Why are We Allowing Our Children to be Hurt Like Angellika?

(SALEM, Ore.) - Tuesday at 10:00 a.m. there will be a press conference at the Oregon State Capitol Press Room in Salem announcing the publication of DRO's report on the restraint and seclusion of children with disabilities in Oregon schools and how House Bill 2939 aims to prevent and reduce these practices. Speakers will include State Representative Sara Gelser (D-Corvallis), DRO special education attorney Christine Shank, and others.

HB 2939 will receive a public hearing in the Oregon House Education Committee at 1:00 p.m. on Wednesday, the 16th of February. This bill will create enforceable minimum safety standards, ensure that parents are informed about incidents of restraint and seclusion, and provide an opportunity to have those incidents reviewed.

It was just less than five-years ago when Angie arrived at Rice Lake around 11:30 a.m. She was sitting having lunch with the other children when she got the giggles and blew bubbles in her milk. Who could possibly predict this to be a fatal mistake? She was reprimanded and told to stop laughing and to stop blowing bubbles, but she laughed again, and was taken to “time out” where she was told to sit still on a hard chair. This is a seven-year old child with attention deficit disorder, so sitting still in a chair was a very difficult thing to do. This was done as a “cool down” period.

During this “cool down,” Angie crossed her legs and rested her head on her knees. Because she did not do exactly what she was told to do she was taken to the “cool down” room, a closet-sized room with nothing but a chair, a mat on the middle of a cement floor, and blank walls. “I don’t want to go,” she cried.

But she was forced to go. She was told once again to sit in a chair and not move. She covered her ears and began to cry. She was tired and curled up on the chair. She fell asleep, was woken up, and told to sit appropriately and complete the cool-down. She was asleep, how much cooler did she need to be?

Head up, feet down, don’t move, and be quiet. Again she fell asleep and again they woke her up. She became agitated and began to swing her legs. As this continued and staff surrounded her, she became more agitated and was restrained in her chair.

She was told if she struggled it would be considered “unsafe behavior”. She knew that meant she would be taken down and put into a face-down prone restraint. She was told by staff not to cry and to control her emotions. But she was not able to control her emotions and she couldn’t stop crying. During the course of the chair restraint she fell out of her chair. Knowing what would come next, she pleaded with them, saying she would complete the “cool down.” But it was too late.

It appears that in the minds of the staff, and after a staff discussion, this called for an all-out face-down floor restraint. She was taken down by two adults. One grabbed her ankles while the other grabbed her shoulders and held her down for 98 minutes. During this time she struggled, cried, screamed for help. But no one responded to her pleas for help.

It was reported that during some of the prone restraints she vomited, lost control of her bodily functions, complained of headaches, complained of eye pain, and fell asleep – or possibly passed out….No one seemed to listened to her, no one seemed to believed her. Instead, regardless of the fact that she vomited, urinated and defecated on herself, and was crying out for help, they continued to hold her down. Finally, she became quiet and still. Finally she gave up. When they released her, (a male employee involved) rolled her small (56 lb) listless body over and noticed her face was blue.

Why had no one noticed this before it was too late? Why had no one responded to her pleas for help? She had stopped breathing. They tried to revive her, called 911, but it was too late. The medical examiner ruled Angie’s death was caused by positional asphyxia and that she died in the course of (the male employee’s) restraint.

His body weight(250 lbs) upon her back significantly impaired and ultimately precluded her ability to breathe.”

The employee was nearly five times the weight of Angellika’s 56 pounds. Imagine a 1,115-pound person sitting on the upper torso of a 250-pound person and you may get the idea of the disparity of a child being restrained on the floor by an adult on top of them.

Angellika’s sad death is just one example of why many parents and educational professionals believe that ‘Positive Behavioral Interventions and Supports’, also known as (PBIS), can provide school staff with a better and more humane manner to interact and help children with challenging behaviors than do the “old-school” child behavior modification techniques of ‘seclusion and restraint’.

