The roundtable discussion was organized in response to a February report by the state Office of the Child Advocate (OCA) that raised “significant concern” about the frequency with which young children with autism and other disabilities are restrained or secluded in Connecticut schools.

In each of the last three years, the state Department of Education has reported about 30,000 incidents of restraints or seclusion, with autistic students the most frequently subjected to the practices. More than 1,300 children have been injured while restrained or isolated. Research has shown that the techniques can be traumatizing to children, with no evidence that they have therapeutic value, the OCA report says.

On Friday, leaders of the legislature’s Committee on Children reported that a bill was being finalized that includes several provisions aimed at reducing restraints and seclusion, among them: allowing the use of seclusion only in emergencies, not as a regular part of a child’s educational plan; barring prone restraint; limiting instances of restraint and seclusion to 15 minutes, unless an administrator approves an extension; and requiring school staff to meet in any cases where a child is restrained or isolated four or more times within 20 school days.

Murphy told the group that while some students may need to be removed from a classroom for disruptive behavior, he is opposed to secluding children in locked or isolated settings.

“There are appropriate interventions to remove a child from a space and give them time to calm down,” he said, adding, “That’s very different than locking a child up.”

Earlier this month, the U.S. Senate Health, Education, Labor, and Pensions Committee passed an amendment introduced by Murphy that would require states to establish policies to prevent the unnecessary use of seclusion and restraint for disciplinary purposes in schools. The amendment will be included in the revised 2015 version of the Elementary and Secondary Education Act, Murphy said.

Connecticut state law now allows for the use of restraints and seclusion in emergencies that pose imminent danger to a student or others. But it also allows for special education students to be placed in seclusion if their individualized education programs (IEP) provide for such placement — a provision that some child advocates say is overly broad.

State Education Commissioner Dianna Wentzel said her department, working with the University of Connecticut Neag School of Education, had increased training to school staff on positive behavioral interventions and supports — an alternative to restraints and seclusion. She said that while data collected by the department on incidents of seclusions and restraints was “really troubling,” the discomfort it stirs “will create movement in this area.”

Murphy and Child Advocate Sarah Eagan said the use of restraints and seclusion is a symptom of a larger problem: that schools are not properly resourced to deal with students with complex behavioral problems and communication deficits.

“We hear a pushback that some kids need to be restrained and secluded, and usually, these are children with disabilities,” Eagan said. She said giving school staff adequate training in alternatives to manage autism and other developmental disorders is critical to changing that way of thinking.

An elementary school student was put into seclusion after “swinging her coat at staff.”

These are among hundreds of incidents — deemed “emergencies” by school personnel — that warranted restraining and isolating pre-school and elementary school students in Connecticut last year. A new report by the state Office of the Child Advocate (OCA) raises “significant concern” regarding the frequency with which young children with autism and other disabilities are restrained or secluded; lapses in documentation or actual compliance with state laws; and the prevalence of “unidentified and unmet educational needs for children subject to forceful or isolative measures.”

Office of the Child Advocate

A report in a student file

The OCA report, released Wednesday, reviewed records of restraints and seclusions for 70 students at seven public schools and special education programs around the state, including Hartford and Fairfield County. Those students, chosen randomly, were restrained 1, 065 times and placed in seclusion 703 times. In a number of cases, the report found, there was no documentation showing that the children had received requisite behavioral evaluations, or that educators had monitored and reviewed cases of repeated seclusions, as required.

Underlying the findings is a larger concern that students subject to restraints and seclusion are not receiving adequate support — for example, intensive language, processing, sensory or cognitive interventions — for their social and behavioral problems.

“Restraint and seclusion are symptoms of a larger challenge – helping our providers, with training and resources, to find ways to meet the needs of children with special needs,” said state child advocate Sarah Eagan, who prepared the report in consultation with special education experts.

Under existing state law, children may be restrained only in emergencies, where they pose a risk of imminent harm to themselves or others. Seclusion—defined as confinement in a room, as opposed to a therapeutic “time-out” — may be used not only in emergencies but also as a planned intervention that is specified in a child’s educational plan.

In each of the last three years, the state Department of Education has reported about 30,000 incidents of restraints or seclusion, with autistic students the most frequently subjected to the practices. More than 1,300 children have been injured while restrained or isolated, some of them seriously. Research has shown that the techniques can be traumatizing to children, with no evidence that they have therapeutic value, the OCA report says.

