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Restraint, seclusion methods in North Dakota schools scrutinized

BISMARCK - A 6-year-old boy diagnosed with autism and ADHD is found with unexplained bruises after being strapped in a wooden “restraint chair” in a North Dakota public school.

An 11-year-old boy with ADHD, anxiety disorder, depression and “autism-like” behaviors is restrained by being sat upon by school staff members.

An 11-year-old girl with a disability, whose diagnosis was not reported, is confined to an isolation room -- a small storage room with windows -- for half of the school year.

These are some of the reports the North Dakota Protection and Advocacy Project received last year on the use of restraint and seclusion in North Dakota public schools.

“I don’t think putting kids ... in a room, when they’re struggling, and holding the door shut is a solution,” said Jenny Renton, the Bismarck mother of a 14-year-old boy diagnosed with Asperger's syndrome.

Restraint and seclusion have been used in schools for decades on students with and without disabilities. However, it’s unknown how frequently these methods are practiced in North Dakota. Some school officials contend they are rarely used, and the U.S. Department of Education states restraint and seclusion should only be used in situations "where a child’s behavior poses imminent danger of serious physical harm to self or others and not as a routine strategy implemented to address instructional problems or inappropriate behavior.”

About 25 percent of school districts in the North Dakota have no written policy on when it's appropriate for staff to use restraint and seclusion.

“I’d like to make sure every school district does have a policy on seclusion and restraint, because we have anecdotal evidence of children being improperly secluded or improperly restrained," said state Sen. Joan Heckaman, D-New Rockford. Heckaman is a member of the seclusion and restraint task force recently created by the North Dakota Protection and Advocacy Project.

There are cases that show misapplication of restraint and seclusion have resulted in physical injury or psychological trauma to students. In some cases across the country, their misuse has resulted in death.

North Dakota is one of five states with no law protecting students against the use of restraint and seclusion in schools. The others are New Jersey, Mississippi, Idaho and South Dakota.

“I think that several legislators are dragging their feet on this because they want the (school districts) to have control,” Heckaman said.

Data collection

In 2009, the U.S. Government Accountability Office released a national report that revealed hundreds of students had been abused or had died as a result of restraint and seclusion.

Because schools are not required to report how often these practices are being used, information from the North Dakota Department of Public Instruction is particularly elusive.

Some data is available through the U.S. Department of Education's Civil Rights Data Collection, with the most recent data from 2011. In 2009, the department's Office of Civil Rights required all schools to submit the number of incidents of restraint and seclusion, which is self-reported by school districts.

The results of the 2013-14 Civil Rights Data Collection will be released later this year, an Education Department spokesman said in an email.

According to data from the Education Department, 1,249 cases of restraint and seclusion were reported in North Dakota from 2009 to 2011, and about 90 percent of those cases involved students with disabilities.

Since September, state lawmakers have been analyzing the prevalence of restraint and seclusion in schools, and whether there should be a state policy.

An interim education committee started to gather data and information on restraint and seclusion practices, including how many school districts have a policy in place.

A survey of all school districts in October found about half the districts had a policy on restraint and seclusion. The same survey, administered by the North Dakota School Boards Association, was sent to school districts again this month -- and the numbers quickly changed.

The newest survey shows 58 percent of districts have a policy, 26 percent don't, and 17 are in the process of adopting one.

Legislators are debating whether there's a need for a state policy on restraint and seclusion, with some arguing such policies or guidelines should be up to individual school districts.

“The locals will have control over the policy; it’s just that we will require them to have a policy," Heckaman said.

Visiting the 'quiet room'

Renton’s son was 9 years old when he was first put in the “quiet room” in a Bismarck public school.

The room, she said, was the size of a closet and had a small window on the door so you could peer inside. A teacher or staff member would stand outside the door holding it shut, she said.

She was told her son was being aggressive when the school called her to pick him up. When she arrived, she saw him in a panic.

“He was very distraught and screaming, crying -- terrified, I guess I would say,” Renton said.

He was put in the room twice before he transferred to another school. Her son started out “OK” when he finally got to middle school, but things quickly went downhill: He was placed in a quiet room more than 10 times, Renton estimated.

She said her son became fearful of going to school. When he was put in the quiet room, he would break things and tear off the wallpaper, she said.

“He’d become very destructive,” Renton said. “When they put him in there, he was already in a heightened state.”

Police were called on him three times at the school, according to Renton. Two of those incidents resulted in citations for simple assault and disorderly conduct, she said.

Her son, now 14, wasn’t diagnosed with Asperger's syndrome until he was 11. He’s been homebound for his entire seventh-grade year, attending middle school for just three hours a week.

“Our hope would be that he could be back in school, but we just don’t know that he personally could function in that setting,” she said.

Renton said she’s frustrated with the lack of resources and knowledge or awareness of how to handle children with autism or behavioral issues.

“Obviously that kid is having problems for a reason, and we need to find a way, parents and teachers and school staff ... to figure that out before it gets to that point," she said.

Another parent said he'd also like to see more resources available for North Dakota schools. Carl Young's adopted son, Marc, now 14, went to a public school in Garrison until third grade, when he attacked his teacher when she tried to search him for a missing deck of playing cards.

“We started having issues with him not paying attention, not doing his work, getting up from his chair, disrupting class -- all typical behaviors of a child with ADHD," Young said.

Marc has been diagnosed with reactive attachment disorder and obsessive-compulsive disorder, and he is on the autism spectrum. The school would put him in a room when he became aggressive, though Young said he doesn't have a record of how many times that happened.

“There’s no consistent documentation about the number of times he’s been locked in that room," said Young -- though he adds there have been times, for safety reasons, he agreed with the school's decision to do so.

Still, Young said he'd like schools to be required to report how often they use restraint and seclusion. He also said he’s frustrated by the lack of resources and services available for Marc, but he understands the school district is “doing the best that they can.”

Marc hasn't been back to a public school since third grade. He was home-schooled for a short period, and now he's going to school at the Dakota Girls and Boys Ranch in Bismarck.

Developing policies

Most larger school districts have a policy on restraint and seclusion, including Bismarck. The district adopted a policy last July for its 25 campuses, and staff underwent training in the fall.

The policy states restraint and seclusion may be used to "control violent, disturbed, or depressed behavior" that has or may immediately result in harm to a student or others, or in "extreme or extensive damage to property."

In addition, staff are trained to recognize violent, disturbed or depressed behavior, Superintendent Tamara Uselman said. They are also trained in de-escalation techniques to avoid using restraint and seclusion at all.

“This is a scary topic ... for staff, until they really know the policy and they feel well-trained. Then I think it’s not probably as frightening," she said.

A group has been established to start reviewing data across the district, Uselman said.

“Because we want to know, over our 12,000 kids: Is it frequent? Is it infrequent?" she said, adding that the review will include parent input.

“We want it completely transparent what’s going on," she said.

Mandan Public School District has been using guidelines regarding the use of restraint and seclusion in its schools for the past 10 to 15 years, said Tracy Klein, director of special education.

Restraint and seclusion have been "ongoing at different levels throughout the last decade in regards to Individuals (with) Disabilities Education Act," he said.

Mandan doesn’t have seclusion rooms, but it does have “quiet areas” that are used for education and small group instruction, Klein said. Students are able to go to these rooms as means of self-regulation.

The areas are monitored at all times and doors are never locked, Klein said. Restraints are used only when there's a student or staff safety issue, he said.

Klein said he's comfortable with the guidelines and practices Mandan Public schools use, and said he thinks each district should be able to develop its own policy.

“As far as a state policy, my reluctance is there would be the one-size-fits-all model," he said.

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