No Harm Done? Think Again

No Harm Done? Think Again

Seclusion and restraint are dangerous practices, sometimes leading to serious injury and even death, especially when children are involved. When no one is hurt during these interventions, it might be tempting to breathe a sigh of relief, and to accept them as a risky but necessary way of modifying children’s unacceptable behavior.

Tempting, but wrong.  The act of forcibly isolating or restraining a child is, almost by definition, a violent act. Whether or not the scars are immediately visible, someone is hurt each and every time these interventions are used.  Most experts agree that these interventions cause psychological harm, especially for children who were previously victims of trauma or abuse. Some children have been diagnosed with post-traumatic stress disorder following seclusion and restraint episodes, while others have shared their feelings of desperation and even attempted suicide while isolated. After the event, children who have been restrained have reported nightmares, anxiety, and mistrust of adults in authority. Children who were secluded report experiencing feelings of anger, depression, humiliation, despair, and delusion.

Although there is little research specifically about the effects of seclusion and restraint on witnesses to these actions, there is plenty of evidence to demonstrate that children who witness violence suffer psychological harm that can lead to negative behavioral and physical outcomes lasting even into adulthood. For example, the Adverse Childhood Events (ACE) study tracked 17,000 adults to better understand the consequences of childhood trauma. This study found that witnessing violence in one’s home may place children at higher risk for developing a mental illness, substance use disorder, and even some chronic health conditions such as heart and liver diseases.

But are these interventions necessary to help children learn appropriate behaviors?  The answer is no; seclusion and restraint have not been found to be effective either in supporting positive behavior or reducing negative behaviors. A new report by the U.S. Senate Committee on Health, Education, Labor, and Pensions summarized the research: “There is no evidence that physically restraining or putting children in unsupervised seclusion in the K-12 school system provides any educational or therapeutic benefit to a child.”

In fact, while there is no evidence to support the efficacy of these dangerous, risky interventions, there is plenty of evidence to support effective alternatives. The Senate report notes that positive behavioral interventions and supports (PBIS) are “proven to reduce disciplinary incidents, increase a school’s sense of safety, and support improved academic outcomes for all students.” One school in Pennsylvania serving children with significant behavioral challenges reported using PBIS to reduce the use of seclusion and restraint from about 1,000 per year in 1998 to only three incidents in 2012.

Bottom Line: Interventions that are physically and psychologically dangerous to children and that provide no proven benefit have no place in our schools.

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