Just Say No Way to Restraints

I put up an action calling for an end to the use of aversives, restraints, and seclusion a few days ago. Restraints like the basket hold, in which a child's arms are crossed over his midsection and held behind his back, were used by staff at a public school my son attended a couple of years ago. He was banging his head and the basket hold, as we were later told, was the procedure to be used.

We didn't know our rights then. From the first time the head-banging occurred, we should have (and this is what we do now) called a meeting with the teacher, case manager, behavior consultant, and other members of Charlie's Child Study Team. We should have called for a Behavior Intervention Plan to be developed, after careful observation and evaluation of Charlie and of all possible reasons for him banging his head, via a Functional Behavior Assessment. We should have specified what kinds of procedures we gave our consent for the school district's staff to use. We should have insisted that all of this get written into Charlie's IEP and that we be informed, in writing, whenever any practices like restraints were used on Charlie.

That's what we do now when Charlie starts having trouble at school. When he was seven, we were frantic to stop the head-banging, understandably.

 And stopping it was what the basket hold was intended to do and eventually it did, but not until after Charlie had strained and twisted and back-arched. While the holds stopped the head-banging, eventually, they ultimately led to Charlie's head-banging increasing and worsening, and in November of 2005 we took Charlie out of that classroom and out of that school district, forever.

Ever since then, Charlie has been in school, and sometimes had a home program, that relied on Applied Behavior Analysis (ABA). I recognize that there are serious ethical issues with ABA and behavior therapy themselves----the history of behavior modification is not pretty---Charlie's always responded well to ABA teaching, from the time that he was 2 and a couple of months and in his home ABA program. He liked the sometimes excessive structure, the use of discrete trial teaching that "broke down" tasks into small components, and most of all he liked the therapists, energetic young people who made it fun and with whom Charlie truly developed a relationship. In contrast, the behavior therapy used in the school district that authorized the basket holds, was more like an outdated sort of behavior modification that saw Charlie as a bunch of "problem behaviors," not a person.

Charlie's current and most recent teachers focus first of all on understanding what leads up to head-banging and then seek to change what happens before Charlie does something like head-banging. They're pro-active in making changes and adjustments and teaching Charlie to signal his distress and, when he feels the anxiety coming, to ask to do things that can calm him, like wearing headphones and listening to music. (Apparently Charlie has a liking for---no surprise---the sounds of the ocean and---!!!---Coldplay.)

It definitely takes planning, careful teaching, and teachers and therapists trained to know how to do all of this. We've been back having lots of conversations and email exchanges with Charlie's teacher since 2009 started; ever since our trip to California, Charlie has been struggling. Combined with a visit to his pediatric neurologist and a change in his medication, and a lot of efforts by his teacher and the aides, things have been getting better.

Head-banging was something Charlie did, though only rarely, when he was very young. I wonder often, could things have gone differently for him if there had never been any basket holds?

Yes, I wish I knew than what I knew now.

And that's why I just blogged about it.

Photo by vlauria.