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Request to physically restrain

(16 Posts)
geeandfeesmum Wed 21-Sep-11 13:47:48

my DD (4, ASD) has been attending preschool for over 6 months now. She began attending before she was diagnosed and they have been very supportive through the whole process. However, just lately there have been some changes to her routine. She is attending 5 days a week now for shorter hours. Her brother is no longer there as he has started school. I am no longer able to pick her up so it has fallen on the relatives that usually take her. The preschool has also secured 1-1 funding for her although because I no longer take her or pick her up I don't know what is happening with that, if it has started or what will happen.

Her behaviour has been getting increasingly worse. She is climbing out of her car seat again. They are having to carry her out of preschool just to get her to leave. Yesterday, when they went to pick her up she was running around naked refusing to get dressed, climbing on tables and throwing things and screaming.

Today when they took her the preschool asked if we would sign a release form for them to be able to physically restrain her if necessary. I have always agreed with them on what they do with her. They have always acted in her best interests. I can totally see their point on this because I don't want her to the other children or herself in danger but it makes me sad. I have been wavering over special school or mainstream and now it seems like there is no way a mainstream school will accept her like this. I think I will sign it because I see there point. I just wanted to come on here because I never thought I would be dealing with problems like this and it just makes me scared for the future and I knew you would understand what I am goin through and what she is going through herself.

purplepidjinawoollytangle Wed 21-Sep-11 14:00:08

Carrying her in and out is a physical restraint. Holding her hands/arms so she can't hit is a physical restraint. The term covers everything, and there are a lot of steps to get to before staff are allowed to completely remove all control over physical movement.

I've worked with children and used (and been trained in) restraint techniques. The process starts with a hand on the shoulder and/or arm to guide a person away from a situation. Holding a person flat on the floor so they can't move is extreme (and highly upsetting all round) and I've been involved a handful of times over six years in various settings.

If you trust the staff and their judgement on situations where restraint will be used, go for it. Feel free to ask me questions about specifics, although there are several different training methods and I won't necessarily be able to answer questions about the ones the would use.

jandymaccomesback Wed 21-Sep-11 14:27:02

I think I'd ask for more detail about what training they have received, who has received it etc. When I had training in behaviour management including restraint I had a certificate which had the date when it needed to be renewed by updating the training. Hope this doesn't sound too heavy, but restraint applied badly can result in further harm to the child and harm to the staff if the child becomes aggressive (which would be a natural reaction to being restrained).

I would want a copy of her behavioural management plan... and if they say 'a what?' don't give permission for anything until there is one, and also proof that the staff are trained in physical intervention.

As purplepid says, in the eyes of the law 'restraint' can mean anything from a guiding hand , or shepherding motion, to a figure 4 pin down restraint (thankfully I have never had to do this) and it has to be specified EXACTLY what is to be used, and under what circumstances, for every child. If they try and tell you different they are WRONG.
I have worked for many years in a special school where we are trained due to the level of challenging behaviour (talking 6 ft non verbal autistic teens), and it is not undertaken lightly.

Badly done restraint can result in injuries.. imagine them grabbing your daughter by the arm because she is climbing over the tables.. and her pulling away.. cue one dislocation... worst case scenario but you get my point... it HAS to be done in the right way, by the right people and for the right, and legally binding, reasons.

purplepidjinawoollytangle Wed 21-Sep-11 16:04:15

Medusa, similar to my experience - when physical restraint is mentioned, you automatically think supine, pinning a person to the floor, stories of suffocations in prison... The stuff I've done (ie the restraints I've actually used vs the ones I've been trained in) bears very little relation to that.

I would have thought with a 4yo it would be no more than hug/wrap/remove or similare small-child restraint involving one person.

6yo DNiece loves a good hug/wrap, but then she likes to hide under sofa cushions etc - and I only do it as part of a game instigated by her!

OP, any staff using a physical restraint must have undergone training in that particular restraint, and it must be marked on your dd's care plan or equivalent.

The only injuries I've known during restraints have been caused to me, and were the reason I used the restraint not the other way round!

bialystockandbloom Wed 21-Sep-11 17:52:37

If this is a normal, mainstream preschool, I would not allow anyone to physically restrain my dc unless they had suitable training. I doubt any of the staff at my ds/dd's nursery (mainstream) or even school are suitably trained.

I think they're missing the point. She is evidently not coping without support. They should be putting something in place asap - applying for statement, and in the meantime on SA+

Actually themore I think about this, the angrier I'm feeling on your behalf. FFS they're talking about restraining a 4yo with ASD, but apparently not talking to you about how they're supporting her, applying for statement etc hmm

Also, why restraint? Has she hurt anyone? Herself? Sounds like they can't cope with her behaviour but nothing you've said suggests violence/aggression, so it would raise alarm bells with me that they're talking about restraint simply to manage her.

Sounds like she's having a rough time due to routine changes. She needs to be helped with coping with this immediately.

I would ask for a meeting with the head as soon as possible.