The ‘PBIS’ system looks at the reason the student is engaging in particular behaviors and then focuses on positive ways for the student to get those needs met. Research consistently shows that when PBIS is properly used, behavior is defused before it becomes unsafe, negating the need for use of restraint and seclusion in the majority of cases. There is now a movement to at least address making the use of seclusion and restraint upon Oregon’s school children ‘more transparent’ to their parents and guardians. The measure which is currently pending in a committee of Oregon’s legislature.

HB 2939 will receive a public hearing in the Oregon House Education Committee at 1:00 pm on Wednesday, February 16, 2011. The bill will create enforceable minimum safety standards, and ensure that parents learn about incidents of restraint and seclusion and have an opportunity to have those incidents reviewed.

There is a growing body of work and advocacy movements regarding the harm done by use of restraints and seclusion upon children in school settings. A January 2009 report “School is Not Supposed to Hurt: Investigative Report on Abusive Restraint and Seclusion in Schools” is informative and can be read, in full, at: (http://www.nationaldisabilityrightsnetwork.org/sr/SR-Report.pdf )

Sadly, the aforementioned report is not for the faint of heart. It identifies the abusive use of restraint or seclusion nationwide by school administrators, teachers, and auxiliary personnel, which has resulted in injury and trauma and, in far too many cases, death to children with disabilities. Furthermore, the report points out that because there is no mandated system in place to report or collect data on these abuses, the report is clearly only able to identify “just the tip of the iceberg” In September 2010, U.S. Senators Dodd and Burr joined to introduce a anew federal ‘restraint and seclusion’ bill, S. 3895, the Keeping All Students Safe Act. Senator Dodd's floor speech is available at the Congressional Record. The bill was referred to the Senate Health, Education, Labor and Pensions (HELP) committee. The involvement of Congresspersons into this issue is indicative of a growing voice of public interest in banning the use of prone restraint and seclusion in schools, or in the least, increasing teacher training to eliminate future unintentional tragedies.

National Disability Rights Network and Disability Rights Oregon are trying to call attention to this pervasive problem hoping spur action on the local, state, and national levels to address this crisis immediately.

The U.S. Government Accountability Office (GAO) is known as "the investigative arm of Congress" and "the congressional watchdog." GAO supports the Congress in meeting its constitutional responsibilities and helps improve the performance and accountability of the federal government for the benefit of the American people.

In 2009 the GAO testified before the U.S. House of Representatives Committee on Education and Labor regarding allegations of death and abuse at residential programs for troubled teens; however, then recent reports also indicated that vulnerable children were also being abused in other settings; specifically, public and private schools.

There had been reported and “documented cases where students were being “pinned to the floor for hours at a time, handcuffed, locked in closets, and subjected to other acts of violence. In some of these cases, this type of abuse resulted in death.”

(1) provide an overview of seclusions and restraint laws applicable to children in public and private schools;

(2) verify whether allegations of student death and abuse from the use of these methods are widespread; and

(3) examine the facts and circumstances surrounding cases where a student died or suffered abuse as a result of being secluded or restrained.

In the end, the GAO found and reported back to the Committee that there were “No federal laws restricting the use of seclusion and restraints in public and private schools and widely divergent laws at the state level.” In 2009, the GAO could only identify to the Committee that five states then collected and reported information related to the use of seclusions and restraints in public and private schools.

At the federal level, the Children’s Health Act of 2000 amended Title V of the Public Health Service Act does regulate the use of restraints and seclusions on residents of certain hospitals and health care facilities that receive any type of federal funds as well as the use of restraints and seclusion on children in certain residential, non-medical, community-based facilities that receive funds under the Public Health Service Act. However, the Act had no reach into the venue of public and private schools use of restraints and seclusion upon children in their charge. In fact, reported to the Committee that in 2009 nineteen states had no laws or regulations related to the use of seclusions or restraints in schools. Only two years earlier (in 2007), the Oregon Department of Education (DOE) had issued its first administrative rules to regulate the practices of restraint and seclusion of children in educational settings in Oregon. However, the 2007 ODE rules have had minimal impact because they are unenforceable and do not require any state oversight.

