Restraint and Seclusion
Our news feeds often provides tragic examples of how deadly the practice of restraint and seclusion can be. Recently, three staff members (including the principal) at an El Dorado non-public school called Guiding Hands Inc. were indicted for their role in the 2018 death of Max Benson, a thirteen-year-old with autism. Max was held in a prone position by staff members for two hours before he died, to prevent him spitting on another child.
Data taken during the year before Max Benson’s death shows that more than 100,000 students were subjected to restraint or seclusion in U.S. public schools. Of those students, 78% of them were students with disabilities. No federal law currently exists that monitors or limits the use of restraint and seclusion. While a few states place limitations on the use of restraint and seclusion to control student behavior, legislation is being introduced to limit its use, study the effects of its practice, and explore alternative methods to protect the safety of students. To learn more, we spoke with Chris Arroyo, regional manager of the California State Council on Developmental Disabilities (SCDD), Denise S. Marshall, chief executive officer of the Council of Parent Attorneys and Advocates (COPAA), and Dr. Sarah Pelangka (BCBA-D), special education advocate and owner of KnowIEPs.
What is restraint and seclusion?
The Stop Hurting Kids Campaign defines the practice of restraint and seclusion as “techniques used to control or modify challenging behavior by force or isolation.”
The Department of Education’s Civil Rights Data Collection defines seclusion as “the involuntary confinement of a student alone in a room or area from which the student is physically prevented from leaving.” Seclusion isn’t the same as a timeout, which is a behavior management technique that is part of an approved program for the purpose of calming and involves the monitored separation of the student in a non-locked setting. It’s also not an in-school suspension. Seclusion can include: “placement in a dark isolated box, prolonged isolation without contact or bathroom breaks, or locking a student in a closet or other tight space.” Certain amendments to state education codes have updated the way seclusion is practiced, such as students in seclusion not being left in a locked room or left alone without constant observation.
Federal guidelines published in 2012 outline fifteen principles that states, districts, and schools should consider when developing restraint and seclusion policies, including that restraint and seclusion should never be used as punishment and that teachers and other school staff should be trained in effective alternatives. The guidelines define restraint in three ways — physical, mechanical, and chemical — and state that mechanical and chemical restraints should never be used.
Physical restraint is defined as a “personal restriction that immobilizes or reduces the ability of a student to move his or her torso, arms, legs, or head freely.” According to the Stop Hurting Kids Campaign, it can include: “face down or prone restraint, immobilizing a student by pinning arms and legs onto the ground, restricting breathing through restraint, holding a student in one’s lap with arms immobilized, or pinning a student against the wall.” Physical restraint does not include a physical escort, which is temporarily touching or holding onto a student who is acting out to walk them to a safe location.
Mechanical restraint is defined as “the use of any device or equipment to restrict a student’s freedom of movement,” and can include “taping a student’s arms and legs to a chair, strapping the student into a Rifton chair, and specially constructed tables or desks from which the student cannot leave.” Orthopedically prescribed devices, adaptive supports, mechanical supports, vehicle safety straps, or medical immobilization are not considered mechanical restraint.
Chemical restraint is the use of medication to subdue or control a student’s behavior (except as authorized by a licensed physician or other qualified health professional).
Is restraint and seclusion ever necessary?
Dr. Pelangka explains that under federal and California law, restraint and seclusion are permitted “only as a last resort,” which is defined as whenever the student has placed themselves or others in imminent danger.
“When I am in IEP meetings and this is reviewed on the Behavior Plan, the discussion always begins by stating that CPI (crisis prevention and intervention) is only to be used as a last resort,” Dr. Pelangka says. “This always goes under the ‘Reactive Strategies’ section of the behavior intervention plan, where they discuss what to do should the behaviors continue to escalate.”
So what constitutes an extreme situation when restraint might be used?
Dr. Pelangka shares this example: “Say the parent doesn’t consent to the BIP or the IEP, and the student is at school and they are placing either themselves or others in imminent danger: staff have the right to protect that child and the other children,” she says. “They cannot allow the child to run into the street into oncoming traffic, for example. They cannot allow the child to continue to hit others or themselves with force. Restraint and seclusion is not limited to students with disabilities — it applies to all students. Gen ed parents don’t sign anything regarding the use of restraint; if their child gets into a fight, staff will intervene as they see fit to break it up, for example. Now, this isn’t to say what the staff does is legal.”
