Seclusion and Restraint: Federal Updates and Advocacy Opportunities
Vaillancourt, Kelly, Klotz, Mary Beth, National Association of School Psychologists. Communique
ADVOCACY IN ACTION
The issue of seclusion and restraint has been a recent hot topic widely discussed among many education and disability rights advocacy groups, and now the United States Congress. The Children's Health Act of 2000 protects children from abusive seclusion andrestraint practices in facilities that receive federal funding such as Medicaid. These centers include residential group homes, treatment facilities, and hospitals. However, there is no federal legislation that regulates the use of these techniques in our public schools. Historically, policies and procedures related to seclusion and restraint in the schools have been maintained at the state and local district level, although examples are limited. As of April, 2012, there are 30 states that have either a statute or regulation providing protection against seclusion and restraint for students. However, there is wide variation among these laws and regulations, and only 13 states have laws or regulations that cover all students, while others only protect studentS with disabilities (Butler, 2012). Recently, there has been increased debate regarding appropriate Staff training, proper seclusion and restraint techniques, monitoring and parent reporting, and when, if at all, these methods are appropriate to use in the public and private school settings.
Over the past several years, allegations of abuse and death related to seclusion and restraint, media coverage of these events, subsequent federal investigations, and Congressional hearings about this topic have resulted in increased pressure on Congress to pass legislation to address the use of seclusion and restraint in the school setting. Currently, there are two pieces of federal legislation that are intended to regulate state and local policy regarding seclusion and restraint, and the U.S. Department of Education recently released a resource document related to this issue. Although NASP does not have a formal position regarding seclusion and restraint, the association actively promotes the use of preventive measures and positive behavioral supports (PBS) with all students. This article will provide you with background information relating to this legislation as well as NAS P's response. The article will also highlight key recommendations from the U.S. Department of Education's (2012) Restraint and Seclusion: Resource Document, and summarize the behavioral practices that NASP promotes, including the role of the school psychologist in ensuring that all students' behavior is properly supported.
DEFINITIONS OF SECLUSION AND RESTRAINT
It is important to note the distinction between seclusion and time-out. These two terms are often used interchangeably, but they have very different meanings. Time-out involves removing a student from the group or requiring the student to go to a separate designated area, but the individual is monitored at all times by an adult and is not physically prevented from leaving the area. Typical examples of time-out include sending a student to sit at a desk in the hallway, facing the wall in the classroom, or sitting in a designated section of the classroom away from the rest of the group. The Children's Mental Health Act of 2000 defines seclusion as, "the involuntary confinement of an individual alone in a room or area from which the individual is physically prevented from leaving." Regulations issued around this definition indicate that seclusion can mean confinement in rooms that are locked, blocked by furniture, held shut by staff outside the door, etc. Examples of seclusion include forcing a childinto a room and locking the door, strapping a child to a chair, or pinning a student to the floor to keep him or her from leaving an area (National Disability Rights Network [NDRN], 2009).
Restraint, as defined by the Children's Health Act of 2000 and further interpreted by the Center for Medicare and Medicaid Services in final regulations, means any manual method, physical or mechanical device, material, or equipment that immobilizes or reduces the ability of an individual to move his her or arms, legs, body, or head freely. …