Preventing and Reducing Seclusion and Restraint

by Kym Grosso of Autism in Real Life , from a blog post entitled, "Students Traumatized in Special Education Across America, Seclusion, Restraint, and Aversives."

At the heart of this issue, many schools lack understanding about autism, why behaviors happen, how behaviors can be communication or sensory related, how calming and verbal deescalation techniques work and how to modify behavior using positive behavior support. Often, our children cannot speak or communicate well, so they use behaviors as a form of communication to get their needs and wants known. Because school staff do not understand these behaviors as a way for the child to try to communicate, the child is punished and the need goes unmet.

In addition to looking at behavior as communication, schools should consider creating comfort rooms or quiet tents available so children with autism can seek relief from noise and other stimuli. Sensory rooms should also be available for our children so they have access to the tools in their individual sensory diets in a quiet environment. Sensory can be an effective way of helping students regain control of their emotions. Instead of letting (or pushing) a child into crisis, a sensory area/room can be a helpful deescalation resource.  Over time, many kids can learn what sensory techniques help them most so they can self-regulate independently. Schools can even make sensory available in the regular classrooms via portable sensory kits as a way of having sensory objects available without having to leave the room. I can tell you from personal experience that schools, even within the same district, often vary in their knowledge regarding sensory and the resources they have available as far as creating sensory rooms. There are many online resources available that list research and information about how to reduce seclusion and restraint via comfort and sensory rooms ^{(8)(9)(10)(11)}.

In the end, if schools really want to eliminate seclusion and reduce restraint, the message needs to be advocated from the top down. Administration needs to take a stand and create a culture which is focused on learning how to prevent crisis situations so the need for restraint is reduced. A good place to start is by reading the Six Core Strategies to Reduce The Use of Seclusion and Restraint Planning Tool, created by the National Association of State Mental Health Program Directors. This tool, Six Core Strategies, has been shown to successfully reduce seclusion and restraint in mental health facilities as well as schools (Azeem MW, Aujla A, Rammerth M, Binsfeld G, Jones RB, 2011)^(12)(13)(14). In addition, there is a free DVD, Leaving The Door Open: Alternatives to Seclusion and Restraint, created by SAMSHA which can assist schools in training staff on alternatives to seclusion and restraint. SAMHSA's website has information about alternatives to seclusion and restraint. The TASH website has information as well.

In order to prevent and reduce seclusion and restraint, schools need to have the desire to learn and the ethics and compassion to seek alternatives. Over a decade ago, our nation's mental health industry recognized the trauma and potential risks of seclusion and restraint. Schools can change too, but they have to acknowledge the problem before they can reach a solution⁽¹⁷⁾. And if administrators lack the compassion to recognize the trauma this practice causes, they should at least be looking at the potential cost savings to taxpayers. The business case for reducing seclusion and restraint has been well documented ⁽¹⁸⁾.

Read the entire article here.

Excerpt reprinted with permission of the author.