It’s important for parents to know that it’s illegal for anyone at school to restrain a child if they have not been certified in the restraint procedures. “If a substitute aide is working with a student for the day, for example, and that aide is not NCPI trained, and that aide places the student in a restraint, that’s not legal,” Dr. Pelangka says. “Any student who has restraint written into their IEP/BIP is required to have the necessary number of certified staff with them at all times to meet their needs. If the school cannot accommodate this, parents need to be informed immediately, and the student should not go to school, to be honest. The school will owe the student services for that time. They cannot maintain the safety of that child, and if something were to happen, they are liable.”
Chris Arroyo says that while restraint and seclusion may sound like a reasonable response to a kid who is out of control, it generally represents a treatment failure.
Marshall agrees. “Imposition of restraint is extremely dangerous for all involved and [represents] the failure of treatment. Only when a child is in immediate danger of hurting themselves or others should restraint be imposed.”
As for seclusion, she says, “We do not believe there is any occasion when a child should be locked alone in a room at school. Simply put, seclusion should never be used.”
While Section 504 doesn’t prohibit the use of restraint and seclusion, it does prohibit disability discrimination. If a school restrains or secludes a student with a disability for behavior that wouldn’t result in the restraint or seclusion of peers without disabilities, that would be considered discrimination (see this fact sheet from the Office of Civil Rights). If a school restrains or secludes a student inappropriately due to assumptions or stereotypes about their disability, that would also be discrimination. Repeated use of restraint and seclusion could result in a denial of FAPE to a student with a disability and therefore violate Section 504.
What should parents do if the school asks for consent to use restraint and seclusion?
First, Dr. Pelangka says, it's important to understand that the school does not need permission from a parent to use restraint and seclusion if they deem it necessary. And because restraint and seclusion are permitted by law, parents cannot write a “no consent” letter into the IEP or 504 plan preventing the school from using the practice, either. But that doesn’t mean you have to agree to restraint and seclusion in writing.
Marshall says that while parents may be asked to agree to the use of seclusion rooms or restraints as part of the IEP or 504 plan, they should not do so. “Parents should not agree to putting restraint in an IEP — instead, put in that you only agree to its imposition if your child is in immediate danger, and that you never agree to have your child put in seclusion. IEPs can also outline the positive skills the student is working on and information about what helps to de-escalate the child.”
Arroyo adds that parents can write a letter to be included in the IEP that clarifies under what circumstances restraint and seclusion can and cannot be used. However, he warns against giving written consent to the school to use seclusion or physical restraint, even for emergencies.
Instead, he says, ask for a behavioral plan and a crisis and de-escalation plan. It’s important to work through the root causes of the behavior and propose alternative strategies to avoid the behavior occurring in the first place. Arroyo recommends that school officials document all behavior interventions to be used in a behavior intervention plan. This can also include adding positive behavioral interventions and supports (PBIS) into the IEP or 504 plan.
Why are having tools to manage behavior so important? Arroyo explains:
What are the alternatives to restraint and seclusion?
Evidence does show, however, that the use of these aversive interventions can result in emotional and physical trauma, serious injury, and death.
There are over two decades’ worth of research in supporting the use of positive behavioral interventions and supports (PBIS) to proactively teach students to learn appropriate social, emotional, and behavioral skills. PBIS, which has been shown to reduce challenging behavior by 80% in two-thirds of cases, addresses the underlying causes of behavior, develops positive plans for intervention highlighting a student’s individual needs, and includes socially meaningful supports. The Stop Hurting Kids Campaign also recommends a complementary approach of trauma-informed care, which acknowledges that challenging behavior may be a manifestation of previous trauma.
A 2018 study published in Advances in Neurodevelopmental Disorders found that implementing a new model that used a method of peaceful conflict resolution resulted in a 99% decrease in restraint frequency at a health care facility serving children and adults. Another study from the University of Connecticut found that the use of PBIS reduced restraints by 25% and seclusions by 59%. Clearly, research shows that alternative approaches to restraint and seclusion are available and that many schools are using them successfully.
“What we need is more training and more restorative justice practices across schools,” Dr. Pelangka says. “Rather than suspensions, expulsions, etc., we need more meditation and growth mindset practices in schools. More proactive practices as opposed to reactive. PBIS CAN be effective, although it doesn’t always work due to lack of consistency and lack of training. Administration needs to buy in, and there needs to be better oversight and more staff available to support the districts. Too many educators believe they are not responsible for managing behavior, that that’s the parents’ job. That is not true. Our kids spend so much of their lives at school, the two cannot be separated. Until educators and administration adopt this mindset, we won’t see the change we need to see.”