The new review raises concerns that providers are broadly applying the “emergency” label, without documentation to back up that rationale or to show that they tried other interventions. It also found that, among children whose educational plans allowed seclusion, the technique was being used for minor incidents, without adequate reporting or review.

Among the cases cited in the report was a 9-year-old student with autism who was confined after he “refused to say ‘hello’” to a visitor who entered the classroom, and then “did so with vocal gestural protest.” In another case, a student who was playing a board game with his classmates was placed in seclusion after he “lost the game, but continually repeated ‘I won,’ with vocal/gestural protest.”

A fourth-grade boy diagnosed with autism was repeatedly placed in closed-door seclusion for “dysregulated” behavior, even though he engaged in suicidal gestures while in isolation. “Tied sock around neck” and “Threatening self: ‘I want to die’” are among the notes in his file.

Office of the Child Advocate

A room used for seclusion.

The report found wide inconsistencies in how schools and education programs handle restraint and seclusion. Even the spaces where children were secluded or confined varied widely – from padded rooms to storage and utility closets.

State and federal rules require that children whose behavior interferes with their ability to learn receive a formal behavioral assessment and intervention plan. But the report found no such records for 19 of the 70 children and inadequate records for others.

The review found that for many children with emotional or developmental disorders, educational plans lacked appropriate supports or services – leading to an “over-reliance” on restraint and seclusion. Part of the remedy is to offer teachers and administrators more training and resources to identify and address young children’s “social-emotional and functional communication development,” OCA said.

“Teachers, administrators, and related providers must have access to the tools they need to assist children at the youngest ages, provide guidance to families, and coordinate care with other agencies and community providers,” the report says.

The report comes two years after Connecticut formed an interagency task force focused on reducing restraint and seclusion. The state Department of Education compiles data from districts on the use of restraints and seclusion, but has “too few resources (though ample will) to investigate and monitor schools’ actual compliance with the law or best practices,” according to OCA.

The report makes 14 recommendations, which Eagan said she was assembling into a legislative proposal. In addition to requiring training for staff to reduce reliance on restraints and seclusion, the proposal calls for a statewide policy requiring any school district or program that uses restraints or seclusion to show evidence that it is using “evidence-based strategies for positive behavioral supports.”

The proposal also calls for: prohibiting the use of seclusion except for emergencies; banning the use of prone or face-down restraints and restricting the use of mechanical restraints; requiring a child’s education team to convene if a student has been restrained or secluded more than twice in a 30-day period; requiring school or program leadership to review restraint and seclusion data on a monthly basis; and establishing a special unit within the Department of Education, as well as a best practices committee, to monitor and reduce use of restraints and seclusion.

State education department spokeswoman Kelly Donnelly said Wednesday that education officials “share the Child Advocate’s concerns and would like to see the numbers reduced, as well.” She said the department “actively promotes and offers trainings on proven preventions and interventions to de-escalate behaviors before it reaches an emergency situation,” and is an active member of the interagency effort to reduce restraints and seclusion.

In a December report on seclusions and restraints in the 2013-14 school year, the state education department said it had provided professional development training to “multiple audiences” in regulations for using restraints and seclusion and interventions to reduce their use. The department also said it was using data to identify districts that needed additional guidance and training in positive behavioral interventions.

Office of the Child Advocate

Chart on seclusions and restraints compiled by the education department.

A total of 35,892 incidents of restraint or seclusion were reported by schools in 2013-14, an increase of 6.4 percent over 2012-13. Nearly 85 percent of the incidents were deemed “emergency” interventions, with a decline in the number of restraints and seclusions lasting more than five minutes. There were 370 injuries reported, nine of them serious – six during an emergency restraint and three during an emergency seclusion.

To read the full report click here.

The report from the state Department of Education shows that autism was the primary disability among special education students subject to “emergency” restraint or seclusion, with 40.4 percent of all such incidents involving a child with autism. Autism also accounted for nearly half of all cases in which children were put in seclusion as part of their individualized education plans, or IEPs.

Jordan Harrison Graphic

The report shows a slight decline from the previous year in the overall number of students restrained or secluded, and a drop in reports of injuries – from 840 in 2011-12, to 378 last year. But the number of serious injuries rose from eight to 10, and more than 900 reported episodes of seclusion or restraint lasted more than an hour.

