Restraint in school-how much is too much?

[amistillsexy]

DS1 has HFA/PDA. He started Y5 yesterday.

Last term, we had many meetings with school about how they can meet his needs. He has 32.5 hours a week funded support (so, full time one-to-one), but he was regularly leaving the classroom and having meltdowns, which always resulted in his being restrained. It got to the point where he'd come home and say 'A good day today, Mum, I was only restrained once!'. I emailed and spoke to the Head about my concerns that incidents were not being effectively de-escalated, and she always agreed and promised to put better systems in place.

At the very end of last term, I had a meeting with the Head and the Inclusion Officer, who assured me that everything was set up for this year, that the new 1-1 was very experienced and capable, and that restraint would only be used as a last resort.

Today, DS left the classroom needing a 'safe space'. He went under the stairs and crawled into the space under the bottom step, so he could feel squashed. He was told to get out as it 'wasn't safe', and when he didn't come out, two members of staff got hold of the top of an arm each, and walked him off to a room. He said that he walked with them because he'd 'learned that lesson before'. When I asked him to elaborate, he said it hurts when they grab his arms, and so it's better to just walk with them. He has a small but noticeable bruise on his arm, which looks like a thumb or finger imprint.

The thing is, when they grabbed his arms, he wasn't hurting anyone or anything, he was just squashed into the tightest space he could find and he said he was making little noises (he made them for me- squeaking and whimpering). At home, no matter how bad things get, we avoid any form of physical restraint unless we absolutely have to (if he is trying to hurt one of his brothers, for instance), and then only as a last resort.

I'm interested to hear from others whose children are in this situation-do other schools use 'restraint' in this way? I'm trying to work out what to say to school and whether to take this any further.

This must be very worrying for you.

The Dept for Education has issued guidance on the use of force/restraint in schools which you can find here

I would have a good look through for the sections which cover your situation and then talk to to the head about the guidance and how it is being applied.

Your son is clearly struggling to cope so I would be making an urgent appointment to discuss this too.

School did use restraint on both my sons (AS) despite advice from the educational psychologist to avoid if at all possible. I flipped for ds2 when it occurred twice in one week and removed him from the school. They also had problems understanding what ds2 would consider a safe place - his place of preference was curled up on the floor in the boys toilets - which exercised the deputy-head no end because of the 'germs'. ds1 had already been permanently excluded by this point and is now in an EBSD school. This has made a huge difference to the frequency of his meltdowns both at school and at home. My feeling based on this experience is that if the frequency of meltdowns is so high then the setting is wrong - persuading the LEA of this is another matter.

restraint is meant to be used to avoid a child harming themselves or others

your son's school are using restraint to control him unnecessarily IMO

A thumbprint is very worrying

Thanks for the replies. You are all telling me what I've been thinking myself.

The thumbprint is very worrying, yes. It's very slight, but he's not easily bruised anyway. I find that document you linked to even more worrying, inappropriately employed. It basically give carte Blanche to any adult in a school to manhandle the kids, from what I've read so far.

I'm going to email my concerns to school today. We recorded his account of what happened last night, so we have that as a record. I'm building my evidence .

Do have a look through the guidance as it can help, when dealing with heads, to express your concerns in accordance with what is expected from all schools.

Also, it can help to approach this by saying how worrying and difficult it is for everyone and suggest that there may be a clear training need here.

Are you sure he can manage in school? Have you looked at other options? It pains me to hear about a child who is so distressed as school shouldn't be like this for anyone.

Thanks, I.A. I will read it thoroughly when I get chance. No, he doesn't really manage in school. He only learns what he teaches himself, or what he is motivated to learn...and then he learns do much, he knows all there is to know. No teacher could hope to keep up with him. Last year's teacher rearranged all his topics to include ds' favourites, but ds just became bored and frustrated with the lack of depth, and inaccuracies.
This wouldn't be so bad, but at the same time he writes like a four year old, because once he'd learnt letter formations, he refused to practice them. He also refuses to type or record his thoughts or ideas, coming up with all sorts of 'logical' reasons why he shouldn't do it.
I'm a primary teacher (or I would be, if I'd ever been able to trust I'd be able to go back into teaching and not have to give it up because of ds being excluded/needing picking up/endless meetings to sort things out), and I find it impossible to actively teach him anything, it drives me up the wall whenever I start. I couldn't home school.
This is his third LA school...it's the other side of town, and no other school will take him. Nor do I think they'd do any better. His options are Special (which wouldn't suit him, as he's not in that kind of category) or the LA wanted him in the PRU when his last school excluded him. There is an asd specialist school in the next LA. The difficulty is arguing the case for funding.
I want to cry. I don't know what to do for him. He was so sorry last night, and felt so ashamed of himself. I'm afraid I just couldn't allow him to take the blame, and told him it was the adults who should have known they were pushing him too far and allowed him to cool down. This morning he was in such a state of high anxiety, I really don't think he'll be able to hold it together today. :-(

I am restraint trained. They shouldn't have done that, he was doing no harm to others or himself. They should have left him where he was and observed/made sure he was ok by just being there.