The 2009 GAO national study did find hundreds of cases of alleged abuse and death (in the United States) related to the use of these methods on school children during the prior two decades. Examples of these cases included a 7 year old purportedly dying after being held face down for hours by school staff, 5 year olds allegedly being tied to chairs with bungee cords and duct tape by their teacher and suffering broken arms and bloody noses, and a 13 year old reportedly hanging himself in a seclusion room after prolonged confinement.

Although GAO continued to receive new allegations from parents and advocacy groups, in 2009 the GAO could not find a single Web site, federal agency, or other national entity that collected information on the use of these methods or the extent of their alleged abuse.

The GAO also examined the details of 10 restraint and seclusion cases in which there was a criminal conviction, a finding of civil or administrative liability, or a large financial settlement. Each of those cases shared three common themes: 1) they involved children with disabilities who were restrained and secluded, often in cases where they were not physically aggressive and their parents did not give consent; 2) restraints that block air to the lungs can be deadly; teachers and staff in the cases were often not trained on the use of seclusions and restraints; and 3) teachers and staff from at least 5 of the 10 cases continue to be employed as educators.

Today in 2011, some doctors and teachers still contend that using seclusions and restraints can reduce injury and agitation and that it would be very difficult for educational organizations to run programs for children with special needs without being able to use these methods. However, the GAO has testified, raising a very serious issue, that these techniques can be dangerous because they may specifically involve physical struggling, pressure on the chest, or other interruptions in breathing. Another factor is that children are subjected to restraint or seclusion at higher rates than adults and are at greater risk of injury, most certainly by disparity of size to adults (or number of adults at the same time) restraining them.

Additionally, even if no physical injury is sustained, the GAO testified that individuals can be severely traumatized during restraint. In some cases, post-traumatic stress disorder is being experienced by children as an outcome of the infliction of seclusion and restraint practices which are being used upon them in their educational settings. In addition to the GAO, the Council of Parent Attorneys and Advocates, an organization that works to protect the civil rights of children with disabilities, itself issued a report describing even further examples of injury and abuse of children resulting from the use of seclusion and restraints in schools.

This week, ‘Disability Rights Oregon’ (DRO) has issued an important and timely report (see below) so as to provide support for House Bill 2939 and to provide guidance to the Oregon public on this issue. The bill is sponsored by Representative Sara Gelser from Corvallis, Oregon.

The DRO press release:

DISABILITY RIGHTS OREGON

PRESS RELEASE

February 9, 2011

Contact: Bob Joondeph, Executive Director, 503-243-2081

Today, Disability Rights Oregon released a new report, Keep School Safe For Everyone: A Report on the Restraint Seclusion of Children with Disabilities in Oregon Schools. In Oregon, and across the country, children in our schools may be placed in restraint or seclusion in response to behavioral issues. "Restraint" is the restriction of student's movement by holding the student manually or with devices such as tape, rope and shackles. "Seclusion" is involuntary confinement in a room or other enclosure. These practices still occur even though extensive research has shown the restraint and seclusion fail to diminish challenging behavior and, in fact, make it worse. In recognition of this situation, the Oregon Department of Education (DOE) issued its first administrative rules to regulate these practices in 2007.

Since the new rules were adopted, DRO has continued to receive complaints of inappropriate use of seclusion and restraint. This prompted us to conduct an investigation to find out if schools are actually following the rules. We learned that while many school districts have adopted policies as required by DOE, most of those policies do not comply with state requirements and some districts have no policies at all.”

For more information please read:

The recent 2011 DRO Report on Oregon: "Keep School Safe For Everyone: A Report on the Seclusion of Children with Disabilities in Oregon Schools":

http://www.disabilityrightsoregon.org/results/DRO-Keep%20School%20Safe%20for%20E\veryone%20Report.pdf

On the “Restraint & Seclusion of Children with Disabilities in Schools” as a NATIONAL ISSUE: A 2009 Report GAO-09-719T, to the U.S. House Committee on Education and Labor regarding seclusion and restraints of children across the United States: