The following extract from a recent practitioner article from key Studio 3 practitioners highlights the growing issue of restrictive practices in school settings.
The use of restraint and seclusion in school settings is an international problem. It has been the impression of the authors that there has been an alarming increase in the acceptance of these practices in school environments, particularly in the last five to ten years. Changing the practices used in relation to restraint and seclusion can be a challenge, but this challenge is amplified in environments that are poorly staffed and resourced. The Studio 3 organisation promotes a solution-focused approach to this problem with culture change in schools at its heart. In this article, we will outline some of the key issues, and use our knowledge of behaviour management to recommend solutions.
When vulnerable children in schools become highly distressed, restrictive crisis management interventions such as restraint and seclusion are often used. Using these restrictive crisis management techniques can prolong the distress individuals experience as they are not able to effectively regulate. Restraint involves physically holding an individual to contain them, and seclusion refers to the isolation of an individual to an area they are prevented from leaving to manage their behaviour (McDonnell, 2022). At Studio 3, our goal is not to criticise or chastise the staff engaged in these practices, as they are likely scared and under overwhelming stress. However, we think it is important to understand and recognise the potentially long-term physical and emotional impacts these practices can have on both staff and students. These can include physical injuries and an increase in challenging behaviours (McMurray, 2020). In addition, restrictive practices often have long-lasting psychological impacts, such as trauma or vicarious trauma, experienced by the staff involved.
Without being adequately trained with the necessary tools to de-escalate a crisis situation, restraint often becomes the first resort (Deveau & McDonnell, 2009). This is a significant problem seen across the UK and Ireland, as schools are over-relying on using restrictive practices to manage challenging behaviour. There is also a lack of policy to guide the use of restrictive practices in schools, and as a result these practices often go largely unmonitored (McMurray, 2020).
By adopting a solution-focused approach to restraint elimination, which is the cornerstone of the Studio 3 approach, staff can be equipped with alternative tools to manage a crisis situation. These de-escalation tools focus on reducing arousal, looking beyond the behaviour to the child’s unmet needs, and increasing staff’s feelings of competency. Before considering the solutions needed to eliminate restrictive practices in schools, it is important to have a deeper understanding of the use of restraint and seclusion across schools in the UK and Ireland.
The situation across the UK and Ireland
A number of recent articles have shone a light on the use of restrictive practices in schools. These articles prove for some difficult reading, as not only do they highlight the overuse of restraint and seclusion for individuals with additional needs, but they also provide an insight into the damaging effects of these interventions.
A report published in 2019 by the Challenging Behaviour Foundation (CBF) and Positive and Active Behaviour Support Scotland (PABSS) highlighted the significant overuse of restraint across schools in the UK and Ireland, as well as the damage these restrictive practices can have. 720 families whose children had complex developmental, educational and mental health needs were interviewed. Over half of the children were autistic. It was found that 88% of children had experienced restraint, 61% had experienced seclusion and 87% had been physically hurt during a restrictive intervention. These injuries included bruises, scratches, broken bones and head injuries. Certain statements made by parents were particularly concerning regarding how these injuries were sustained. These included, ‘Teacher slapped X’s face,’ ‘Teacher bent [child’s thumb] back to punish’ and, ‘Abrasions from being dragged.’ While most schools identified restraint as an intervention that should be used in extreme circumstances, this was not what was happening in practice. As well as this, parents were often unaware of occasions when restrictive practices were being used on their children. The majority of the time (76%), parents reported that there were no known records of these instances of restraint, with unclear rationale being given as to why their child was restrained in the first place. One parent recalled:
‘The school would report that she had a wobbly day or had been held, we had no idea at the time what this meant in practice. When we got the incident reports, we realised she had often been held on the floor by 4/5/6 members of staff.’
This problem is a significant one across the island of Ireland. In 2018, Inclusion Ireland published a paper looking at the experience of restraint in Irish schools. After interviewing families of children with disabilities, they expressed their deep concern about the physical and psychological harm restrictive practices were having in Irish schools. For example, one parent recalled that their child was left ‘black and blue’ after being restrained and suffered from panic attacks, depression, suicidal thoughts and ‘lost trust in all adults.’ Inclusion Ireland expressed their concern that the use of restrictive practices in schools was breaching basic human rights, as there was no official regulation on its use in schools. One case study included in the Inclusion Ireland report described William’s story:
William was restrained while on the school bus, with his head held down physically by staff for the full 20-minute journey. William described how painful this experience was and said it was hard to breathe while he was restrained. On other occasions, his hands were held down ‘just in case.’ Between the ages of 5-8, he was also secluded in school, locked in a dark empty room with no handles and the supervision screen covered. On some occasions, William was put in seclusion for convenience as the special needs assistant was not available or because he seemed hyper. William was suspended when the family complained to Tusla (the Child and Family Agency in Ireland) and the school were contacted regarding the matter. Unfortunately, this story is not unique. Another family included in this report described how their child was left unattended in a seclusion room for up to five hours at a time for reasons such as talking in class or not completing work quickly.
In Northern Ireland, Deirdre Shakespeare was one of 22 parents who reported that their children had experienced physical and psychological harm due to restraint (Beattie, 2021). These children had diagnoses including intellectual disabilities, cerebral palsy, and autism. Deirdre reported that her 5-year-old autistic son was mechanically restrained in a chair at his waist and ankles. As a result, his psychological well-being drastically deteriorated, as he regularly experienced night terrors and was often very fearful.
Solutions to the problem
We propose several solutions to confront the current problem regarding the use of restraint in Irish and UK schools. These are listed below and form a roadmap to how restraint can not only be reduced, but eliminated, in educational settings. Continue reading...
Written by Lauren Naismith, Andrew McDonnell, Rhiannon Ansemous, and Karolina Morgalla
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