Restraint shouldn't hurt the person being restrained. If bruises are being left take it up with the head, that is unacceptable.
They should be using a log so every time he is being restrained they should be filling in a form detailing why, how long for etc etc. Ask to look at these too, with the head.

I am restraint trained. They shouldn't have done that, he was doing no harm to others or himself. They should have left him where he was and observed/made sure he was ok by just being there.

Restraint shouldn't hurt the person being restrained. If bruises are being left take it up with the head, that is unacceptable.
They should be using a log so every time he is being restrained they should be filling in a form detailing why, how long for etc etc. Ask to look at these too, with the head.

The head was the one that got hold of his arm, unfortunately. I asked to look at the paperwork last term. They'd only documented three, even though it happened lots more times. The records looked to have been filled in at different times...different pens, handwriting, etc adding details that mitigated things. I got nowhere discussing that. She sacked the 1-1 but this new 1-1 seems no better, and the head is always called to incidents.
It's crap.

It sounds like this placement is wrong - the trouble is that day to day experience is teaching DS that HE is wrong.

Where would be the right places (ignore geography and cost) for him now and for the rest of his educational career?

Compromise on the ideal and then fight like hell and never give up.

I am so sorry. I really do feel for you as this is awful and your son clearly isn't getting his needs met.

Schools are under so much pressure from LAs to say they can cope and just get on with when they can't.

Try and get your head onside with this as the school will end up being blamed.

Think laterally, think creatively, think about education packages that involve some school, or part-time school or dual placements or home tutors. Think about what might suit him.

Our children can't keep getting pushed in to places where they just can't fit in. It's so damaging and I say that as a mum on her third school with a child out of school - again.

Even more reason to complain to the head if they are the one who caused the bruise. Also copy in the governors.
They are failing your child, maybe go higher in hindsight. If they aren't filling in the paperwork properly and are causing bruising it's really not good is it?

Is there anywhere else he can go that would be better equipped?

Restraint should be a last option, when all else has failed and safety is at risk. Staff should be seeking to de-escalate, so should be allowing him to go to his safe space (which should be a safe space, since it's obviously necessary for him).

Have they had any formal training, such as TeamTeach, or are they just making it up as they go along? Also, have you given consent to them potentially using their "techniques" on him?

I was going to ask the same ourve but figured if they have the forms then they have probably had team teach training but are carrying it out ever so badly.

I'm hoping anyway, if they are doing this with no training then they are up for some severe trouble.

It took the staff at DS1's school a while after their training to figure out exactly what they should be doing and when, including with de-escalation techniques (it didn't help that he flipped from craving deep pressure when stressed to hating it to the point where it made him more stressed, so the gentle techniques they'd learnt to help him in that way seriously backfired!)

You definitely need to ask which staff have had the TeamTeach training, ami. I have a feeling there might be some squirming going on. I had to sign a consent form for DS1, when staff working with him were trained.

Have a read of resources on Challenging Behaviour Foundation website and British Institute of Learning Disabilities website about use of restraint etc.

If you have not given consent to using restraint then they should not be using it except when someone's physical safety is at risk. The school are putting themselves in a legal danger zone here as its a physical assault and can only justify it in extreme situations unless restraint is being used as part of a properly agreed positive behaviour plan with hierarchy of strategies clearly set out and implemented by properly trained staff.

The LA should have a behaviour outreach team - may be called behaviour support. Are they using it? Or an autism outreach team?

Is your child statemented? If not I would suggest you apply on the basis his needs exceed what a mainstream school can provide from their own resources e.g. he will need Team Teach trained staff (1:1 or even 2:1) + experts in behaviour strategies.

What about ABA in mainstream? My son has ABA staff (from a ABA consultancy) who support him in mainstream school. He does not have school TAs supporting him as they are not sufficiently trained and to pay for them to be trained and supervised would actually cost as much as ABA staff. We had to go to tribunal but you have a legal right to mainstream school and can argue ABA trained staff are the necessary step to your child being in mainstream school. My son also only goes part-time (with the rest of his education as ABA out of school) as the school are also not that great at teaching the academics, but thats a different story! He does benefit from being in mainstream and can access some of the curriculum but he could not be there without ABA. You don't always have to move the child out of the school into the specialist centre - sometimes you can bring the specialists to the child. LAs don't like this option as they don't really want mainstream schools to see ABA in practice in case they all start asking for ABA staff! Its also generally a more expensive option than SS.

