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New York: Schools misuse seclusion/restraint on disabled students

Jan 29, 2023, Albany (NY) Times Union: NY students ‘deliberately inappropriately’ restrained 214 times in recent years, state says
Survey shows restraint and 'time-out' rooms used hundreds of times per month at some schools for students with disabilities
State investigators found staff at New York schools serving children with disabilities intentionally misused physical restraints on students dozens of times annually in recent years, records obtained by the Times Union show.
The Justice Center for the Protection of People with Special Needs, a state agency that investigates allegations of mistreatment, substantiated 214 such cases between 2016 and 2021. The center classifies these encounters as a form of abuse.
Michael Rozalski, a professor at SUNY Geneseo who studies restraint techniques, said those cases are likely the “tip of the iceberg.” He believes far more incidents of inappropriate restraint go undetected in schools.

Although physical restraints and similar techniques are described in state regulations as “emergency interventions,” data obtained by the Times Union show they have been used regularly — often multiple times per school day — by private and state-operated schools approved to serve students with significant intellectual, developmental or emotional disabilities.

In some cases, holding students in physical restraints or confining them in padded “time-out" rooms may be appropriate to prevent certain students from hurting themselves or others if they cannot be safely stopped through other means, Rozalski and other experts said. But data collected by the Justice Center and the State Education Department suggests that misuse and overuse of these last-resort methods happens in some schools.

"This is an issue the Board (of Regents) and Department are looking into," said Emily DeSantis, spokesperson for the Education Department. "We are having discussions internally and with the field."

Nationally, the interventions have generated controversy because students who are subjected to or witness the practices can suffer lasting emotional trauma. The use of restraint, time out rooms and a similar practice known as “seclusion” has caused thousands of injuries to children and teachers nationwide every year; in rare cases, students have died.

The six years of Education Department data shows some schools reported their staff physically restrained students and sent them to time-out rooms in hundreds or even more than 1,000 incidents per month in recent years, according to state records.

The department has been collecting this data for years, but never publicly released it. The Times Union is the first to report on its existence.

The data shows students subjected to the practices were restrained and put in time-out rooms repeatedly: four to eight times per month per student, on average. Some students experienced the interventions dozens of times a month. In a few cases, students were restrained more than 100 times per month.

Julie Keegan, director of protection and advocacy for people with intellectual and developmental disabilities at Disability Rights New York, said use of these methods is probably even more frequent than the survey shows.

“It is highly likely the surveys result in significant under-reporting,” Keegan said. “There is a notable absence of any action which would ensure accurate reporting, such as audits or collection and review of documentation. It is essentially a toothless data-collection mechanism that lacks any accountability whatsoever.”

Multiple schools said they were actively working to reduce use of these methods on students. 'Standard practice'

Due to the small number of schools who will educate students with more significant disabilities, some parents have had to accept that these methods as a regular part of their child’s classroom experience — even if they question why that’s the case.

Eight years ago, when Chuki Naylor toured private schools for students with disabilities in New York looking for a spot for her then 6-year-old son Donte Naylor, who has autism, she was told by staff at multiple schools that restraints were “standard practice,” she said.

Chuki Naylor (left) holds her son Donte Naylor (right), who has experienced many incidents of physical restraint at his private school for students with autism.

Since then, Donte has been restrained at school twice a month in “a good month” and weekly in “a bad month” at the Buffalo-area school he attends, Naylor said. Restraints are physical holds intended to immobilize someone to prevent harm to themselves or others, although in New York restraints to protect property or to deal with a student disrupting the school are also permitted by law.

Naylor said Donte has been confined in a time-out room once or twice at his school, which is run by Autism Services Inc. Time-out rooms are small rooms, sometimes with padded walls, where students may be confined alone until they calm down.

Since a restraint in August, Donte has been saying he doesn’t want to go to school — a new behavior for him, Naylor said. At the end of their drive to school each day, Naylor has to convince her son to go inside.

Naylor said she is consistently “baffled” why there is a need for using physical force on her son.

When he’s with his family, Donte has rarely needed physical intervention to calm down in other stimulating scenarios, Naylor said. He attends a loud Baptist church with his family regularly, participates in Boy Scout meetings and travels occasionally on planes.

Veronica Federiconi, CEO of Autism Services, said the school is working toward a “hands-off approach” as much as possible, but does on occasion use the techniques to prevent a student from hurting themselves or others.

Multiple schools said restraints and isolation in time-out rooms are sometimes needed to stop aggressive outbursts or self-injurious behavior. These private and state-operated residential and day schools often serve children with the most challenging behavioral and learning needs that preclude them from attending most public schools.

But Michael Krezmien, a professor and director of the Center for Youth Engagement at the University of Massachusetts Amherst, said it is “extraordinary” how often some schools use what are considered to be last-resort methods.

“I would take that as a cause for concern,” he said.

Krezmien said these specialized schools serving students with intensive disabilities are supposed to have highly trained staff who can meet their needs while minimizing use of emergency interventions….

State officials said they review the survey data and may give schools guidance on using the interventions or positive alternative methods.

"In partnership with the other members of the Developmental Disabilities Planning Council’s interagency workgroup, the (Education) Department works to limit, to the greatest extent possible, the use of physical interventions as a means of managing behaviors," DeSantis said…

“These students, many of whom are non-verbal or struggle with communication, are very vulnerable," Keegan said. "Therefore, all information about the institution’s use of restraints is highly relevant, and depriving families of that information is callous and offensive.”

The department collects no data on the use of restraint or time-out rooms in public schools, unlike 38 other states.

Washington Avenue entrance to the State Education Building on Tuesday, Sept. 20, 2022, in Albany, N.Y.Will Waldron/Times Union

However, in response to a national investigation by the Times Union into how the practices are widely used in some public schools, New York lawmakers said they would examine changing the law and expanding data collection efforts. New York’s Education Commissioner and Chancellor of the Board of Regents have declined interviews on the subject.

