Restraining autistic violent child, is it ever OK?

[Nineteeninetyfour]

I'm a longstanding poster but have NC to post this as I don't want it to follow me around if it descends into a slanging match, which I hope it won't. We're reaching breaking point.

We have a 4 year old boy with severe autism and challenging behaviour, he's on the 99th centile for height and is very strong. When he attacks, which he frequently does, he's capable of causing significant harm and is a risk to himself and other members of the family.

None of the widely recommended advice helps, quiet corner / sensory area is a total non starter as when he was redirected there to begin with he interpreted it as punishment and now if we try to put him in the quiet room / area when he's in meltdown it makes him even worse.

We have always been very hands off in terms of discipline, opting for gentle parenting on account of his disability. We don't smack and 'telling him off' does nothing, he simply doesn't understand, however I cannot allow the rest of the family to be punching bags.

For the past week I've resorted to restraining him when his behaviour deteriorates to the point that we (me and dad) are being thumped in the head/face/back repeatedly - anywhere he can hit, he does with all the force he can muster. He slaps, punches, headbutts and kicks. He also throws himself on the floor and bangs his head which is particularly worrying as I'm scared he's going to do himself damage.

The restraint consists of me putting a pillow on the floor and laying him there, with my arms on his arms, and holding him there until he calms down.

I've requested an urgent review with his paediatrician as we are overdue an appointment but am told there are delays because 'covid'

I've also requested an assessment from children's social care approx 3 months ago and still awaiting a response. I'm going to hazard a guess and say because 'covid'

I'm worried that my decision to restrain him is going to be deemed abusive, but I don't know what else I can do when he's smashing the house up and beating us.

What is the general consensus please? Am I handling this inappropriately? If so what do you suggest?

No advice, but I just wanted to say that that sounds really tough - it sounds like you are trying your best with the resources that you have

Of course you need to restrain him. It’s for your benefit, his and anyone else he might hurt.

I think it is absolutely acceptable and necessary to restrain him in those situations. You are protecting him from himself.

Have a look at Yvonne Newbold

yvonnenewbold.com/resources-on-send-vcb/violent-children-should-parents-ever-restrain-send-vcb-blog-6/

Sympathy from me I used to have to restrain ds to a degree because he smashes my house up he has gone through three laptops and two switches losing his temper now he is older incan warn him break it I will not replace it or remove the stuff myself which makes him scream more but he equals my weight and height now there is nothing else I can do except remove the stuff his brother and the cats from him

I also minimise his triggers as much as I can but its tricky because one is school work he screams about doing homework I respond fine don't do it get a detention he tells me I will have to collect him I tell him no he gets an after school detention he is walking home he will scream at me about him hurting his legs walking and being in pain (he is hypermobile it will hurt) intell him do your homework you won't need to walk then will you.....its worked so far he did say he will get his dad to collect him I said that's on his dad but as he neither lives or works in our home town its going to be difficult

I mean there's restraining and then there's restraining. What you're doing sounds like it's as gentle as you can make it - a comfortable surface, staying with him, using the minimum amount of restraint needed to prevent him hurting himself or others. Restrainst should always be a last resort and, based on your OP, it sounds like it is.

A strategy that worked for us was to keep a diary of these sorts of episodes, what had happened that day, what happened immediately before everything blew up, what happened during, what happened after. It helped us to look for patterns and identify trigger points, we didn't spot 100% of them but it did help reduce the number of meltdowns as we became better at spotting when one was imminent and better at predicting what was likely to trigger one. This information helped us to intervene with regulation strategies before it got to the meltdown stage.

for you, OP. You're in a rough patch right now but you're not in it alone, there are lots of supportive posters here on MN who have been in a similar boat. I hope the appointments come through soon, don't be afraid to chase them up often and let them know you're available to take any cancelled slots that come up - the squeaky wheel gets the grease.

I have to sometimes, mine goes for windows and electrics. For all our safety.

Having worked with children in both an inpatient mental health setting and secure care setting, I would say there are times when there is not much else you can do.

The law fully allows for people to use reasonable force to defend themselves.

Interestingly I was talking about this with DS best friends mum tonight. Her youngest is seven, severely autistic and very big and strong. She has no choice but to restrain him sometimes as he will walk into the road, or hurt her or his brother. She's been reported to social services on a couple of occasions by neighbours/school run parents who are presumably less aware of his difficulties. Social services have never taken the reports beyond a simple checking in call as they are well aware of his needs and why its necessary to restrain him.

Its really tough OP, I hope you're getting support.