DS has a behaviour plan and its written into his statement he has this and how often its reviewed and everyone involved (including me) has to sign it. All staff are trained in all the strategies and supervised. If an incident happened there would be a debrief of what happened and why. (Actually since he has had ABA incidents are very rare as the positive strategies are pretty effective)

DS is too academically able for the local MLD / SLD schools and too autistic for mainstream. There are no autism specific schools or units. So ABA is the only option for us.

If you can tackle this from the perspective of suggesting to school they need more resources / training / specialists coming in and will they support you getting a statement / increasing the provision in the statement to cover costs of eg behaviour support / ABA trained staff / team teach training etc etc. I know from bitter experience schools just go into defensive / denial mode if they feel accused / challenged. Better to say its clear positive behaviour strategies are not working & need to be reviewed / need more specialist help so staff are not forced to resort to restraint. I am sure no teacher is comfortable using restraint. My parents were both teachers and were paranoid about being sued if they had to intervene physically. Unions generally tell teachers not to get involved, so I am sure the school is not happy with the situation either and if you can offer a solution you can all get behind and put to the LA that would be the best outcome.

There was a legal case a year or so where a teacher successfully sued a LA as she was assaulted by a child with autism and successfully argued the LA was negligent for not having trained her properly to deal with him. So the school is also on dodgy ground with its responsibilities to its staff if they are out of their depth.

Thanks all, for all your answers. I'm struggling, to be honest. Spent most of the day in tears. Not because of this incident, more because of the implications. I think a bit more information might answer most of what people have asked/suggested and explain my despair.
This is his third school. When his last placement broke down, the LEA asked me to go and look at the PRU, and wouldn't engage in any other discussion until I'd jumped through that hoop. The HT of the PRU agreed with me that DS was no way PRU material, and since he was only 6 at the time, she refused to accept him, as they only accept from 7 (Y3).

The school he now attends was the only school in the authority who would (a) accept him and (b) meet his needs, according to the authority. If he doesn't go here, there is literally no-where left (except the PRU, now he is 9 ). When I removed him from his last school, I emailed all the schools in a 5 mile radius, and only two replied. It was a total nightmare. I also found it very hard to have DS at home all day. I could not home-educate, and we need me to get back into teaching very soon, as we have totally run out of money.

As for the school situation, it is really difficult. The HT is very nice, and agrees with all I say. She is definitely 'on my side', and I have tried very hard not to rock the boat (it being our last chance and all!), but there is always a reason why the systems didn't work, or why on this particular day things went wrong, and she assures me that things will be sorted out, then something different happens, and we're back to square one. The staff involved are all Team Teach trained, although they don't seem to be using it correctly, and I have never signed a consent form.

Behaviour support team from the LA have been involved, but the 'strategy' they put in place relied on the TA 'grading' DS's behaviour on a scale of 1-5 every ten minutes of the day. If he averaged 5, the rest of the class would get a treat, if he averaged 1, he would get a consequence. If the TA thought he was a 0 (I.e., not achieving a 1), he would be automatically excluded. I sat and picked through this in a meeting for about 2 hours. They insisted it was a brilliant plan. They put it in place and I went home. The phone was already ringing as I walked in the door, asking me to come and collect him. That was his last day at his last school-I never sent him back. The ASD team have very generic strategies, which they know don't work, but they don't know what else to suggest. They don't even come to meetings any more.

We haven't got any ABA, Agnes. I though it was for non-verbal children with ASD?I have no idea how we could get it, or pay for it. I have always taken the line you suggest, by going in with the attitude that they are doing their best, and I really think they are. I just wish they'd stop grabbing him!
Agnes, Your description of your son fits mine-he doesn't fit in anywhere.

