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?

Family member had similar challenges with her eldest she was taught to use a towel wrapped around him to keep him safe until he stopped lashing out. I am not sure if this information is out of date but it was a final straw after she was badly injured a few times

Thank you all so much for the helpful replies.

I'm looking at the Yvonne Newbold page now. I'm also going to look up Team Teach mentioned above.

The reason I posted here and not the SN boards is because they're so quiet, I know there are a sizable amount of MNers with children on the spectrum and I wanted my post to reach as many people as possible - I'm sorry, I know its annoying when AIBU is cluttered with non AIBU's.

Also, I did want to know whether people felt my handling of the situation was inappropriate or not. As I await a response from CSC I have been worried what they'll think of the fact I have been restraining him. I was worried it may be seen as abuse

We have no CAHMS involvement. He was referred to them via our GP when I first raised concerns about his development. CAHMS referred us on to the Single Point Of Access Team (and to his paediatrician) before discharging him from their services. He was never seen in person.

He has SALT and I raised his aggression with the therapist who has signposted me to our local children's centre, she said they can put me forward to particular parenting courses that help with managing challenging behaviour so I'll be contacting them tomorrow.

RE the restraint, his breathing is never compromised and I use the least amount of force I possibly can. I just feel so bloody crap about the fact I have to do it and feel so guilty because I know how some people would view it.

The triggers today were:

Dad coming in from the shop

Me removing his number blocks as he was getting too over stimulated and throwing them at me.

Me not getting him starburst sweets he demanded because they send him hyperactive which leads to meltdown.

Me not immediately getting him juice because I was busy in the bathroom, if you don't get him what he asks for immediately he goes biserk.

..

We have a now and next board, sand timer, always make sure he knows what to expect. We follow all the advice from SALT, his paediatrician (although her advice is now outdated because its been so long since she's seen him and he's changed so much)

I forgot to add, he's in nursery at the minute and starts school in September. He has an EHCP and is in a specialist setting both now and when he starts school in September.

Second what @Istherehopeforme has written

Sadly there are so many families who don’t receive early intervention for challenging behaviour. What I would advise is that through observation and reflection you try to understand the communication behind the behaviour, then your child can be helped to learn a more appropriate and safe way to express themselves. He is young and can learn, and if he doesn’t learn now it will be so much harder when he is a young adult.

I hope you get some support from services soon

I recommend Yvonne Newbolds facebook group. Learning disability teams can also provide support with looking at the reasons for the behaviour, triggers etc
We have only held ds ( now 16) long enough to get him somewhere safe but he doesn't damage things (goes for us or hurts himself) so we have never had that to consider. Children do quickly become too big to safely restrain ( and parents cannot have restraint training) so it is important to learn to manage behaviour in other ways and the child over time, learning to manage their own behaviour.

You need to contact Social Services again and point out that your son is a child in need under section 17 Children Act 1989, and therefore they had a statutory duty to carry out both a care and a carer's assessment within 45 days of receiving your request. Ask them to contact you within a week to confirm arrangements for the asessment, and tell them that if you don't hear from them you will have to apply for judicial review to enforce your child's rights.

I used to work for a charity where we supported adults with severe learning disabilities and yes restraint is common, there are ways and means of doing it to lessen harm, also we were taught some moves if someone was to pull our hair, grab our neck etc. I would recommend going private maybe and also seeking an OT assessment privately as they are trained in sensory integration etc.

OT - In this area you can self refer but it's a long wait. I'll get the ball rolling for that tomorrow and chase up children's services too.

parents cannot have restraint training

I'm really surprised by this, how come? I'm sure there's a good reason but it seems bizarre to me that parents can't have that training, given that we are up against the dangerous and aggressive behaviour daily in many cases.

I've just read this page about why parents aren't given restraint training and why it should be avoided and now I feel even worse

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

Www.safespaces.co.uk

Would something like this be helpful?

How about contacting a charity that specialises in supporting people with a learning disability and asking for some advice and they may able to signpost you in the right direction? I'm not sure any of our tenants ever had a home life sadly many came from old fashioned institutions and were cared for in large residential style buildings from a young age or were fostered and came to us when Foster parents no longer could cope. Others however had a lovely mixture of life in residential care and time at home at weekends or every other weekend etc. Would your child be due a medication review? Children grow fast and may need to increase something as his height and weight increases.

Our almost 8yo son sounds the exact same. Thankfully we have a social worker now and they refer (and re-refer once techniques have become stale - race yourself for ever changing ways to handle it) us to the LD CAMHS and OT departments. We have to restrain from behind and kind of do rhythmic squeezes around his arms/torso. Looks cruel as hell but it's the safest way (for us and him) to deal with the violence. And it also goes towards his sensory diet too. Self refer to social services and get a social worker. We did that when our son was 4. Best thing we ever did. We now also get respite for 2 hours a week which is a godsend. An absolute godsend. Just to gather our thoughts, have a cry, spend quality time with his brother etc. We're all black and blue in this house due to the meltdowns and, like you, our son doesn't understand and has no communication ability to explain what's wrong. It's mainly frustration (we think!). Good luck x

"I'm really surprised by this, how come?"