That sounds so hard, OP. And he’s only 4. Gosh I really feel for you. Friends I know have transformed their child’s room into a safe space do he can have a meltdown peacefully. Only soft surfaces.
I hope you get some help soon.
If you can keep a diary ho track the abc like previously suggested, I think that might help. I know it’s not easy analysing in the middle of it.

Sounds like you are doing the right thing. Your son could really injure himself, or you or another person. I’d think as long as he’s not injured and his breathing isn’t compromised it’s ok. And of course you’d only hold him as long as necessary.

A friend of mine has a slightly older severely autistic child, she does a similar thing to your pillow thing. She also does rhythmic beating with side on fists on his back to calm him down. The beating on the back thing isn't done out of anger or frustration on her part, it's a tactic she's found works and, I believe, was trained to use. It's quite hard beating though, but it's not done to hurt him, and is with a certain rhythm to it.

Restraint in those situations, like you’re doing, is fine. Do you have CAMHS involvement for him? In our area you would, though it's different elsewhere. They would be working with you on management strategies. Keep going and good luck getting some support

Yes, it's okay, but you need how to do it safely. There is training available. A the special school where I taught, we used Team Teach. Their trainers came to us though, and taught us and carried out regular refreshers with us as a school staff, on training days.

I'd need to look into it more to find what's available to individual parents.

You have my sympathy. It's hard to explain to anyone the damage that a snall child with no 'off button' can do to a grown adult. One of my TA's ended up in hospital due to an injury that an out of control 5 year old caused. But of course you need to protect your boy from self-injury as well.

That sounds really challenging. Im not sure it’s relevant what the general consensus on restraining a violent autistic child is and I don’t know why you would post such a contentious issue on AIBU of all places 🤦🏻‍♀️ - Surely all that matters is doing what’s best for your child and for you and your family.
Might it be better to ask MNHQ to move this to the SN Children topic?

It’s absolutely terrible that you are having to wait so long to get support from your pediatrician and children’s social care. I hope you hear from them soon.

Have a look at the challenging behaviour foundation, there is some great stuff on there

www.challengingbehaviour.org.uk/for-family-carers/

Oh, and my friends child would never understand any kind of telling off, he's 11 and non verbal. Well, he screams and repeats words but with no apparent meaning attached to them.

@Nineteeninetyfour

I'm a longstanding poster but have NC to post this as I don't want it to follow me around if it descends into a slanging match, which I hope it won't. We're reaching breaking point.

We have a 4 year old boy with severe autism and challenging behaviour, he's on the 99th centile for height and is very strong. When he attacks, which he frequently does, he's capable of causing significant harm and is a risk to himself and other members of the family.

None of the widely recommended advice helps, quiet corner / sensory area is a total non starter as when he was redirected there to begin with he interpreted it as punishment and now if we try to put him in the quiet room / area when he's in meltdown it makes him even worse.

We have always been very hands off in terms of discipline, opting for gentle parenting on account of his disability. We don't smack and 'telling him off' does nothing, he simply doesn't understand, however I cannot allow the rest of the family to be punching bags.

For the past week I've resorted to restraining him when his behaviour deteriorates to the point that we (me and dad) are being thumped in the head/face/back repeatedly - anywhere he can hit, he does with all the force he can muster. He slaps, punches, headbutts and kicks. He also throws himself on the floor and bangs his head which is particularly worrying as I'm scared he's going to do himself damage.

The restraint consists of me putting a pillow on the floor and laying him there, with my arms on his arms, and holding him there until he calms down.

I've requested an urgent review with his paediatrician as we are overdue an appointment but am told there are delays because 'covid'

I've also requested an assessment from children's social care approx 3 months ago and still awaiting a response. I'm going to hazard a guess and say because 'covid'

I'm worried that my decision to restrain him is going to be deemed abusive, but I don't know what else I can do when he's smashing the house up and beating us.

What is the general consensus please? Am I handling this inappropriately? If so what do you suggest?

You absolutely can restrain him and YANBU. I work in a children's home and the 3 reasons for physical intervention according to the regulations we abide by are to prevent injury to themselves or others, to prevent damage to property and to prevent absconding. The restraint should be proportionate and necessary and the best way you can ensure you are executing the restraint correctly is to get some training on it. Our company uses Team Teach methods which are fantastic. I really hope you get some support with this as I know first hand how difficult it can be when faced with a physically aggressive, strong child.

@Hospedia

I mean there's restraining and then there's restraining. What you're doing sounds like it's as gentle as you can make it - a comfortable surface, staying with him, using the minimum amount of restraint needed to prevent him hurting himself or others. Restrainst should always be a last resort and, based on your OP, it sounds like it is.