What should parents do if they believe the school is using restraint and seclusion?
The same 2012 federal guidelines that define the use of seclusion and restraint also state, “Parents should be informed of the policies on restraint and seclusion at their child’s school or other educational setting,” and “Parents should be notified as soon as possible following each instance in which restraint or seclusion is used with their child.”
Both federal guidelines and California law mandate that a Behavioral Emergency Report should be filed when restraint is used and that parents should be notified within one school day. If the student has no behavior intervention plan (BIP) in place, the school must “schedule an IEP meeting within two days of the emergency intervention to determine whether a Functional Behavioral Assessment (FBA) is needed and to determine whether your child needs an emergency behavior plan while the assessment is being done.”
Note your concerns in the IEP and ask to be informed in any emergency situation. If the school district doesn’t comply or follow up with regulation, you can file a compliance complaint or make a written request for an IEP review to address the situation.
Dr. Pelangka advises parents, “If you believe restraint and seclusion are being misused, call an emergency IEP meeting and present the case to the team.” You can then do the following:
- Ask for any and all data — such as Behavior Emergency Reports — reflecting the use of restraint and seclusion.
- Make sure it is written into the IEP that anytime a hold/restraint/removal from class or class removal/seclusion is utilized, parents are informed the day of via a communication log or datasheet.
- Ask for regular data to be sent home.
- Ask to attend the trainings on your child’s BIP. If the student has a history of trauma, their plan should also include trauma-informed care.
- Demand trainings for all staff and have it written into the IEP that required trainings need to occur within two weeks of any new direct service provider starting on the team.
- Above all, work to ensure that a very solid behavior plan is written and that all necessary staff are properly trained, to fidelity. To ensure this is happening, staff and aides should be trained on the BIP once it’s written, and then they should be observed and scored by the district BCBA using a “fidelity of implementation data sheet.” (For example: “Did the staff prompt correctly? Did the staff reinforce correctly?”) Dr. Pelangka says it’s recommended that only when they meet 90% fidelity should they be left alone to support that student.
For a list of statutes, regulations , policies, and guidance addressing restraint and seclusion in your state, check out Attachment A on page 29 of the U.S. Department of Education’s “Restraint and Seclusion: Resource Document.”
What is the data on how restraint and seclusion can harm kids?
Disability advocates have been sounding the alarm about restraint and seclusion for many years. In 2002, Disability Rights California's report “The Lethal Hazard of Prone Restraint” documented the tragic number of individuals killed in schools and care settings by the use of prone restraint (holding someone facedown for an extended period of time, which can cause death by asphyxia). A 2009 National Disability Rights Network report, "School is Not Supposed to Hurt," describes the lack of regulation on the use of restraint and seclusion in most states. A 2009 Government Office of Accountability report, “Examining the Abusive and Deadly Use of Seclusion and Restraint in Schools,” also highlighted the problem.
A year-long national investigation by Hearst Newspapers found that “children were injured at least 1,062 times in the 2019-20 school year during restraint and seclusion incidents” and that since 1989, “at least 85 children, teenagers and young adults age twenty-one and younger have died after being restrained or kept in seclusion in public and private schools, juvenile justice centers, residential facilities or other settings.” They also found that restraint and seclusion is used disproportionately on students with disabilities.
In 2020, the Teacher Project, an education reporting fellowship at Columbia Journalism School, found that private schools restrain and seclude children hundreds or even thousands of times per year. In California, two-thirds of all cases of restraint and seclusion happen at private schools that serve less than 1% of the state’s schoolchildren.
When it comes to seclusion specifically, a 2019 investigation by ProPublica Illinois and the Chicago Tribune found how dangerous seclusion can be, even if the locations used are deceptively referred to as reflection rooms, cool-down rooms, calming rooms, or quiet rooms. The investigation found that most of these rooms were just plywood boxes and that most of the students had disabilities.
How is restraint and seclusion being challenged?
The U.S. Department of Education has written two letters of guidance to states, including their recommendations from 2012. Despite the Department prioritizing this issue since 2009, and the Government Office of Accountability (GAO) saw the issue as urgent, data showed problematic and illogical data collection and quality control. The GAO recommended that the DOE address the use of restraint and seclusion in schools, inform parents of any changes in federal special education law when they place their children with disabilities in private schools, and use “additional quality controls to address misreporting, address factors underlying misreporting, and refine and clarify its definitions.”
