The use of restraint and seclusion in K-12 schools has been scrutinized and criticized for decades, including by the U.S. Department of Education, the U.S. Government Accountability Office, and several research articles published by the National Institutes of Health.
Despite that, more than 100,000 students were restrained or secluded in 2017-18, the year with the latest available federal data.
“We call these procedures of last resort,” said Janice LeBel, director of systems transformation at the Massachusetts Department of Mental Health and an instructor at the University of Massachusetts Chan Medical School. “It’s the last thing you want to do because there’s a serious element of risk attached because you could hurt somebody badly, and there have been deaths associated with these practices.”
Extreme examples of restraint and seclusion have included school staff pinning students to the floor for hours at a time, handcuffing them, or locking them in closets, according to a Government Accountability Office report from 2009. In some of these cases, this type of abuse resulted in death.
According to the report, at least 20 cases in the two decades before the 2009 report involved restraints that resulted in death.
The use of restraint and seclusion is intended to address student behavior that could be dangerous to themselves or others. But often, these practices are overused in public schools in cases where they could have been prevented, according to Lebel and Ben Jones, director of legal and policy initiatives at Lives in the Balance, an organization working to end the use of restraint and seclusion in schools.
Teachers and other school staff use these practices disproportionately on students with disabilities and students of color, according to the federal data from 2017-18. Students with disabilities made up 13 percent of students that year, but they accounted for 80 percent of those subjected to restraints and seclusions.
What is restraint and seclusion?
Restraint and seclusion are practices used in public schools as a response to student behavior that limits their movement and aims to deescalate them, by either physically limiting their movement (restraint) or isolating them from others (seclusion), Jones said. They’re meant to be used as a last resort, but end up being used much more frequently, he said.
Restraint is defined by the federal Education Department as “a personal restriction that immobilizes or reduces the ability of a student to move his or her torso, arms, legs, or head freely.”
Under that definition, any hold educators place on students that limits their physical ability counts as a restraint, Jones said.
Seclusion refers to the involuntary confinement of a student alone in a room or area from which the student is physically prevented from leaving, according to the department. Some schools have seclusion rooms, which are empty, sometimes padded rooms.
The U.S. Department of Education did not respond to multiple requests for comment.
Almost all states have some limitations on schools’ use of restraint and seclusion, and the U.S. Department of Education advises against using these practices, Jones said. However, some states may use alternative definitions. For example, Alabama bans seclusion in K-12 schools, but that law only applies to locked seclusion, when a student is locked in a room by themselves. And some districts still use seclusion, AL.com reported.
“Every effort should be made to prevent the need for the use of restraint and seclusion and that any behavioral intervention must be consistent with the child’s rights to be treated with dignity and to be free from abuse,” the U.S. Department of Education’s guidelines on restraint and seclusion, published in 2012, said.
Schools are required to report data every two years to the U.S. Department of Education’s Civil Rights Data Collection, which is operated by the department’s office for civil rights. CRDC has not published restraint and seclusion data since 2017-18. The office did not respond to multiple requests for comment.
But because states and even districts can use different definitions of seclusion or restraint, there are discrepancies in reporting, Jones said. For example, Alabama reports very few seclusions because it uses a different definition, and bans locked seclusion.
“It’s unclear if that’s because very few seclusions are happening or if it’s because the schools all assumed that seclusion means locked seclusion under the state definition,” Jones said. “And so they’re conflating the two and so not accurately reporting seclusion.”
What are the types of restraints?
There are several types of restraints that districts can use such as physical, mechanical, and chemical restraints.
Physical restraint refers to a manual hold to restrict students’ movement, according to California’s Department of Health Care Services.
Mechanical restraint refers to the use of any device or equipment to restrict a student’s freedom of movement, according to the U.S. Department of Education. Handcuffing a student is an example of a mechanical restraint.
Chemical restraint means the use of a drug or medication on a student to control behavior or restrict freedom of movement that is not prescribed or administered by a medical professional.
