Hands-on physical engagement has long been a method of last resort in schools’ unending task of keeping kids within the bounds of acceptable group conduct — no hitting, no kicking, no going bonkers. Isolation is another tool. With special education students, these situations can be difficult and complex, and Connecticut schools’ use of “restraints and seclusions” on special needs students is monitored by the state.
“We really don’t want to use restraints,” said Ridgefield Special Education Director Karen Berasi.
“It is very rare. It happens to very few children,” she said.
“Our goal is always to solve the problem so restraint doesn’t have to be used at all.”
Jen Haan, the school psychologist at Veterans Park, trains other staff members in appropriate ways to use physical restraint, and also the “de-escalation” techniques used to avoid the need for it.
“It’s really crisis intervention,” she said. “It’s to address any type of behavior that might escalate into destructive behavior or escalate into a violent incident.
“If a child is at risk of hurting themselves or hurting another child, those are the types of situations where you might intervene.”
What is a ‘restraint’?
The word “restraint” might suggest some kind of equipment — handcuffs or straightjackets — but nothing of that kind is used in Ridgefield, school officials say.
What the Ridgefield schools use to limit the consequences of students losing their self-control is, essentially, body positioning by the adults on staff.
An adult, or sometimes two, will hold a child in a way that limits the child’s ability to use his or her arms and legs or head in a way that could lead to injuries — to himself or herself, to other children, or to both.
“A basic restraint is called a ‘children’s control position.’ It kind of looks like the adult is giving the child a hug from behind,” Ms. Haan said. “And it’s really holding them, controlling their ability to move at that point — their arms are at their sides and they’re holding them, essentially until they calm down.”
Early data
The Connecticut Department of Education issued a Feb. 1 report on the use of “restraints and seclusions” at schools statewide. It offers this definition:
“Emergency Restraint means any mechanical or personal restriction that immobilizes or reduces the free movement of a child’s arms, legs or head.”
Ridgefield reported a total of 46 instances of “emergency restraint” being used to control six different students for the 2012-13 school year. In none of the incidents were any injuries reported.
For 2011-12, Ridgefield reported 14 incidents of emergency restraint, and one incident of emergency seclusion. Again, no incidents involved reported injuries to students.
“The only time a student is restrained is when they’re a danger to themselves or others,” Ms. Berasi said. “And even then, the first thing we do is de-escalate the student.”
She added, “Parents are always notified.”
The state numbers are for 2011-12 and 2012-13 because those are the two years that have been completed since the state began to require reporting.
The state also lists what doesn’t qualify as a “restraint” under its definition, such as “briefly holding a child in order to calm or comfort the child” or “actions involving the minimum contact necessary to safely escort a child from one area to another.”
Also not considered “restraints” by the state are a variety of “devices, including supports” for body position or balance, as well as “helmets or other protective gear used to protect a child from injuries.”
Trained team
In Ridgefield schools, during the effort to calm the child before resorting to physical restraint, staff on the scene will call for the “CPI team” — three or four staff members whom Ms. Haan has trained in the use of de-escalation and control techniques as taught by the Crisis Prevention Institute, based in Milwaukee, Wis.
“The staff is taught never to respond on their own. It’s a team approach,” Ms. Haan said. “Even though one staff member is doing the restraint, there’s another staff member there monitoring the situation, ensuring safety.”
In addition to the Crisis Prevention Institute program provided by Ms. Haan, staff members receive training from the Center for Children with Special Needs in Galstonbury.
Rising use
The increase in the use of restraints reflects the changing student population, Ms. Berasi said.
“Every year we are seeing an increase in students with severe disabilities,” she said. “The more we work with students with severe disabilities in the general environment of school, we will need to have specialized programs and specialized techniques and specialized training from outside consultants.”
Seclusion
“Seclusions” are even more rarely used than restraints, according to the state report.
“Emergency Seclusion means the confinement of a child in a room, whether alone or with staff supervision, in a manner that prevents the child from leaving,” the state says.
“Seclusion does not include: time outs in the back of the classroom or in the hallway, meant to allow the student to pull him or herself together; or in-school suspensions.”
The state reports say that in 2011-12 and 2012-13 Ridgefield did not use any seclusions, either in emergencies or as part of a student’s individual education plan or “IEP” — as is sometimes the case, according to the state.
The Connecticut Department of Education’s Feb. 1 report offered some context on restraints and seclusions, or “R/S incidents,” statewide.
It says many incidents involve students with “significant self-injurious and aggressive behaviors” who “often have multiple incidents” and “account for the majority of incidents reported by an organization.”
The state report says 40.4% of the restraints reported in Connecticut during 2012-13 involved students with autism, and 28.3% involved students with “emotional disturbance.”
Ms. Berasi said this reflects Ridgefield’s experience with restraints.
“It’s more likely for a student who is emotionally disturbed, or has autism. And we have some students who have both.”
She added, “In special education, it happens more often in the elementaries than it does with older students.”
Statewide numbers reflect the pattern of a small number of students accounting for most incidents.
“In total, 33,743 incidents of restraint and seclusion were reported to the CSDE [state department of education] in 2012-13. This represents a nine percent decrease from the previous year (2011-12),” the state reports says
“Of the 33,743 incidents, 77.1% (26,002) were in response to emergency situations (imminent risk of injury to self, others or self and others) and 22.9% (7,741) were seclusions in accordance with an IEP. A total of 2,455 students (unduplicated count) accounted for these 33,743 incidents.”
Ms. Berasi said the numbers reflect the increasingly difficult realities of special education.
“It is a sign of the times,” she said. “Everything changes as you move forward.
“There’s a significant increase in autism and there’s a significant increase in emotional disabilities,” she said.
“As we see more students with significant autism and emotional disabilities, we have to be responsibly prepared to de-escalate students and, in rare cases, to restrain them from hurting themselves or others.”