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?

I have used restraint techniques on my own severley autistic child,I have been trained in C&R as I used to be a mental health nurse,and i know they use team teach in his special school,it is what it is and i only ever do it to keep him safe .

I am sorry you are going through this. I dont know about restraint.

But I wanted to say dont give up on sensory/quiet areas. I think you are redirecting him to it too late if he is already in meltdown. Somehow he needs to be there before he is over stimulated. Also without a proper OT you wont know what sensory things to do to help him re-regulate. We spent years doing dim lights and fluffy toys to zero effect, for an OT to tell us our son needed to do something like push a heavy wheelbarrow arround the garden. I really recommend an OT.
if you do an yvonne newbold course she goes through lots of reasons meltdowns might happen and you can hopefully prevent more of them so it doesnt happen so often as it does feel they are without warning but generally there are warnings there.

Another one here who would advocate Team Teach training as a matter of urgency.
www.teamteach.co.uk/parents/
The basic premise of the TT approach is one of deescalation with safe handling where absolutely necessary. I’m sure you already utilise deescalation strategies with your ds, but talking through approaches to supporting him in challenging situations, and developing the skills to work as a team in the home is paramount to ensuring your DS is receiving all that they need.
I find it interesting that you talk about being ‘hands off’, not ‘telling him off’ as a strategy. Clearly, hitting a child is NEVER ok, neither is unnecessary restraint. But children need clear boundaries. All children. Different children may need different boundaries, but they still need them. Where a child is finding living in a neurotypical world very difficult, knowing what those boundaries are will go a long way to assuage their anxiety.
I appreciate that it’s so easy for strangers on the internet to give advice, we don’t live your life or have personal experience of your child. I hope you are able to find the support your family need for your child. You sound like a lovely mum x

Sorry, forgot the TT link!
www.teamteach.co.uk/parents/

When our school did team teach training the parents of the child they were learning for was invited to come in and do it too.
Big hugs for you op.

My job is going into care homes and checking on the care that my clients - all adults with limited capacity - receive and i would always be monitoring the use of restraint.

What i look for is whether it was necessary at the time to prevent harm to themselves or others and fully accept that it is sometimes necessary - i mean some of my clients are over 6ft and 14 stone.

However, i would also look for reflective thinking after the event - what were the triggers ? What could i have done different? etc - an admission that you could have done something better is always a positive for me as it shows you have really thought about it.

I would also look for the things you would have or now put in place to prevent this happening again such as avoiding triggers etc.

If you are worried I would suggest keeping a diary of the incidents, include any diversion or de-escalating tactics you tried and your reflective thinking afterwards. If anyone expresses concern then you have the full information showing you are doing everything you can. It may also help you to identify a pattern or trigger that you have not noticed.

I'm no expert OP but you seem like a wonderful, caring parent in what must be a very hard situation. I think you seem to be handling it in the only possible good way, where you and he are in no danger of further harm. Again I'm no expert but seems like you're making the best possible choice.

It's deeply upsetting being attacked by your own child. Hugs.

It's perfectly ok to restrain your child to keep everyone safe and property undamaged, if he's already in a special school setting then they will be doing that too.

Not everyone has a natural aptitude for safe-restraint techniques, even if they have had training and I've seen bruises on some children because of this. Wearing comfortable clothing yourself is essential as you never know where or when you might suddenly be on the ground with your bum in the air.

I was lucky in that I already had this aptitude from playing a range of contact sports before I had ds. Finding what de-escalates things is essential although it can be quite random - somehow I found that if I stretched ds's legs whilst he held onto the sofa helped calm him for the day.

15 years after the meltdowns started (ds now 20) I am happy to report that DS is one of the most calm and unviolent people I've ever met. So have hope OP x.

Certainly I know that some CAMHs run or refer to courses on non violent resistance for parents. I was mighty miffed that our CAMHs didn’t refer us although they provided one. It seeemed to be a bit hit abs miss. You had to ask for it - bit difficult if you weren’t aware of it!

That sounds really hard op, and I think that given the circumstances that sounds like the safest, kindest restraint.

I hope you get the proper support you need.

Me and a couple of other parents asked about restraint on our NVR course. They're not allowed to teach us it.
So we still get hurt and the house smashed up but now we're even more guilty we missed our DC's meltdown cues.

But I do still restrain when I have to. I didn't the other week, I tried to calm my DD, and ended up being badly injured and having a cut glued together in A&E.

You poor thing. That is so incredibly tough and I am in awe of you.
One thing that may help is a weighted blanket (heavier the better), to act as a sort of barrier between you both when you need to restrain him.

It's got to be done sometimes ( I have a strapping 17 year old severely autistic son ) but what annoys me is teachers get training in restraining but parents can't get trained 🤷‍♀️.