The techniques taught in restraint training require two adults to be present and this cannot be guaranteed at home.
Restraints used in schools etc should be recorded and monitored and this cannot be done at home.

I'd hold off until you learn how to restrain safely if it's not a technique you have been taught. Other than that, I don't think restrain is wrong. It sounds necessary in your situation. It's very sad for you and for him, but ultimately any serious injury is worse.

Don't feel bad, yes sometimes restraint is your only option to protect yourself however, I will say, once you start using it it's almost expected and hard not to go there every time, de-escalation is always more valid. You say the breathing is never restricted however even when trained it's so hard to say this with confidence, they wriggle, their arms move down, even when you are trying to be light it's very difficult to 100% not restrict anything, till you are trained I'd really try anything you can to avoid it.

Sometimes restraints are needed for safety if you are in an environment where there are no other options. For example he runs out into the street. You need to physically remove him from the road and keep him safe. Or if he is hurting others, he may need to be initially restrained.

If you can create a safe space in your house where he can go to deescalate that doesn't involve restraint - that is often helpful. A room with some padding on the floors and walls and whatever colours or items that would be relaxing. Some kids find snoezelen type rooms help them deescalate, others are over stimulated by it.

I have also seen foam shields like this used for younger kids.
vpm.org/news/articles/8753/an-alternative-to-seclusion-and-restraint-was-born-in-virginia-and-its-spreading

I worked with children with severe behaviour difficulties for years. Your first responsibility is to keep your child safe and that is what it sounds like you are doing. Restraint in schools ideally takes two people but if only one is available and the situation warrants it one person should do it. if a child is trying to climb out of a window you don’t wait till the second person arrives you have to act and your first responsibility is to keep the child safe. So it should be to prevent injury to themselves or to some other person not just for social niceties

Keep a diary & if you haven't already done so make a claim for DLA, use the diary as evidence. Have you room to make him a sensory space where he can go when he gets sensory overload? That is what the meltdowns are, he has too much stuff going on, he can't regulate his emotions & he explodes just like a bottle of pop being shaken up all day & then taking the top off. Try to not ask him to do loads at once, split everything in to tiny steps. For a lot of neurodiverse children, home is home & school is school, in their heads the two don't mix. Can you ask school for him to be excused homework? If he has an EHCP this can be written in to it. If you can see a meltdown being close can you divert his attention? Send him outside to kick a ball or could he have a boxing bag or something to wrestle with so he doesn't hurt you?

I grew up as a young carer and social services referred myself and my mother to a course to teach self defence and restraint for such behaviours. So they seem to approve of such measures, as long as it's reasonable. One technique taught was to try and cover the eyes to disorient them which seemed effective and minimised damage. It's definitely not easy sailing, but they'll want to aid you to some extent as it's far tougher if they were then faced with taking on the care of your son.

"I grew up as a young carer and social services referred myself and my mother to a course to teach self defence and restraint for such behaviours. So they seem to approve of such measures, as long as it's reasonable"

Social services can refer to courses that teach deescalation and techniques known as breakaway techniques (I have done such a course) but I have not heard of anyone recently being taught restraint techniques. Legally it would be a minefield for the company providing the courses and for social services. Social services would choose looking after a child themselves over providing training. (To be clear I am not saying they remove a child if someone restrains, it is the providing training that they will not do).

I did a restraint course as a disabled carer for a severely autistic child, and I was taught a restraint using a weighted blanket which was basically like rolling up a body in a rug (like on tv), but it was really gentle and effective. Child lies on blanket then you simply roll them up tightly with their head sticking out. The pressure and weight was calming and he couldn't flail.

Restraint in school or secure placements needs two people but at home, that isn't always feasible. The advantage to doing some sort of restraint training, OP, is that you can avoid hurting your son but also yourself.

I really feel for you - specialist help takes FOREVER,and while you're waiting, your house becomes an unsafe place other children and pets get hurt, and you beat yourself up mentally. Please be kind to yourself and contact the council as often as you possibly can.

Sounds like you’re doing your best. I think you will need some training as he gets older. Someone mentioned Team Teach above , which is what the SN school I’ve worked in uses when children needed restraint. Not sure if it’s just a school thing, but there must be a ‘home’ equivalent.

There is team teach for parents (I've had it) but it does not involve restraint training.

@Sockwomble

"I'm really surprised by this, how come?"

The techniques taught in restraint training require two adults to be present and this cannot be guaranteed at home.
Restraints used in schools etc should be recorded and monitored and this cannot be done at home.

Yes I work for Camhs and parents do ask about this but there isn't safe training for restraint at home . Very different in a setting with a team of staff, also our training and most training should be seen as positive management of aggression rather than restraint which is a last resort if other disengagement hadn't worked. Op see if there is a Camhs LD team locally .