I am about to start looking at secondary schools. I don't know where to start. The most important thing is that every adult that comes into contact with him is understanding and flexible enough to not push things in the wrong way. How do I measure that on a walk round with the secretary

I know ABA is hard and expensive to get (usually you have to pay yourself first and prove it works) I just thought I would float the idea in case there was any chance. With a child on 3rd school any option is going to be expensive so sometimes you do have a stronger bargaining position on costs.
ABA is for children at all levels of functioning. I say ABA because on a good quality ABA programme all staff would be capable of managing behaviour - like you say its not going on the course - anyone can go on the team teach course - its having someone supervising how you implement what you learnt on the course. In my experience you can only get that level of autism expertise in ABA or ASC specialist provision. Councils just don't invest in psychologists, consultants and supervisors to set and oversee programmes.
I'm not surprised the behaviour and outreach teams were useless - that was our experience too. That plan is appalling!
You need to find the solution, whether its ABA or a private ASC school or an out of area school. Then once you know what you are aiming for you force an emergency review / appeal the statement.
PRUs are only supposed to be short term, they cant really offer that as a long term solution, not to a tribunal. A tribunal will not be happy with a 9 year old in a PRU indefinitely.
It would help if the school will agree they are not meeting needs and support you in a more expensive placement.
The school in the next LA sounds like a good place to start. Don't tell yourself arguing funding is going to be difficult, tell yourself the LA is going to find it difficult to argue against funding it. If no school will take him and they cant stick him in PRU indefinitely the LA has no choice. Its their fault for not making their own in area provision. Thats what I tell my LA every time they complain about the cost of DS provision. The LA is saving a heap of money having no autism schools or units of its own for children like ours and the consequence of that is they have to pay for some children to go elsewhere.

My ds is in a special school because he is too capable to be supported adequately in mainstream.

There are many dire SS. There are also some excellent ones who take children of average cognitive.ability.

Where in the country are you?

Remember to take photographs of any bruises

Maybe you should start looking at the specialist school and start to establish how they could meet his needs. Start gathering evidence of how they are not managing his behaviour. Look at is levels and see whether he is making the right amount of progress. Once I got my ds in the right environment which turned out to be out of county specialist school, he made lots of progress.

I have to add that my experience of trying to get ABA for an older child at the so-called 'higher functioning' end of the spectrum was absolutely dire.

I paid for two different, highly recommended, highly experienced 'consultants' to advise. The last one in particular was appalling.

He dismissed high levels of anxiety outright and just sat there telling DS that he 'had to do what his teacher told him'. Didn't bother to speak to him. Said it was all about 'control'.

He then , in a £600 cut and paste report advised an extensive monitoring programme to be undertaking by a hapless TA who hadn't a clue about ASD. This included tasks for DS to learn to 'listen' or be given set times of the day when he could talk or to be taught to sit on a chair in assembly so he was like everyone else. I found it very patronising.

I also found there was no understanding of older children able to vocalise their problems and no attempt to talk to them or listen to them.

I got the feeling that this was because there was a set way of working and taking into account the child's views didn't fit into this.

This meant that all problem areas had to be given a description which was 'negative' and which justified intervention, e.g he wants attention, he wants control etc rather than the classroom stresses him. All very negative, largely I suspect because they didn't know what to do with a child who couldn't cope with the classroom.

This is just my experience.

Oh IE, I agree that it sounds appalling and I'm gutted that was your experience when I believe it could have been so much better. Did you ever call the person I suggested?

Not even to recruit, but just a non-committal phone-call should be enough to restore 'some' faith I'm certain. Her specialism is older children that often aren't even diagnosed and is just bloody sensible and flexible.

Thanks Star. But I've given up on it all now really. He is fine out of school and coping well. School really f*ed him up and I really regret the time, energy and cash spent trying to force my square peg into a round hole.

I am an ABA consultant and I support HFA children in mainstream school. Here are some thoughts:

1. Most of the kids I work with have strategies in place to hide and feel safe. This place is is usually the toilet or shed, your son found a good cupboard. The school needs to understand that this is a good thing. Your son knows when a situation becomes overwhelming, and rather than engage in challenging behaviour, he hides. This is a good coping strategy. In my programs, we identify a safe space, and the child needs to request to leave the room. The school won't win this fight by denying the child a safe place to de-escalate.

1. Restraint needs to be the last option, and anyone who restrains your child needs to be restraint trained. Restraint should 1) not be used as a punishment and 2) should not leave marks. Restraint should only be used as part of a behaviour plan.

1. The behaviour plans that calls for all of the class to be rewarded if a child with autism behaviours shows a poor understanding of autism. Many people with autism are not strongly reinforced by making everyone else happy.

inappropriatelyemployed I am very dismayed to hear about your experience. Behaviour analysts aren't trained to describe behaviour in terms of "control," and I can't imagine any behaviour analyst stating that a child needs to "learn to listen." I am sorry you had such a bad experience. Unfortunately, like any profession, some behaviour analysts may only be trained in one aspect of service delivery and not be very skilled at generalising.