Published: July 15, 2008
The children return from school confused, scared and sometimes with
bruises on their wrists, arms or face. Many won't talk about what
happened, or simply can't, because they are unable to communicate
easily, if at all. Skip to next paragraph
Brian Stauffer
Related
Health Guide: Autism
| Asperger's Syndrome
"What Tim eventually said," said John Miller, a podiatrist in Allegany,
N.Y., about his son, then 12, "was that he didn't want to go to school
because he thought the school was trying to kill him."
Dr. Miller learned that Tim, who has Asperger's syndrome,
was being unusually confrontational in class, and that more
than once teachers had held him down on the floor to "calm him down,"
according to logs teachers kept to track his behavior; on at least one
occasion, adults held Tim prone for 20 minutes until he stopped
struggling.
The Millers are suing the district, in part for costs of therapy for
their son as a result of the restraints. The district did not dispute
the logs but denied that teachers behaved improperly.
For more than a decade, parents of children with developmental and
psychiatric problems have pushed to gain more access to mainstream
schools and classrooms for their sons and daughters. One unfortunate
result, some experts say, is schools' increasing use of precisely the
sort of practices families hoped to avoid by steering clear of
institutionalized settings: takedowns, isolation rooms, restraining
chairs with straps, and worse.
No one keeps careful track of how often school staff members use such
maneuvers. But last year the public system served 600,000 more special
education students than it did a decade ago, many at least part time in
regular classrooms. Many staff members are not adequately trained to
handle severe behavior problems, researchers say.
In April, a 9-year-old Montreal boy with autism died of suffocation when a
special education teacher wrapped him in a weighted blanket to calm him,
according to the coroner's report. Two Michigan public school students with
autism have died while being held on the ground in so-called prone restraint.
Michigan, Pennsylvania and Tennessee have recently tightened regulations
governing the use of restraints and seclusion in schools. California,
Iowa and New York are among states considering stronger prohibitions,
and reports have appeared on blogs and in newspapers across the country,
from The Orange County Register to The Wall Street Journal.
"Behavior problems in school are way up, and there's good reason to
believe that the use of these procedures is up, too," said Reece L.
Peterson, a professor of special education at the University of Nebraska.
"It's an awful combination, because many parents expect restraints to be used -
as long as it's not their kid."
Federal law leaves it to states and school districts to decide when
physical restraints and seclusion are appropriate, and standards vary
widely. Oversight is virtually nonexistent in most states, despite the
potential for harm and scant evidence of benefit, Dr. Peterson said.
Psychiatric facilities and nursing homes are generally far
more accountable to report on such incidents than schools, experts say.
In dozens of interviews, parents, special education experts and lawyers
who work to protect disabled people said they now regularly heard of
cases of abuse in public schools - up to one or two a week surface on
some parent e-mail lists - much more often than a decade ago. "In all
the years I went to school, I never, ever saw or heard of anything like
the horrific stories about restraint that we see just about every day
now," said Alison Tepper Singer, executive vice president of Autism
Speaks, a charity dedicated to curing the disorder.
The issue is politically sensitive at a time when schools have done a
lot to accommodate students with special needs, and some have questioned
whether mainstreaming has gone too far. "Some parent organizations,
they're so grateful to the schools that their kids have been
mainstreamed that they don't want to risk really pushing for change,"
said Dee Alpert, an advocate in New York who reports on the issue in the
online journal specialeducationmuckraker.com.
For teachers, who have many other responsibilities - not least, to teach
- managing even one child with a disability can add a wild card to the
day. "In a class of 30 to 35 children, there's a huge question of how
much safety or teaching a teacher can provide if he or she is being
called on to calm or contain a student on a regular basis," said Patti
Ralabate, a special education expert at the National Education
Association. "The teacher is responsible for the safety of all the children
in the classroom."
The line between skillful conflict resolution and abuse is slipperier
than many assume. Federal law requires that schools develop a behavioral
plan for every student with a disability, which may include techniques
to defuse the child's frustration: a break from the class, for instance,
or time out to listen to an iPod.
But in a hectic classroom, children with diagnoses like attention
deficit disorder, anxiety or autism can seemingly become defiant, edgy or
aggressive on a dime - and the plan, if one exists, can go straight out the
window, investigations have found. Even defying a teacher's instructions -
"noncompliance" - can invite a takedown or time alone in a locked room, they
found.
In an extensive report published last year, investigators in California
documented cases of abuse from districts in the San Francisco Bay Area,
the suburbs of Los Angeles and in the rural northeastern part of the
state. During the 2005-6 school year, an 8-year-old with a diagnosis of
attention deficit disorder and mild mental retardation was repeatedly locked
in a "seclusion room" alone, adjacent to the classroom - at least 31 times in a
single year. His parents heard about it from another parent, who saw the boy
trying in vain to escape.
In another school, a teacher held a 12-year-old with a diagnosis of
attention deficit disorder "face down on the floor, straddling him at
his hips, and holding his hands behind his back," according to the
investigation, which was done by California's office of protection and
advocacy. Congress established such offices in each state in the 1970s
to protect the rights of the disabled.
Leslie Morrison, director of investigations at the California office,
said parents often complained about such episodes but were usually
reluctant to cooperate with an investigation. "They're afraid the school
will retaliate," she said.
And the children, who have an array of psychiatric diagnoses, from
attention deficit to autism, often do not understand what is happening
or why. "They just think they did something wrong and are being
punished," Ms. Morrison said. "Many of them are not verbal at all and
can't even tell their parents."
In Tim Miller's case, school logs obtained by his father illustrate how
quickly a situation can escalate, regardless of behavior plans. In one
entry, dated March 18, 2005, a teacher wrote: "Tim was screaming down
the hall. He ran past me and began to double his fist to punch the
locker. At this point I scooped my arm underneath his and directed him
into my room."
After the boy continued to struggle, this teacher and another "laid him
onto the mat, where he was held approximately 20 minutes," the log said.
Tim, now 15, graduated from the school last year and in June completed
his first year of high school, excelling in a variety of mainstream
classes without incident. In a telephone interview, he said he no longer
thought much about the takedowns. "I just think now that they were
idiots to do that," he said. "I remember telling my mom to pray to God
that they wouldn't keep doing it, and wishing the other kids would see
what was happening."
When a school has a so-called zero tolerance approach to bad behavior,
it often does makes a public spectacle of controlling a child's
behavior, said several parents interviewed for this article.
Kathy Sexton, who lives near Dallas, had to pick up her 11-year-old son,
Anthony, who has a diagnosis of attention deficit disorder, at the police station,
after school staff members had the boy hauled away in handcuffs for cursing at
a teacher.
"I didn't hear about it for hours and had to go get him at jail," Ms.
Sexton said in a phone interview. "He was hysterical, obviously, and
he's had his ups and downs since then. It's hard to know what a thing
like that does to a child that age."
Several companies offer programs to teach so-called de-escalation
techniques to school staff, and a scattering of schools have developed
model programs to pre-empt confrontations, and defuse them when they
happen. But experts say that until policymakers and schools adopt
standards, on exactly which techniques are allowed and when, children
with behavior problems will in many districts run the risk of being
forcibly brought into line.
Dr. Peterson, the Nebraska professor, illustrates the challenges by
citing two recent cases in Iowa. In one, the parents of an 11-year-old
who died while being held down called for a ban on restraints; in the
other, parents charged that a school failed their son by not restraining
him. The boy ran away and drowned.
"It's damned if you do, damned if you don't," Dr. Peterson said, "and it
reflects the level of confusion there is about this whole issue."
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