A strategy that worked for us was to keep a diary of these sorts of episodes, what had happened that day, what happened immediately before everything blew up, what happened during, what happened after. It helped us to look for patterns and identify trigger points, we didn't spot 100% of them but it did help reduce the number of meltdowns as we became better at spotting when one was imminent and better at predicting what was likely to trigger one. This information helped us to intervene with regulation strategies before it got to the meltdown stage.

for you, OP. You're in a rough patch right now but you're not in it alone, there are lots of supportive posters here on MN who have been in a similar boat. I hope the appointments come through soon, don't be afraid to chase them up often and let them know you're available to take any cancelled slots that come up - the squeaky wheel gets the grease.

I completely agree keeping a diary is a good idea, not only to isolate what's going on and see patterns, but to protect yourself from any external involvement. If people can see that this has been done carefully and only as a last resort then you are protected. I also agree you could ask about training to keep you both safe. But really you need proper involvement from CAHMS and other services, I'm so sorry that you're not getting the help you and your son deserve.

I have had to restrain both of my sons many times over the years. I had control and restraint training. Perhaps you could look into that.

Hi! Ok so not to sound harsh but Untrained and unapproved restraint can be very dangerous ( spinal injury’s, breathing, suffocation, trauma etc) so I would for now completely avoid this unless it was an emergency response if being attacked - for something to be considered
reasonable force by the law things are considered such as - is this action proportionate to the risk present , is it necessary to avoid severe harm and are there no other choices here that could be taken/ aka leaving the room/ area.
I would ask for support from the child development team in managing challenging behaviours especially if attacking others and ask what action/ safety plan can you put in place - perhaps a training course in team teach, TCI or MVA - basically any medically approved “restraint” or safe handling course if in crisis could be useful for you. The importance of the environment your child is in and triggers present for them should not be forgotten- taking time to think is there common behaviours your see before he harms someone else, common place? After a certain activity etc- what signs in his body to do you see that gives an indication he is moving away from his baseline behaviour - recognising these can help you avoid a crisis escalating and you can using descalation techniques before he gets to the point of attacking ( crisis) . These techniques could be removal of a trigger, use of language , redirection, pressure point touch, distraction etc..
Try to think back over the last 4/5 times he attacked out... and ask yourself who/ what / where when why to try to see if any common ground of what triggered him... also think what is this attacking behaviour meaning for him- for example, is he biting / hitting in order to have his own sensory needs met?

Please please be reassured that there is help out there to support you with this,make demands and demands for appointments/ support etc . I have worked with so many families who were at their wits ends with behaviours but over time with the correct strategies this can and will improve xx you are a great mum for identifying you need support with this and you can tell from your post you greatly care for your child xxx

We also use Team Teach in my special school.

Is dc in school? What do they do there and does he have an ehcp?

Are camhs involved? They may be able to support with triggers (have you noticed any?), responses and levels of actions to take for those caring for him. Does the (from the sounds of it very gentle) restraint work? He could be getting some sensory feedback from this itself so it might be good to talk to camhs around what else could be used.

As he is 4 he will still be under the hv service- they should have a special needs hv who can support with things like the ehcp or arrange team around the child meetings to bring the right practitioners around the table to support your son and you.

I would chase social care and ask for a child with disability team assessment- they can also refer on to occupation therapy to see if there are any adaptations that can be made to make the environment safer for him when he headbands etc.

Are there other dc and what do they do when your son becomes challenging to manage? Do they have somewhere they can go to whilst he calms to avoid them getting hurt?

I'm so sorry you are going through this. The positive is that you are seeking help whilst he is young and early intervention is always the best approach imo.

One easy hold I used to do when they were little (pre training which I did because I needed to know how to manage them as they got older and stronger) was to take them to the floor, wrap my arms and legs around them from the back and tuck my head down to the middle of their back so they couldn't smash their head backwards onto me iyswim. A tight hold can itself be calming, like weighted blankets are.

And you are not doing anything wrong by restraining your child when the alternative is letting them severely injure themselves or someone else.

It’s only happened once, but I have resorted to holding my extremely upset dd with ASD in a full body hug including using a leg wrap because she is strong. She was trying to run out doors and jump out windows. I held her firmly and told her I loved her until she relaxed and seemed in control again and then she had the choice on when to get up, but she actually often stayed for the comfort. Over the course of the night, when she worked herself up again and tried to bolt again we started over. It was a long night. My only other option was to call an ambulance and that would have been worse for her.