Don't worry about mainstream v ss yet. You have yet to see how she copes in mainstream with 1:1 support - she might be fine.

madwomanintheattic Wed 21-Sep-11 18:02:51

there are lots of children in ms who require a care plan, behavioural plan, and a restraint agreement, so don't spend any time fretting over that as a pointer for the future. in schools we are familiar with, they prefer to remove the rest of the class to a safe location if they are in danger (school hall or outside for example) rather than use a restraint procedure in the first instance. and there are well-rehearsed plans in place for if and when... usually the teacher and/ or TA stays with the child to prevent self-harm, and a nominated pupil alerts other staff members to the migrated class and calls for support.

but yes. time to schedule an appoinment with the nursery to update yourself on exactly where they are with support/ sa etc, in particular whether and how the 1-1 support is being implemented. in dd's case i suspect it would be useful for this support to be provided by the same person ft, so that s/he can start to identify triggers/ use of quiet time or safe space when overloaded/ stimulated etc. whether you are doing the drop off/ pick up or not, you do need to keep up to date on what's going on.

madwomanintheattic Wed 21-Sep-11 18:04:30

bialy makes an interesting point though - i was assuming she was attacking staff/ other pupils, but you do need to clarify this before blanket approval of 'restraint'.

ouryve Wed 21-Sep-11 18:08:30

I would definitely ask what specific training they've had. Some of the staff at my DS's school have had team teach training which focuses on calming and diffusing techniques, with anything more than minimal restraint being the absolute last resort. The staff who were prioritised for training are staff he knows and trusts and who understand DS1 well enough to have a good idea what might have set him off in the first place.

Tota1Xaos Wed 21-Sep-11 18:20:45

agree with the other posters. ask searching questions about why they have suggested restraint, and what they propose to do, and in what circumstances. and of course what training staff have had/will have. oh and ask what advice they have had from inclusion services/autism outreach (whatever your area has to support SN in pre-school years, there will be someone from council that does this)

oodlesofdoodles Wed 21-Sep-11 21:32:18

Just adding to/agreeing with the OPs. I think the pre-school's request to retrain should set alarm bells ringing. She's not a naughty girl, she's a wee thing struggling to cope with the new regime and not having big bro around. It's the school's job to structure the morning in a way that works for her and to motivate her to behave appropriately.
This may be a side issue, but my dc is horrendous when he gets too hungry. Is she eating enough to get her through the morning?

pigletmania Wed 21-Sep-11 22:02:31

I signed one for dd 4.5 at preschool. It sounds very heavy and quite hard handed but its not really, just for dd own safety as she does not have much of a safety concept. Like holding her in a hug to stop her running off, or removing her from a dangerous situation.

pigletmania Wed 21-Sep-11 22:07:06

I was happy signing it as it sound like what I would do with dd.

Agnesdipesto Wed 21-Sep-11 22:24:26

Training is usually 'Team Teach'.

You can ask them to define what they mean by restraint - it could be holding her from harming herself eg stopping her slamming her head into the ground or it could mean pinning her down. You could agree to certain things but not others. They need to know eg not to put pressure on joints etc.

It should also be part of a behaviour plan set up by experts in ASD and where the main focus of changing her behaviour is positive eg a reward system / motivators. Restraint is used only when positive behaviour approaches have failed / as a last resort, not in the absence of a proper reward system

You can use this as evidence for statutory assessment - which you will need to do if you even want to consider special school - it can take 6-18 months depending how much the Council argue to get a statement / placement so I would be starting this process now even if you decide to stick with mainstream. Also usually from school age you cannot get fulltime 1:1 without a statement.

I think there is guidance on restraint for schools etc- ask them to send you a copy / the link. I would also think they need to get outside support to sign off on it eg an ed psych or outreach team to cover themselves as much as anything.

After diagnosis you should have had a meeting with education (council or outreach team) to tell you what they intend to do (no we didn't get one either) but its not ok to just send you away with a diagnosis there needs to be external expertise going into pre school eg SALT, autism outreach, EP - you need to find out when this is going to happen.

geeandfeesmum Thu 22-Sep-11 10:47:35

Thanks for all the responses. As I say they now have funding for one to one but I'm not sure when it being or if it already has been implemented.

DD had been throwing sand and toys at the other children which is what I believe the preschool want to avoid in the future. There are a lot of new children in the class and previously if ever DD wanted anything the other children gave it to her. My guess is that the new ones don't. She didn't much acknowledge the children in the class before. It seems as though she is acknowledging the new children more if only aggressively.

I am mostly just sad because you just don't expect this sort of situation when you have kids do you?

The statutory assessment/statement process is currently on going. I sent my parent report in last week and then I will apparently get a response back as to whether they are going ahead but with what I don't know. It's all just so confusing.

I have a meeting at the preschool next week to discuss her IEP. I'm not going to sign anything until then.

Agnesdipesto Thu 22-Sep-11 13:58:22

That sounds good but def read up about positive reinforcement / reward systems - what they want is this behaviour to stop and that means lots of praise and rewards when she is not throwing sand / snatching etc not just punishment or restraint when she does. As much as possible you want to Praise the good / ignore the bad - and only restrain if its dangerous.
They should also look at consequences like time out, removal of favourite item etc first before going straight to restraint.
I did know a child who spent their whole reception year sat in the corridor on the knee of a TA restraining him because that was the only technique being used. There are better ways.
Also child has to know how to do the skill they are being punished for eg have they taught her how to share? Clearly not. So that should go on the IEP if its a flashpoint. And accept teaching a child with ASD to share is a long long process - they need to start with adults before they move to peers.

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