I have done NVR and Team Teach. My DD (10) does not have any SEN at all, no DX but has a lot of unresolved trauma due to some DV she has witnessed so she kicks and bucks, and does it very hard. I have been physically marked more times than I can count and she is a small, light thing. I have to restrain her legs now as I found my own response to it worrying as I get very angry and want to lash out back at her and obviously I can't retaliate. It is really, really hard to deal with as a parent. I do not think YABU OP. As you said, we can't be punchbags, it doesn't do our DC any favours or oursleves.

There is PBS training for parents and there is deescalation similar to team teach but I found it more helpful as there was more direct examples of how to implenent the ideas.

PBS is positive behavioral support and it has a lot more information and help and support to help him in all the time around his meltdowns to help them be less common.

There is online training and there is a physical element that im not sure if they teach parents but I found there was enough in the theory to start to reduce the behaviours anyway.

Haven't RTFT yet but just while I have a moment to respond: DD is autistic and her meltdowns were spectacular for many years. We don't need to restrain her anymore, as a general rule, because now she's 11 the outward explosion has turned inwards and she is having serious problems with anxiety instead. In some ways, the violent meltdowns were easier to manage. :-(

One thing I wanted to mention, apart from obviously saying that you absolutely must do what you need to keep everyone safe, is to think about the way you respond in the moment. You may well already be doing this, of course, but I found that staying supremely calm and empathetic - even when I most certainly didn't FEEL calm and empathetic! - was really helpful when DD was melting down. I would gently say that I could see how upset she was, that I was there for her, that she was safe and that I would keep us BOTH safe. Yes, I would have to restrain her in a tight bear hug, catch wrists and hold them, prevent legs from kicking out etc. But I kept giving the message that it was going to be OK (not that she WAS okay, because clearly in that moment she was not - an important distinction I think). And that I was there and would keep everyone safe.

Apologies if this isn't relevant or useful. I guess this might be a useless approach if your DS doesn't have much understanding of speech yet. But it did really help us, along with changing my own 'lens': when she was kicking off she was HAVING a hard time, not GIVING ME a hard time. That helped me stay empathetic and understanding rather than resorting to shouting, angry expressions, etc.

Of course it's not only okay but necessary.

@Sockwomble

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.

Who told you parents couldn't have restraint training?

Please have a look at the free courses for parents offered by studio 3 regarding their low arousal approach.

[quote Nineteeninetyfour]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/[/quote]
Me too.

Thing is if an adult came up to me on the street and started hitting, kicking, headbutting, pinching, biting, stamping on my feet and following me when I tried to get away, I'd defend myself as best I could and hope a bystander was calling the police.

I have bruises now from DS last meltdown. I can't walk away as he will come after me, if I lock myself in the bathroom he will throw himself against the bathroom door and I'm worried he's going to break it down and hurt himself in the process and possibly me. We try and avoid his triggers but sometimes it's only obvious in hindsight what the issue was, or he comes home from school already starting one because of something that's happened in the day. I try and defend myself without restraining DS but sometimes I do have to grab his legs or his arms or hold him to stop him banging his head against the wall.

We're only just starting with the referral process so we have along way to go.

Sorry but YABU. You can't physically restrain a child. Equally you can't just allow them to attack others so you're in a very difficult position. Basically doing nothing is not an option, restraining them is not an option, so you need to find another way.

The reason for this is quite simple. The general belief is that it's wrong to get physical against a child. Physically restraining them is just another form of smacking - it's abuse.

The child's behaviour is caused by their illness. They're behaving this way because of it, therefore you wouldn't feel the need to restrain them if they didn't have the illness. By adopting a different behaviour in restraining them because of their illness you are discriminating against them on the basis of disability. While you may not be committing a crime, do you want your child to grow up in a world where they are discriminated against because of their condition?

You're damned if you do and damned if you don't though, I don't envy you.

Autism isn't an illness.

And yes, you can restrain a child as a last resort for their own safety and that of others provided it is done safely and with the minimal amount of force needed. It is nothing like smacking.

I am so sorry OP, having lived through this myself I know what it feels like.

Please google the recent reach on Folate Receptor Autoimmune Antibodies, carried out by Dr Frye and also Professor Raemakers. There are several peer reviewed studies easily searchable.

My autistic eight year old has derived great benefit from calcium folinate supplements - prescribed by the NHS, although we had to get testing done privately. It has improved his language to the point that meltdowns are much rarer, due to increased communication.

Feel free to PM me for further details, or anyone else who might be interested.

"Who told you parents couldn't have restraint training?"

The CCG and social services. We asked for less than that (and did eventually get what we wanted) but the first response was that we don't offer restraint training because we would be legally liable if it wasn't used properly and also no company will provide it because of the requirement of two people and monitoring.