Before diving into the fray, let me give you a bit of my own personal history on the subject. I’ve already written abit of my own old school background on the subject of spanking. My first real exposure to the practice in special education was when I was a para at the local psychoeducational center about 15 years ago. Basically the guideline for time-out was when the student was hurting others or destroying property. The same goes for restraint. Basically, it makes sense to me that if a child of 9 is severely emotionally disturbed and is beating the crap out of another student (or teacher) that physical intervention is warranted. If he/she is throwing a chair or gouging out their own eye, I’m trying to wrap my mind around how I might help the child or others without the laying on of hands. I already know the answer to that, which I’ll share in a moment.
But we did use restraint and seclusion using guidelines and training from the Crisis Prevention Institute. We also used life space interviews after a student got out of time out. The procedures that we followed at the psychoed were, in my opinion, second to none. But seclusion and restraint were NOt our methods of choice. We relied an a very robust arsenal of positive behavioral supports, because you simply can not teach a classroom where everyone is in timeout. It took a lot of personnel to moniter the rooms, as well as the risk of personal injury. So in our class at the time, we had a point sheet/token economy, a level system, a group reward/contingency program, therapeutic rec/leisure and generally tried to make the climate as positive and rewarding as possible. so when a student had to go to time out, they were really and truly missing out on something. On top of that, I introduced a sort of “punch-out” token economy that was more immediate. The effect of that, was that I could take up the token card instead of ejecting the student while reinforcing everyone else. So it was a time-out-in-place. But the student always got reinforced when they were ready to rejoin the group/task. By the end of that year, I rarely ever, ever had to put a kid in time-out or lay hands on them in our class. However, the practice of restraint and seclusion did end up costing me personally and dearly that year.
I have no idea exactly what happened, but it was all over for me. My knee somehow got terribly twisted and I went down hard and heavy. It could have been the uneven grass we were on or the sudden swerve the kid took and me being too stupid and reckless. At that moment, the true idiocy of my actions caught up and washed rght over me in a wave of pain. And I would spend the next few hours in an emergency room. Nothing was broken, but I had some ligments that were badly torn. That was it for my running career. To this very day, that knee will sometimes bother me for wierd and strange reasons. Losing weight definitely has helped keep me from limping and gimping around. But it is a persistent reminder of the folly inherent within restraint practices. At least by school teachers, no matter how young and fit.
My next job was at a psychiatric hospital in a child and adolescent unit. Even though it was the late 1990’s it seemed like the 1980’s sometimes the way it was run, especially in the area of behavior management. When I arrived, there were lots of people who were experts on therapy and behavior but none of them were behaviorists. The social workers were into family systems, the behavior specialist was actually specialized more with those who had been sexually abused and the doctor/psychiatrist was into psychoanalytical therapy while being supported by the MD’s and nurses with lots of psychotropic medications. seclusion and restraint was used quite regularly, but it is hard to imagine not using it with some of the severe behaviors that warranted being hospitalized. I saw it all while I was there, but since it was a locked facility, I never had to chase anyone down. Plus the health service technicians did all of the physical work. And sometimes that meant a 5 point restraint system under a doctor’s order. While there was a token economy and level system in place, it was not used very well. So I did use other contingencies that I had control over, like access to a computer lab. The kids loved the computer lab and I had the best hardware and software money could buy at the time. I had a $7,000 budget! So I had resources to apply towards behavior and teaching. If a kid acted up in my class, he/she was simply removed to time-out or more medication.
But the big issue/movement in the 1990’s was deinstitutionalization, which meant that the C&A unit was closed and I lost my job. I’ll have to write more sometime about the repercussions of that movement. Suffice to say that the present movement towards not using seclusion and restraints is a direct result of that battle that was mostly won by the advocates. Most of the cases that were served by a huge (and expensive) team of doctors, nurses, behavior specialists, recreation specialists, psycholigists and social workers are now being served by the school system and mostly one teacher and a para. So the teachers are being held responsible for behaviors and clients that they are not trained to care for. Is it any wonder that there is abuse and mistakes and serious consequences?
When I first started here, most of the kids were fairly moderate. We were community-based, which involved going into the community almost everyday to a job or community site. My kids loved getting on the bus and getting off the school campus. So did I and the paras. The contingency was simply that if a kid acted up, he didn’t get to go out that day. And that was usually sufficient. Today, the climate has changed. Community-based instruction is quickly disappearing. We go out maybe once or twice a week. The shift has been toward academics and the Standards. True, we try to work on life skills and weave the content with the skills but some standards and skills simply do not line up. And the level of severity of the disabilities has become more acute. Many of these students would have been under the care of a team of doctors, nurses, psychologists and specialists back in 1970’s and ’80’s. But those facilities went away the same time as the C&A unit. Now it is all me.
Seriously, I do support the work of those advocating for more and better humane treatment of students, generally speaking. But just as there were adverse consequences to pushing everyone out of institutions and into the community, there will be adverse consequences for making seclusion and restraint forbidden practices. I hope that the movement results in a more positive climate within schools and classrooms, but I don’t think it will result in the sort of programs envisioned by most people. What made states move to deinstitutionalize was that they saw they could save a ton of money. The result was a lot of mentally ill homeless people and many of them being served within jails and prisons. Sure, many were better off in group homes. Many weren’t. A 10 minute period in seclusion often allows the student to remain in school the rest of the day. If the police are called, will the result be the same?
I’m going to go ahead and attach my seclusion/time-out procedure so that you can feel free to review it. I’m open to criticism about it if there is anything wrong with it. Of course, if you are against seclusion/time-out under any and every circumstance then you won’t like it no matter what the policy is! But the alternative of having the student removed indefinitely, or having people hospitalized is not very attractive. It would wonderful if everyone was extensively trained and supported, but that hasn’t ever happened even in the most ideal of circumstances and conditions. With serious budget constraints across the country, professional development is the first thing that gets tossed out the window, followed closely by para and behavioral support.