“This is just so disheartening,” said Shannon Knall of Simsbury, policy chair of the Connecticut chapter of Autism Speaks, an advocacy group. She blamed the high incidence of children being restrained and secluded on “a tremendous lack of training” of teachers and school staff in alternative interventions.

“The numbers of children with autism are skyrocketing, and I think our school districts are just overwhelmed,” she said. “The people on the front lines need training and tools” in alternative behavior management. “If you only give someone a hammer and a nail, that’s all they’re going to use.”

This is the second year that the state Department of Education has compiled data on restraints and seclusions submitted by schools. While the education department has no specific strategy to reduce those practices, the report says that the “continued examination” of the data will inform “technical assistance and trainings” that promote the use of positive interventions and reduce reliance on restraint and seclusion.

The release of the report comes as a coalition of eight state agencies, including the Office of the Child Advocate and Office of Protection and Advocacy for Persons with Disabilities, begins a public education campaign to reduce the unnecessary use of restraints and seclusion in schools. The education department is a partner in that effort.

Sarah Eagan, the state’s child advocate, said the new report illustrates that the use of physical restraint and seclusion is still common in schools, especially among young children with developmental disabilities. About half of all the 2012-13 incidents involved special education students in grades five and below, with about 180 incidents involving children in kindergarten and pre-K.

“What this highlights is that ultimately, the practices are widespread,” Eagan said. “What we have to remember is that the use of restraints and seclusion [for behavior management] has no research to support it. We’re really going to have to support schools and teachers with resources and tools so they can find a better way” to de-escalate problem behaviors.

A seclusion room for children with emotional/behavioral problems.

Connecticut state law allows for the use of restraints and seclusion in emergencies that pose imminent danger to a student or others. It also allows for special education students to be put in seclusion if their IEPs provide for such measures – a provision that some child advocates say is overly broad.

Schools reported that the majority of restraints and seclusions – 71 percent — were in response to emergency risk of harm, with the remaining 7,741 seclusions done in accordance with an IEP. In many cases, individual children were restrained and secluded multiple times throughout the year. Forty students were physically restrained or secluded more than 100 times — and 11 of them were subject to those practices 300 to 900 times during the year, the report shows.

Eagan noted that the U.S. Department of Education issued a “resource document” to schools in 2012 that discourages the use of physical restraints or seclusion except in extreme situations where a child’s behavior poses imminent danger of serious harm to self or others. But there is no federal law restricting the practices.

Data in the new state report shows the majority of restraints and seclusions lasted 20 minutes or less. However, 30 emergency restraints and 119 seclusions lasted more than two hours.

Farm Hill Elementary School

Reporting by individual school districts and programs varied widely, with some smaller programs reporting hundreds of incidents, and some large districts reporting a handful. Hartford schools reported no incidents, Bridgeport reported 28, and New Haven reported 54.

Education department officials said they were following up with districts that reported very low numbers.

Eagan said that, on the flip side, some programs may be diligently reporting “every time they put hands on a student,” boosting their numbers.

Among districts reporting the highest number of restraints and seclusions were: East Hartford, with 1,644 cases involving 165 special education students; Darien, with 895 incidents involving 10 students; Vernon, with 357 incidents involving 24 students; and Windsor, with 298 incidents involving 19 students.

High numbers were reported by many state-approved private special education programs and regional education centers, including: CREC, with 3,860 cases involving 89 students; Benhaven School in Wallingford, which serves children with autism, with 2,162 incidents involving 30 students; and the Connecticut Center for Child Development in Milford, which also specializes in autism, with 3,183 cases involving 35 students.

The co-chairs of the legislature’s Committee on Children, Sen. Dante Bartolomeo and Rep. Diana Urban, both expressed concerns about the unnecessary use of restraints and seclusion at a recent forum on the issue convened by the Office of the Child Advocate and the Office of Protection and Advocacy. Last year, leaders of those two agencies called for an end to the use of restraints and seclusion as behavioral interventions in schools, as they investigated the controversial use of “scream rooms” at the Farm Hill Elementary School in Middletown.

The report indicates that black and Hispanic children are more likely to be restrained and secluded than white students. Fifty-seven percent of students who were restrained or secluded were members of minority groups, while the majority of special education students statewide are white.

Read the full report below.