Education board votes to limit restraint techniques

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MALDEN, MASS., DEC. 16, 2014….Public schools and specialized private schools in Massachusetts that educate children with behavioral or emotional issues will be required to follow new regulations when using restraint or seclusion techniques to control behavior.

The state Board of Elementary and Secondary Education voted in favor of regulation changes Tuesday.

The final regulations backed away from earlier versions that prohibited the use of “prone restraints” – a controversial technique where students are pinned to the floor with their heads down and legs and hands held.

Critics of prone restraint argue it is overused by untrained staff, and has led to serious injuries, including death. Because a student’s face is held to the floor, there is a greater risk for asphyxiation, according to critics of the practice. Proponents say the technique is sometimes necessary for students with severe behavioral and emotional problems.

Several states, including New Hampshire and Maine, have banned prone restraints.

Some parents believe school staff resort to using restraints and timeouts too often. Board members pointed out restraints are rarely used in most schools.

Greg Smith, a parent, told the board that many students with behavioral or emotional issues must attend specialized schools where the restraint techniques are used.

“Too many children end up being trapped in schools where they are being restrained or secluded,” Smith said.

Smith called the regulation changes a “big step in the right direction.”

Rather than ban prone restraints, the board opted to limit their use to extreme circumstances after educators from the Massachusetts Association of 766 Approved Private Schools convinced state education officials the technique is necessary in some instances. The 766 Approved Private Schools (maaps) educate students with special needs.

Education Commissioner Mitchell Chester said the new regulations, which would take effect in January 2016, strike a reasonable compromise between protecting students and recognizing that sometimes restraints are necessary to protect the student himself, other students or staff.

“I think this is a very well-reasoned middle ground on not blanketedly prohibiting the use of prone restraint, but on the other hand making sure when it is used, it is last resort; the folks who use it are trained, and it is well-documented,” Chester said.

The regulations emphasize training, board members said.

Under the new regulations, prone restraints can only be used in an emergency situation when other efforts have failed, and where there is a safety concern, according to Chester. The technique can only be used by staff trained to administer prone restraints, and must be documented and recorded with the DESE.

Education Undersecretary James DiTullio said, “This is a very difficult issue. Nobody likes talking about restraining students . . . ”

“Not every student is what we would call a traditional student,” DiTullio added. “There is a great need for many of these students the type of techniques we are discussing today.”

Schools will also be required to collect data about all restraint and seclusion incidents, and report them to state education officials. The department will know in much greater detail how restraints are being used, and be able to better monitor their use, board members said.

DiTullio said he hopes the new regulations create a “data revolution.”

“This is an area where there is a disturbing lack of data,” he said.

James Major, executive director of maaps, told the board before they voted he was glad the specialized schools were able to weigh in and express their concerns.

Rick Graff, clinical director of the New England Center for Children, said at the school where he works the students are prone to “chronic self-injury,” and they require restraints to prevent them from hurting themselves. Several of the board members visited the New England Center for Children while considering the regulation changes.

Graff described treatment of chronic self-injury as a “science,” and asked the board to leave the restraint decisions to the experts.

“We put a treatment plan in place, and it takes a while to even see if it works. If it is working, what you will see is a slow, steady progression,” Graff said.

The changes to the regulations were not spurred by any incident, Chester said.

“There was no incident that was a catalyst. It was really just time,” he said.

The regulations had not been updated since the early 1990s, according to board members. The regulations mirror ones adopted by the Board of Early Education and Care last week.

Copyright 2014 State House News Service

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