Legislation is also being introduced and passed to address the use of restraint and seclusion. The Alliance to Prevent Restraint, Aversive Interventions, and Seclusion (APRAIS) is a coalition of organizations including Autism Society, AUCD, COPAA, CHADD, NAMI, NDSC, and TASH. APRAIS supports federal legislation that would prohibit the use of seclusion or any physical restraint that restricts breathing, such as the Keeping All Students Safe Act, which has been introduced numerous times into Congress, the most recent bills being HR 3474 and S 1858, both introduced in 2021 but not yet passed.
But legislation itself may not be enough. Max Benson, the 13-year-old student with autism, died the same year that California passed landmark legislation prohibiting the use of restraint or seclusion for coercion, discipline, convenience, or retaliation. The bill, AB 2657, which was signed into law earlier in 2018, calls restraint and seclusion “dangerous interventions” and allows schools to use it only when there is a clear danger of serious harm to the student and/or others. AB 2657 also requires schools to report data annually on the use of restraint and seclusion to the California Department of Education, with the data separating the students into three categories: those with an IEP, those with a 504 plan, and those who do not have either. California code also states that any use of restraint and seclusion will be followed up in the same manner as behavioral emergency reporting as listed in Section 56521.1.
While AB 2657 is a good first step, there’s more California can do to protect its students. Disability Rights California’s review and subsequent report on restraint and seclusion outlines their recommendations, including banning prone and mechanical restraints, limiting restraint and seclusion to fifteen minutes, and promoting PBIS.
Parents can also find support at COPAA — which has worked since 2008 to end the use of seclusion and severely limit restraint through passage of a federal bill — and join them in helping to pass federal legislation to protect our kids! The COPAA Declaration of Principles Opposing the Use of Restraint, Seclusion, and Aversive Interventions provides a guide to best practice.
Questions to ask your school
Whether you’re navigating a new school or thinking about approaching your current school to talk about their policies on restraint and seclusion, asking questions is the first step.
- How does the school use restraint and seclusion? (They may respond by detailing their positive behavior management policies, but that doesn’t mean they don’t use restraint and seclusion.)
- How many instances of restraint and seclusion has the school reported to the Department of Education over the last five years? (You can also check this online.)
- Does the school follow the State Department of Education’s guidelines on the use of restraint and seclusion? Follow up by asking if the school district has a written policy on use of restraint and seclusion, and ask for a copy.
- What happens if a student acts up or has difficulty with their behavior?
- Is the staff NCPI trained to use restraint?
- Ask who on campus is trained in how to implement a student’s BIP, and ensure that all staff members who will be in regular contact with your child are trained, including yard duty staff, security, and resource officers.
- Many specialized classrooms have a “quiet room” where students are able to calm down. When touring any NPS or district/county self-contained program, ask to see their quiet room or time-out room. Walk inside and see what it looks like and feels like. Does the room have a door with a lock? (Locked seclusion is illegal in California.) Is the light working? Is there a window so that the child can be observed at all times? Ask when it is to be used, and clarify that you don’t want your child in that room.
- Ask what reinforcement systems the school uses. If the system doesn’t sound like it will prove effective for your child, ensure that they are open to an individualized system for your child. If they are rigid and only want one system, that’s not okay.
- Ask about their alternatives to restraint and seclusion. Is this a PBIS school, and what is their PBIS policy? What kind of positive behavior management strategies do they use? What are their third-tier strategies for students with additional behavioral needs? Who in the classroom is trained in positive behavior support or ABA? What is the tier plan for an emergency or behavioral crisis?
Finally, talk to other parents and attend school board meetings. Give the school data from the Department of Education and ask for change. Call the DOE and tell them what is happening at your school and what you can do. Change is possible! Read the powerful story of these families from Contra Costa County, who won a landmark settlement against the DOE to end the use of illegal and abusive restraint and seclusion practices in their school and created a safer campus for their children.
- Stop Hurting kids Campaign (especially resources tab, definitions, and “Hear our Stories” video)
- 2012 U.S. Department of Education’s Restraint and Seclusion: Resource document
- Information about Seclusion & Restraint Data
- OSEP Civil Rights Data Collection 2017-2018
- TASH on Seclusion & Restraint
- COPAA Declaration of Principles Opposing the Use of Restraints, Seclusion, and Other Aversive Interventions Upon Children with Disabilities
- Read COPAA’s 2020 report, The Crisis of Trauma and Abuse in Our Nation’s Schools.