mod2_5.html.×
Masten, A. S., Herbers, J. E., Cutuli, J. J., & Lafavor, T. L. (2008). Promoting competence and resilience in the school context. Professional School Counseling, 12(2), 76–84. [Article]
Masten, A. S., Herbers, J. E., Cutuli, J. J., & Lafavor, T. L. (2008). Promoting competence and resilience in the school context. Professional School Counseling, 12(2), 76–84. [Article] ×
Morris, B. K. (2008). Positive behavioral supports. Retrived June 18, 2016 from autism-help.org/intervention-positive-behavior-support.htm.
Morris, B. K. (2008). Positive behavioral supports. Retrived June 18, 2016 from autism-help.org/intervention-positive-behavior-support.htm.×
Mohr, W. K., & Anderson, J. A. (2010). Faulty assumptions associated with the use of restraints with children. Journal of Child and Adolescent Psychiatric Nursing, 14(3), 141–151.
Mohr, W. K., & Anderson, J. A. (2010). Faulty assumptions associated with the use of restraints with children. Journal of Child and Adolescent Psychiatric Nursing, 14(3), 141–151.×
Perry, B. (2003). Effects of traumatic events on children. The Child Trauma Academy. www.ChildTrauma.org.
Perry, B. (2003). Effects of traumatic events on children. The Child Trauma Academy. www.ChildTrauma.org.×
Samuels, C. A. (2015). Those opposing restraint and seclusion gain new traction with state legislatures. Education Week, 34(21), 1–3.
Samuels, C. A. (2015). Those opposing restraint and seclusion gain new traction with state legislatures. Education Week, 34(21), 1–3.×
Senator introduces restraint and seclusion legislation: The keeping all students safe act. (2012). Curriculum Review, 51(7), 10.
Senator introduces restraint and seclusion legislation: The keeping all students safe act. (2012). Curriculum Review, 51(7), 10.×
Trader, B. (2015). Testimony prepared for Mississippi Department of Education public hearing on restraint and seclusion use in schools. stophurtingkids.com.
Trader, B. (2015). Testimony prepared for Mississippi Department of Education public hearing on restraint and seclusion use in schools. stophurtingkids.com.×
U.S. Department of Education. (2012). Restraint and seclusion: Resource document. www2.ed.gov/policy/seclusion/restraints-and-seclusion-resources.pdf.
U.S. Department of Education. (2012). Restraint and seclusion: Resource document. www2.ed.gov/policy/seclusion/restraints-and-seclusion-resources.pdf.×
U.S. Department of Education Office for Civil Rights. (2014). Data snapshot: School discipline. Issue Brief No. 1. ocrdata.ed.gov/Downloads/CRDC-School-Discipline-Snapshot.pdf
U.S. Department of Education Office for Civil Rights. (2014). Data snapshot: School discipline. Issue Brief No. 1. ocrdata.ed.gov/Downloads/CRDC-School-Discipline-Snapshot.pdf×
U.S. Senate Committee Report. (2014). United States Senate Health, Education, Labor and Pensions Committee. Dangerous use of seclusion and restraints in schools remains widespread and difficult to remedy: A review of ten cases. https://archive.org/stream/ERIC_ED544755/ERIC_ED544755_djvu.txt.
U.S. Senate Committee Report. (2014). United States Senate Health, Education, Labor and Pensions Committee. Dangerous use of seclusion and restraints in schools remains widespread and difficult to remedy: A review of ten cases. https://archive.org/stream/ERIC_ED544755/ERIC_ED544755_djvu.txt.×
Westling, D. L., Trader, B. R., Smith, C. A., & Marshall, D. S. (2010). Use of Restraints, Seclusion and Aversive Procedures on Students with Disabilities. Research and practice for persons with severe disabilities, 35(3–4), 116–127. [Article]
Westling, D. L., Trader, B. R., Smith, C. A., & Marshall, D. S. (2010). Use of Restraints, Seclusion and Aversive Procedures on Students with Disabilities. Research and practice for persons with severe disabilities, 35(3–4), 116–127. [Article] ×
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December 2016
Volume 21, Issue 12