Many states have laws limiting the use of mechanical and chemical restraints, Jones said. A majority of states also ban prone restraint, putting a student in any kind of hold where their breathing is restricted.
Are restraint and seclusion dangerous?
The use of restraint and seclusion on young people is not limited to schools. Several psychiatric programs, behavioral health programs, and other centers that work with children also use them.
Across all these programs, restraint and seclusion have led to several injuries and dozens of deaths over the past few decades, according to research and news stories. The GAO report does not have an exact number of students injured due to restraint and seclusion.
They also leave students traumatized, LeBel and Jones said. For example, Jones said worked on a case where a student who was secluded in a former closet at school that was painted blue refused to go into any blue rooms in his home.
“A student walks away with a traumatic experience, so they’re left with the memory of that, in which they view educators differently now,” LeBel said. “The capacity to be able to regroup, get back on task, to be able to engage in learning is now compromised, because those educators have now interjected a whole new role for themselves.”
If students share their stories of restraint and seclusion with their peers, it can also lead to a general environment of mistrust in educators, LeBel said. Restraining or secluding students can also be traumatic for staff, she said.
Are restraint and seclusion equitable?
Restraint and seclusion are both used predominantly on students with disabilities and students of color, according to federal data.
Students with disabilities made up 80.2 percent of students subjected to physical restraint and 77.3 percent of students subjected to seclusion, despite making up only 13.2 percent of total students enrolled in public schools, according to national data from 2017 collected by the office for civil rights at the U.S. Department of Education.
Students with disabilities are impacted more by restraint and seclusion because schools or classrooms are sometimes not well designed to fit the needs of students with complex disabilities, said Erin Maguire, the special education director and director of equity and inclusion for the Essex Westford school district in Vermont.
“We have not figured out how to design environments to support students with really complex needs,” Maguire said. “And there are times where I think some of our environments are really triggering for children with complex developmental needs, and sometimes students who are being stressed by that circumstance can express themselves in ways that can be unsafe sometimes.”
Black students made up 33.9 percent of students subjected to physical restraint, and 34.5 percent of students subjected to seclusion, despite making up only 15.2 percent of students enrolled in public schools.
“There is a lack of equity and equality in how restraint and seclusion is practiced in school settings, and it is used to the detriment of youth of color, and youth who are disabled,” LeBel said. “We see disproportionality and bias in these practices.”
Why are restraint and seclusion used?
Restraint and seclusion should only be emergency or crisis responses, according to several state departments of education and school districts.
However, they continue to be used more commonly, according to the federal Education Department, although there’s no evidence the tactics work to deter the kinds of behavior they’re used to address.
Restraining and secluding students should not be treated as discipline to keep student behavior in check, but only in case of true emergencies to ensure student and staff safety, Jones and LeBel said.
“In my experience, the vast majority of these episodes could have been prevented and didn’t need to happen,” LeBel said.
Staff performing restraints and seclusion should be trained in how to safely deescalate situations that might prompt those tactics. But there are much more proactive steps districts should take that can prevent those kinds of situations in the first place, both experts said.
Some states, such as Vermont, require staff performing restraint and seclusion to be trained, but that is not a uniform federal mandate.
“Deescalation and crisis management are far too late. That’s after the kiddo has escalated, right before an emergency is going to happen,” Jones said.
What are alternatives to restraint and seclusion?
Assessing students’ behavior and putting proactive measures in place to prevent escalation is one of the best ways to prevent the use of restraint and seclusion, LeBel said.
If a student is dysregulated, can’t control their emotions, or spirals out of control quickly, it’s important to observe and understand what may be causing such behavior, she said.
“You want to understand the kind of conditions that can activate this kind of problematic circumstance. But the first thing that you can do to help prevent it is to assess it,” LeBel said. “The second thing you want to do is, then you want to engage the family and the child in solution building, to learn what helps them calm down.”
It can be important for school personnel to have information on students’ general well-being, including whether they’re sleeping and eating well, how they behave at home, and whether they are dealing with household trauma that might affect their behavior at school, she said.