Academic journal article Education & Treatment of Children

Factors Associated with the Use of Restraints in the Public Schools

Academic journal article Education & Treatment of Children

Factors Associated with the Use of Restraints in the Public Schools

Article excerpt

Abstract

The improper use of reported restraints has been associated with serious injury and death in both mental health and school settings. However, there is currently no federal legislation that regulates the use of reported restraints in the schools in contrast to health care facilities (e.g., Children's Health Act of 2000). As children with disabilities are significantly more likely to experience restraint events, we examined what variables may predict the use of reported restraints in the public schools among these children. Results indicate that schools with lower socioeconomic status and located in states that did not prohibit corporal punishment or regulate the use of reported restraints in the schools experienced more reported restraint events.

The use of restraints has been termed "a low frequency but high consequence event," (LeBel, Nunno, Mohr, & O'Halloran, 2012, P. 78). Ryan, Peterson, Tetreault, and van der Hagan(2008) note the use of restraint "... continues to be an understudied but overused procedure among of one of our nation's most vulnerable populations," (p. 214) which are children with disabilities. With respect to restraints, there are generally three types discussed in the literature: physical, mechanical, and chemical restraints. Chemical restraints refer to the use of medications to control behavior or restrict a patient's freedom of movement (Ryan & Peterson, 2004), which, while increasing in frequency in their administration in the schools (Canham, et al., 2007), are generally out of the purview of the schools in terms of decision-making. Physical restraints, also known as ambulatory and manual restraints, refer to a personal restriction that immobilizes or prevents a student from moving his or her torso, arms, legs or head freely, in which the restraint mechanism is the body of another person(s). A physical escort is not included in this definition (U.S. Department of Education [U.S. DOE], 2012a). Mechanical restraint refers to the use of any device or equipment to limit a student's freedom of body movement (U.S. DOE, 2012a). As both physical and mechanical restraints are utilized in the schools, the use of these restraints is the focus of the current study.

An accurate number of the instances of serious injury and death that resulted from individuals being restrained improperly or without consideration for other medical conditions is unknown (U.S. Government Accountability Office [USGA0], 2009; Mohr, Petti, & Mohr, 2003). While we could not locate an authoritative source on the number of injuries and deaths associated with the use of reported restraint events, the Child Welfare League of America (2002) estimates that approximately 8 to 10 deaths result each year from the use of reported restraint procedures. Over one-third of these deaths have been attributed to the improper use of reported restraints (Ryan, Robbins, Peterson, & Rozalski, 2009). While rates of injury associated with the use of reported restraints are unknown, the reported injuries number in the hundreds as a conservative estimate (USGAO, 2009). Additionally, Huckshorn and LeBel (2009) note that those staff implementing restraint procedures may also harm themselves.

The use of reported restraints in any setting for any population may be considered controversial (Ryan & Peterson, 2004) and should be subject to scrutiny. According to Section 504 of the Rehabilitation Act and Individuals with Disabilities Education Act (IDEA), the use of restraints would appear to be contraindicated as these legislative mandates intend to provide access to individuals with disabilities to society in general (Rehabilitation Act) and to school settings via a free appropriate public education (Jones & Feder, 2010; Ryan & Peterson, 2004). However, it appears that students with disabilities appear to experience the majority of reported restraint events in the schools (LeBel et al., 2012). …

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