The department recently issued updated guidance clarifying how time-out rooms can be used in schools.

'Deliberate inappropriate'

At some schools for students with disabilities, restraints are intentionally misused by staff, investigators have determined….

The survey In 2009, after the U.S Government Accountability Office identified “hundreds of cases of alleged abuse and death related to the use of these methods on school children” — including some in New York — the Education Department asked some schools serving students with disabilities to report for the first time how often they used restraints and time-out rooms.

But the department said it no longer has copies of that survey because its records retention policy does not require it to keep older documents.

After 2009, the department did not conduct another such survey until 2015. Over time, the state expanded the survey to add day schools as well as residential schools, department records show.

Kimberly Berg, a program planner at the New York State Developmental Disabilities Planning Council who coordinates a state interagency group on restraint and seclusion, said she hopes to see data collection efforts expand further.

“There is ample room for expansion and ample opportunity,” Berg said. “That would be the ultimate goal.”

In recent years, schools like the Wildwood School in Schenectady and Latham, Summit Academy in the Buffalo area, the Center for Discovery in Sullivan County, Mary Cariola Children’s Center in Rochester and the Judge Rotenberg Educational Center in Massachusetts have reported some of the highest use of these methods. (Out-of-state schools, where some students who live in New York are placed, report data on just their New York students.)

Some schools said their incident counts might seem high because they typically had multiple short-duration restraints within one incident as they try to release students as quickly as possible. …

One student at the residential school was physically restrained 303 times in June 2019, survey data shows.

“We have a long history of effectively treating clinically intense students who have not been treated successfully elsewhere and who cannot be served in public schools or other specialized settings,” said Julia Burgess, a spokeswoman for the institute. “We work to decrease their aggressive and self-injurious behaviors, and improve their lives and the lives of their families. ... The overwhelming percentage of the time, we are able to intervene successfully and move on.”

George Willis, of Trumbull, Conn., said his 16-year-old son Joe Joe started living at the May Institute in 2019 because his acute autism meant he often engaged in dangerous, self-injurious behavior and the family and his local school struggled to keep him safe.

Willis said he is often notified — usually about once a month, sometimes more often — that the May Center used physical restraints on Joe Joe. Willis believes these methods are needed to prevent Joe Joe from injuring himself, the staff and his peers.

Before he received intensive treatment, Joe Joe was exhibiting aggressive behaviors more than 600 times a day, including slamming his body against the floor or smashing his head through windows. He was constantly covered in bruises, Willis recalled.

Now "he is practically mark-free,” Willis said. “We love the way they take care of him.”

In recent years, between a quarter and half of the schools surveyed reported never using physical escorts, restraints or time-out rooms for emergency response in the previous three-month period. The Education Department defines a physical escort as “physically touching or holding a student in order to move the student from one location to another.”

Most schools saw a reduction in use of emergency interventions in the spring of 2021; at some schools, students did virtual learning at home in those months.

At Wildwood School, emergency interventions increased by 43 percent from 2019 to 2021, data shows.

“When they are engaging in self-harming behavior or behavior that will harm a fellow student or staff (member), it is important to intervene and prevent that in the safest way possible,"

said Wildwood Spokesman Tom Schreck. "It is also important that the interventions utilized are the safest both physically and emotionally for the student.”

Schreck said the school has been working with a consultant to improve behavioral assessments and treatments for students.

Alternative approaches

The Summit Center in the Buffalo area tried for years to reduce its reliance on restraints and time-out rooms with limited success.

In 2018 and 2019, the center reported using emergency interventions more often than any other school in the survey.

At Summit Academy on Stahl Road in Amherst, staff members used the interventions 2,297 times from April to June 2018 on about 30 students. The next spring, employees used these techniques almost twice as frequently, survey data indicates.

A small portion of the school’s 180 students experienced these methods, but for the 39 students who were subjected to them in June 2019, on average they faced interventions 44 times a month — meaning multiple times per school day.

Another Summit Academy location also had some of the highest use of restraints and time-out rooms reported in the state.

But in 2018 and 2019, the center began slowly rolling out an alternative method that involves the use of blocking pads. In 2021, use of emergency interventions dropped significantly,

survey data shows. The center’s CEO Stephen Anderson credits the implementation of the technique, called Ukeru, for producing “the most dramatic results.”

“We sometimes have to clear entire classrooms of all the other kids in order to implement Ukeru,” Anderson said. “We all feel emotionally better about it, but it’s still not a perfect solution. The perfect solution is building competing skills so these kids don’t need their acting-out behavior to accomplish whatever they’re trying to accomplish.”

At two nearby Autism Services schools, staff began training in Ukeru methods in 2016, said Federiconi, the CEO.

Back then, they had hundreds of emergency interventions per month and more than $700,000 per year in worker’s compensation costs due to related injuries, Federiconi said.

After implementing Ukeru, their schools have a few dozen incidents a month and far fewer injuries. She said their goal is to get to a point where even Ukeru’s blocking pads are not needed in the classrooms.

The Center for Discovery in Sullivan County, another residential school that reported higher usage of emergency interventions, is being paid by the state to publish a website of advisory materials on reducing use of emergency interventions.

School programs run by the Center for Discovery reported the use of 1,932 physical escorts and restraints in April, May and June of 2018 and 1,745 interventions in the same period in 2019, survey data shows. But in 2021, escorts and restraints dropped to 379.

Spokesman Michael Rosen said the Center had been over-reporting incidents in the survey, using definitions that were too broad; administrators have since worked with the Education Department to revise their data. The center does not use time-out rooms, he said.


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