Autism Society of Washington
November 30, 2012
Restraint and seclusion
In light of recent news on issues of restraint and seclusion, the Autism Society of Washington would like to offer the following statements.
First, it is important for the public to know restraint and seclusion is used and legal in public schools in Washington State. Aversive intervention is used with all ages, from small elementary school children through teens and young adults. Washington Administrative Code (WAC 392-172A-03120: Aversive interventions definition and purpose) specifically addresses this.
The WAC advises that a positive behavior intervention support be used prior to the use of aversive interventions. “Aversive interventions, to the extent permitted, shall only be used as a last resort. Positive behavioral supports interventions shall be used by the school district and described in the individualized education program prior to the determination that the use of aversive intervention is a necessary part of the student’s program.”
Aversive interventions have become routine practice and often times result in physical and emotional harm, even death to students. At issue is not only if school staff has the skills and knowledge to apply aversive intervention safely but also whether these practices are appropriate at all. We are also concerned that, under the law, restraint and seclusion can be used without family’s or guardian’s consent.
We oppose the use of seclusion rooms for any purpose. Experience has shown that the potential for inappropriate and abusive use of these rooms is so detrimental to student’s welfare that any value experienced by some students is far outweighed by the harm done to a substantial number of others. We are also highly skeptical of the use of physical restraint. In the vast majority of cases it is grossly overused, resulting in physical and emotional harm to children. There are many regions throughout the country that do not use these methods and instead use positive-only interventions, based on several decades of mental health research and practice, with better results. Professional staff must learn more sophisticated approaches that spot potential sources of acting-out and disruptive behavior, and intervene well in advance with curriculum, teaching, and counseling methods that promote success within a relationship between staff and students based on trust, communication, problem-solving and mutual respect.
Other organizations have policies addressing this urgent issue that mirror our own. The National Association on Mental Illness policy on human restraint and involuntary isolation states: “(aversive) is only justified as an emergency safety measure in response to imminent danger to a patient or others.” Also, “Restraint and seclusion have no therapeutic value and should be used only for emergency safety by order of a physician with competency in psychiatry or a licensed independent mental health professional (LIP)” The NAMI policy also calls for de-briefing after incidents.
All families need to know that an extremely important component to your child’s Individual Education Plan (IEP) should be a Functional Behavior Assessment / Behavioral Intervention Plan. If you are unclear about this component or you feel it is inadequately written and utilized, please ask for an IEP review to address this. Do not wait until inadequate patterns of behavior and use of aversive interventions are escalating.
Children, teens and adults living with autism very often have a behavioral manifestation of their disability that is consistent, identifiable, and often times driven by external triggers. It is important that people understand that their “behavior is communication.” As one of the indicators that actually define their autism diagnosis, behavior is a common expression of the disability.
Additional policy on restraint and seclusion can be found with these organizations: