The Bizarro World

The Bizarro World originally appeared back in the late 50's in Superman comics. It described the world where the fictional character Bizarro, Superman's polar opposite, lived. In the Bizarro World of Htrae (Earth spelled backwards) everything is the complete opposite of what happens here on Earth. Any Seinfeld fan would also remember this concept, as it was reintroduced in a 1996 series when Elaine met a group of new friends that were the polar opposites of the Seinfeld characters. These bizarro characters were kind, considerate, law abiding, and wonderful citizens looking out for the common good of everyone. They were not selfish, shortsighted or hyper focused on themselves, as the Seinfeld characters often appeared.

The Bizarro World came crashing into my memory as I followed the school district's public comments over the last week or so. I realized that our administrators must be living in their own little Bizarro World!

First let's describe the characters in this Bizarro World. Our Superintendent and Board of Ed President have described Israela Franklin, Director of Special Education as, "a successful, experienced, dedicated and caring professional and a very important part of our district's leadership team." They went on to state in this Bizarro Letter (available by clicking here) that they have confidence in her abilities and skills and view her considerable experience to be a great asset to Cherry Hill. They have also stated, "It would be a considerable loss to our district if Mrs. Franklin decided to leave for any reason." Keep in mind, the Bizarro World is the exact opposite of reality!

On 11/29/07 our school district decided to publish some sort of Fact Sheet on their website. Ironically, they titled this, "Separating Fact From Fiction." Remember in Bizarro World, things are the complete opposite! So what this translates to on Earth is: "Co-mingling Fantasy with Fact." The comments from the school district appear in red below.

"On Tuesday, the media devoted significant attention to an issue that has been referred to by others as the “quiet room” at one of our elementary schools. "
Here on Earth, it was actually the school district that opted to refer to this as a "quiet room." Parents called it exactly what it was, a padded closet. Some parents even referred to this as a padded cell! In any event, it was a closet and not a room at all!

Here is a picture of the actual padded closet that our bizarro administrators are calling a Quiet Room:

Here is an idea of what our bizarro administrators are describing:

The photo pictured above is an actual Quiet Room located in another school district that a reader past on to me. Notice that the room is more cheerful and actually contains seating (beanbag chairs) educational materials (books). The room can also be used for small group instruction and even as a reward for some children.

Although in Bizarro World, parents may be against the use of Quiet Rooms; here on Earth, most parents are accepting of this practice when it is used in a positive fashion, by a highly qualified teacher, that is specifically trained in the use of positive interventions. In fact, here on Earth, I have stated repeatedly that a quiet room was used for my own son as a positive intervention. It was used under the direction of a highly qualified and well trained teacher that realized it would be advantageous to alleviate sensory overload, a common source of behavioral meltdowns. Quiet Rooms are not a problem when used appropriately and no parent in Cherry Hill ever stated that they were a problem. It is when our Bizarro Administrators manipulate the purpose and want to use closets in place of rooms and then want to use them for the opposite meaning -- as an aversive, that this becomes problematic.

Referring to what we know was a padded closet, the Bizarro School District has stated: "This issue was addressed and resolved more than a month ago."

This is absolutely not true! Had the issues been resolved, or even discussed with any degree of honesty by school leaders, this would not have received the media attention that it did. Parents want answers because these are important issues that impact our children. But make no mistake, the problems go far beyond the padded closet. Parents are upset about the cuts in the special education budget that have impacted programs, services, therapies and support services that our special needs children require. The use of a padded closet was just the tipping point! Parents are also very concerned with the level of competency when it comes to our special education leadership. In just about every public statement made by our administrators, it has become more apparent that they do not understand the nature of the disorders for which these children suffer.

Our Bizarro Administrators have referred to this padded closet as an area used for "small group instruction."

Obviously, no one is going to believe that! There was no desk, no chair, improper lighting and absolutely no educational material to be found in this padded closet! It was in violation of the state's requirements to qualify as an instructional area, did not meet building codes to even be considered a room; and certainly would have violated our fire codes! Also, we have resource rooms in most of the schools and other areas that are slightly more acceptable for "small group instruction."

In addition, the school district has stated: "The space was created this fall by a team, which included building staff and a parent, for a very specific case related to student safety. The room was used one time this year in a crisis situation, with prior parental consent and with supervision. There was follow-up notification to the parent immediately following the crisis situation."

In direct contrast, the school principal has admitted that this closet was in place last year and was used on at least one occasion last year. The gym mats may have been a recent addition, but the closet was used previously. Parents are not interested in the "one" occasion that the district claims it was used this year. If the parent gave consent, than that was between the parent and the school district.

The school district has also stated that "the room was never used for punishment or disciplinary measures." Okay, in their own example, a child was having a meltdown, was in a crisis situation and the child was placed in this closet. (with or without a staff member is almost irrelevant.) This was a disciplinary measure! Not knowing the details of the situation a reasonable person could still come to the conclusion that if the child had been compliant, had followed staff instructions, had not acted out or had not reached this level, s/he would have never been taken to this closet. Therefore it was a form of punishment and/or discipline. It was clearly a response to the child's behavior, which makes it retaliatory and punitive.

To say that any child would go from typical and acceptable behavior to a crisis -- leaves out a great deal of information. Having more experience than I really wanted with an explosive child, I can tell you first hand that a child does not go from typical behavior to explosive behavior for no reason at all. Something triggers it. Something that usually involves the non-existence of positive interventions, a poorly written or poorly executed Behavioral Intervention Plan, or an IEP that was not focused on the child's skill deficits. I do not know the child to which the district is referring (and find it appalling that they even mentioned this other situation) but I would venture to say that this situation was avoidable had the school district provided appropriate support services and positive interventions.

Our Bizarro School Officials have also stated: "The room was dismantled more than a month ago. Following a Cherry Hill Special Education PTA meeting in October, district administrators directed that the gym mats be removed from the room and that the building principal attempt to identify a larger, more appropriate space. "

Administrators were aware of the padded closet before it was brought out at the SEPTA Parent Forum. Our Special Education Director must review IEPs and a copy is kept on file in the district's special education office. So it is a fact that they were previously aware of this room! They even went as far as defending the use of this padded closet at the SEPTA Parent Forum in a room filled with about 50 parents, including the President of the Board of Education. Referring to the padded closet when parents raised this concern, Mrs. Franklin admitted that "these areas are in other schools and that principals are actively seeking space in their buildings to set up more areas like this one." So why did they suddenly order that the closet be dismantled? Because it was brought to the attention of the general public and was widely criticized! If the parents that spoke about this at the Parent Forum had not raised the issue, the padded closet would still be there and would still be in use!

At the same SEPTA meeting Mr. Gallagher stated, "Sometimes this room is necessary when children are having meltdowns. These are children that would have normally required helmets years ago." That is a clear indication of the fact that society has evolved enough to recognize the dangers of seclusion and aversive techniques, while our current administration has their head in the sand!

The school district has also stated the following in their public comment: "There does exist, in any school, the periodic need to move a student to another place for small group or individual instruction/support."

We have already established that this padded closet was not conducive for "small group instruction" because it did not meet even the most basic requirements. Look at those pictures again! This was not used for students having a good day that just needed small group instruction. It was used for students having a horrific day that our administrators decided to make worse by the use of a padded closet! These children were having meltdowns as a result of sensory overload or skill deficits.

"Children may need more time in a quiet environment to complete a test in accordance with their IEP or 504 accommodations."
This was not an area used for testing. Remember, no desk, no chair, inappropriate lighting!

"Children may have behavior plans that allow them to move to another room to enjoy a reward for staying on task."
If we are "rewarding" children by placing them in a padded closet -- we clearly have a problem! "Wow Johnny, great job. Here's your reward -- Go bang your head against the wall in the padded closet!" C'mom folks, is anyone buying that this was a reward!

"A student may be exhibiting signs of escalating anxiety, at which time the teacher and/or assistant accompany the student to another room to engage the student in private conversation about how to re-enter the classroom and become re-engaged in the general activities."
Are we expected to believe that placing a child in a padded closet, against their will, will somehow reduce anxiety? Would any child be capable of engaging in a reasonable conversation with a staff member if they are being held against their will in a padded closet?

"A small reading group may use the space to obtain extra help."
Are we now describing this padded closet as a potential resource room? There was barely enough room for one student and one staff member in this closet! How would you accommodate a small reading group? Also, I do not think that a flickering overhead fluorescent light would be a good choice for a reading room! There was no educational value involved in the use of this padded closet, no matter what kind of spin they are putting on this!

"These and other examples are tied to situations unique to certain programs and to students in the context of these programs. "
Ah, finally an answer! Since other children were involved in this program the padded closet may have been utilized for these other children. If they are stating it was part of the program -- then parents have every right to raise concerns!

"Parent consent is in the form of parent participation in meetings with IEP teams... as they outline and discuss plans for students' programs case by case."
Interesting that they have mentioned the very IEP meetings where parents have tried to address the need for the Functional Behavioral Assessments and positive interventions that the the district needs to implement. And there in lies the problem! IEP teams are making decisions based on what suits the school districts budget and not on what meets the child's needs.
Did you ever attempt to get a needed program or support put in place? Case Managers are being micro-managed by this administration and deny critical services on a regular basis. It is obviously a lot less expensive to bolt gym mats to the walls of a closet than it is to provide the required programs and support services that could truly help the child make progress!

Here are some other interesting comments from our Bizarro Administrators:
"Individual or small group instruction may occur in the principal's office, the guidance office, the nurse's office, the library, or in another space."
So again, why the padded closet? If we have all of these spaces available, why are they stating that this closet was necessary for small group instruction?

"Any space in any of our schools now used for individual or small group support or instruction meets the criteria for an instructional area (e.g., minimum size, ventilation, floor covering, lighting). "
Sounds like a bit of double talk to me. Perhaps the legitimate spaces used meet the requirements for an instructional area -- but if the padded closet was used, as they stated "for small group instruction" then it was a violation of those criteria.

"The district already uses positive behavioral approaches in designing behavior plans for students." Hmm, the term "positive" seems to be subjective these days! I guess in Bizarro World, where things mean the opposite -- seclusion and physical restraint are positive interventions.

There is an interesting letter that appeared on the school district's website dated December 3rd that has been signed by both David Campbell, Superintendent and Anne Einhorn, BOE President. The letter clearly states that: "the room did not meet the criteria for small group instructional space." However, in the previous statements made by administrators they claimed it was used for small group instruction!

The letter goes on to state, "Upon learning of its existence District Director of Special Education Israela Franklin and Assistant Superintendent James Gallagher immediately directed the building principal to dismantle the room and attempt to identify a larger more appropriate space. That was accomplished."

That is not at all what happened! I was at this meeting and clearly heard Mrs. Franklin and Mr. Gallagher defending this padded closet and pointing out that there were others being set up throughout the district. Mrs. Einhorn was at the meeting too, and heard the very same comments!

This letter was written to support our Bizarro Director of Special Education in that it states, "We would like to affirm our support of Mrs. Franklin ... she is a very important part of the district's leadership team."

I have contacted our BOE members to learn of their view on these issues. I also contacted Mrs. Einhorn. Her response was rather interesting. Mrs. Einhorn has stated, "The board of education asked the director of special education last December to evaluate our district program for special education and focus on the board of educations own board goal in the evaluation process. That board goal is: "Review special education programs to ensure that every child's needs are met in accordance with the Individual Educational Program (IEP) and in compliance with state mandated program requirements". Our special education director is still evaluating our district on behalf of the board of education."

It appears that we are asking the rat to guard the cheese! Only in Bizarro World!

*Originally published in the Courier Post, Autism Blog, Kathi Magee: On Autism 12/04/07.

Best Practices in Behavior Management

Many have emailed me personally about the Best Practice Guidelines from the Children's Welfare League of America (CWLA). Some inquired as to how they came about, others asked for the specific guidelines and why Cherry Hill does not follow them.

Let me begin by explaining how the CWLA came to their conclusions on what is considered "Best Practice." The CWLA was a participant in the Children's Health Act of 2000. They also wrote the Best Practice Guidelines for Behavior Management. Through their acquired experience they became all too familiar with the dangers associated with restraining special needs children, as many had incurred significant injuries and in some cases children actually died from the use of physical restraint. The CWLA was also familiar with the psychological impact that restraint and seclusion had on special needs children. These children became more anxious, and their behaviors worsened when secluded. After several years of writing and re-writing their guidelines on restraint and seclusion, the CWLA came to realize that the bigger problem was that restraint and seclusion could not possibly be part of any "Best Practice" approach. These techniques needed to be prevented and eliminated as much as possible. Restraint and seclusion serve no educational value and these practices injure and in some cases led to the death of special needs children.

The CWLA was also aware that training alone was not enough to reduce restraint and seclusion. Although staff training is a key aspect, many times the core leadership, needs to be changed in order to facilitate the culture change necessary to eliminate the need for restraint and seclusion. "To truly reduce, if not eliminate these aversive techniques, it would require a change in leadership and a change in the organizational culture." (quote from the CWLA's report on preventing and reducing the use of restraint and seclusion.)

After numerous revisions of their Best Practice Guidelines, by September 2003 they changed the name of the grant to Best Practices in Behavior Support and Intervention: Preventing and Reducing the Use of Restraint and Seclusion.

The five goals for the Best Practices in Behavior Support and Intervention are:
1. Staff will use restraint and seclusion in emergency situations only when absolutely necessary to maintain the safety of themselves, [students], and others.
2. Eliminate the unnecessary use of restraint and seclusion.
3. Reduce the risk of deaths.
4. Reduce injuries among [children] and staff.
5. Reduce the duration of restraint and seclusion.
6. Increase debriefing with children, family members, and staff.

*Please note: As these goals were written to include children in residential facilities, I have substituted the word "resident" with the word "student" or "children" as necessary.

The CWLA strongly recommends the establishment of an Oversight Committee to monitor the reduction of such aversive techniques. The committee should include executive leadership (administrators), supervisors, staff members (teachers and aides), advocates and parents. The sole focus of the oversight committee is to monitor the campaign to reduce the use of restraint and seclusion.

• The committee must be empowered to implement changes (NETI, 2003).
• It should ensure that an executive team leader is on-call and that staff immediately report every incident of restraint and seclusion to him or her.
• The committee should carefully review every physical intervention incident, take responsibility for recommending any program or policy revisions based on incident review, and make sure that staff members are receiving the necessary resources to realize the committee's mission (Abrams, 2001).

The CWLA strongly believes that every time physical interventions become necessary it is an indication that the child's program has failed.

How can this help our special needs children in Cherry Hill?
First, we as a community must come to the realization that the Best Practice Guidelines must be adhered to in educating our special needs population. This will help both our special needs population as well as our typical students. It will also provide for training of our teachers and aides that are working with our children on a daily basis.

I think we can all agree that aversive techniques do not "teach" our children the skills to maintain themselves in a socially appropriate manner. Restraint and seclusion do not foster a child's development and do not serve any educational value.

Teaching the appropriate skills so that children can regulate their own behavior and focusing on the positive interventions for behavior modification should be the standard approach in our school district. It also happens to be the law. Any school administrator that does not comprehend this essential concept in behavior management should not be a school administrator.

Moving Forward:
Many parents have voiced their concerns about the use of physical restraint and seclusion as it applies to our special needs children. The blog that focused on this topic has continued to receive reader comments, which are now in excess of 130! While I am reasonably sure that the Board of Education continues to follow this blog, I think it may be important for parents to address the BOE about this topic during the next BOE meeting (Tuesday 11/27/07, 7:00 PM at Clara Barton Elementary School).

I think the BOE needs to hear from parents, as it pertains to the concerns regarding restraint and seclusion practices. Our BOE should also be made "officially" aware of the fact that parents have tried to follow the Chain of Command in resolving this critical issue. The fact that administrators, including our Superintendent, refused to address the matter with parents, does not mean that parents did not attempt to follow the Chain of Command. We have been given the usual runaround and parents need to advise the BOE of this.

If you are a parent that has tried to follow the Chain of Command, only to be referred back to the first link - it is important that you let the BOE know this. It is my understanding that our administrators position is that they have not received any complaints about this situation.

It is highly possible that the BOE was given a watered down version of this padded closet and it's uses. It may be important for the BOE to hear the other side of this issue and learn more about this padded closet and the detrimental impact it could have on our children.

It has become apparent that many have lost faith in our current school administration. The fact that our administrator's even allowed this padded closet to be constructed, let alone defended its' use, is grounds for any parent to question the morals and integrity of our administrators. To add insult to injury, many were denied access to administrators when we had questions about this matter. Also, some of the comments that were left on the two prior blogs, presumably from administrators; have now led to a serious lack of confidence in the administration's ability or willfulness to provide a safe learning environment for our children. This too, needs to be brought to the attention of the BOE.

If we approach the BOE, during public comment, in a thoughtful and dignified manner, explaining our overall concerns, I believe we can make a great deal of progress and set forth measures to eliminate these aversive techniques in the future and hopefully foster an environment where parents, teachers and administrators can work together for the common good of our children.

There is some indication that our teachers support our position on this issue. We have had several teachers write in on the blog that have indicated the lack of training in regards to applying these positive interventions. Our teachers and aides have been requesting this critical training for some time. They are interested in applying these positive strategies to not only "teach" our children the necessary skills but also to reduce the incidents of restraint and seclusion. With all of the issues that our teaching staff is facing (working without a contract) I applaud them for taking the time to support parents on this issue.

Please join me at the next BOE meeting to stand up for the children in Cherry Hill that require positive behavioral supports. Mark your calendar for Tuesday, November 27, 2007 at 7:00 PM. This meeting is at Clara Barton Elementary School.

Since many have asked, and a few administrators have alluded to the fact that this padded closet did not exist, I am providing the pictures of the padded closet for anyone interested in viewing them. You will quickly realize why I do not like referring to this as a Quiet Room, as it was quite literally a padded closet! Click here to see the photos.

Please Note: I am not supplying these photos to "stir the pot" as an administrator accused me of recently. I want readers to see exactly what we are referring to and form their own conclusions.

*Originally published in the Courier Post, Autism Blog, Kathi Magee: On Autism, 11/20/07.

Restraint and Seclusion

The majority of parents that commented on my last blog (see Cherry Hill's Chokey) were horrified when they learned that physical restraint and aversives, such as seclusion were being used on children in the Cherry Hill public school district. I received over 100 responses to that one blog! That is the highest ever on the Autism Blog, so it was obviously a great concern to many parents.


I was pleased that so many weighed in on this issue. We saw comments from parents of both special needs children and typical children, as well as a few teachers and other staff members that were able to offer their insight. It is my hope that through these public discussions, we can improve the situation for all of our children.


The issues of morality and legalities involved in this matter may seem complex. While we can all come to our own opinions on issues of morality, some parents may have been at a disadvantage since they may not be familiar with the laws related to special education. For the parents of typical children, without an IEP, I wanted to provide the legal information regarding the Individuals with Disabilities Education Act (IDEA) and the Free and Appropriate Public Education (FAPE) provisions. Obviously, IDEA is rather extensive, so I am just going to supply the basic information and that which relates to restraint and seclusion.


Every child in our school district that is "classified" as having a disability has an Individualized Education Plan (IEP). IEP's must follow the IDEA, which is a matter of Federal Law. There are also state laws that come into play, but for now I will focus on the requirements of IDEA as it relates to behavioral interventions.


IDEA supports positive approaches for all students.
The Individuals with Disabilities Education Act (IDEA) creates a presumption in favor of positive methods. IDEA requires that an IEP team consider positive behavioral interventions and strategies when it comes to a child's behavioral concerns.


A Functional Behavioral Assessment (FBA) is the type of evaluation used to determine a child's behavior support needs. This evaluation typically results in the development of a Behavioral Intervention Plan (BIP). The BIP will list the strategies to improve the child's behavior and determine the appropriate goals. All of this becomes part of the child's IEP.


The behavior plan is a very important aspect of the IEP because it tells staff how best to handle the behaviors of the individual child. Keep in mind it is an "Individualized" education plan. Special education is never a "one size fits all" approach and behavioral interventions must be individualized for the particular child.


Maladaptive Behaviors:
For parents of typical children and for teachers not specifically trained to work with children that display explosive behaviors, it is often hard to imagine why a child would "explode" in the classroom. There are many things that can lead to these maladaptive behaviors.


For children with neurological disorders, the behaviors are often triggered by skill deficits. Some of the common skill deficits are in the areas of social and communication skills. Perhaps the child has communication skill deficits that hamper his/her ability to express his needs verbally. Combine that with a low tolerance for frustration and this could easily trigger a meltdown. If the child's social skills are deficient, s/he may not understand what behaviors are socially appropriate. Effective teaching strategies could help the child learn what behaviors are appropriate in various social situations and curtail the maladaptive behaviors.


Some children have such severe Sensory Integrative Dysfunction that certain noises or lighting conditions become intolerable. This too, may manifest as inappropriate behavior. This is another thing that the behaviorist would need to consider in developing an "individualized" plan.


For some children, they may need to follow a very strict routine, so interuptions in their schedule (for assemblies, class parties, etc) may be triggering the inappropraite behaviors. Keep in mind that for most autistic children the inability to transition and extreme rigidness are part of the overall disorder. Just going from the classroom to the playground is a huge transition.


Some children may have simply learned that a certain behavior helps them to achieve a certain goal. The behaviorist then needs to consider what the child is accomplishing by displaying certain behaviors. Maybe the child becomes overwhelmed in the classroom and is actually acting out to get a "time out." In which case, the child can be trained to ask for a break when needed, rather than acting out in class. In this case, punishing the child would not teach them the appropriate way to ask for a break, it would just frustrate the child even more.


With so many pieces to the puzzle, the behaviorist needs to consider all of the possible antecedents in order to put together an effective behavioral intervention plan that is truly based on the individual child's needs.


Behavioral Interventions:
According to the IDEA, positive behavioral interventions and strategies must be considered first. Emphasis on the development of new, positive skills is different from the use of aversive techniques, restraint or seclusion, which are applied solely to control or reduce unwanted behaviors.


Some states have clarified the language in IDEA even further, specifying in state law or regulations that all methods used to support children with disabilities in the schools must be positive. At the present time, NJ continues to allow the use of physical restraint and aversive techniques in some situations, but requires advanced parental knowledge and consent before using any of these negative techniques. Basically, if it is not in the Behavioral Intervention Plan and it is not in the IEP -- it is not permitted.


A parent must sign a consent form BEFORE physical restraint or aversive techniques, such as seclusion may be utilized on their child. This is what led to the concerns in the last blog because the parent(s) were not notified in advance and did not give parental consent.


Restraint and Aversives:
Physical restraint refers to a broad category of restraints in which a person's movements are restricted by the use of physical force. Physical andor mechanical restraint has been used in the past as a means of behavioral intervention in a variety of programs for special needs children. If a child did not respond in the fashion that the adult felt was appropriate, staff was permitted to restrain the child to teach them a lesson.


An aversive would describe a type of punishment for displaying an inappropriate behavior. It refers to the deliberate infliction of physical and/or emotional pain and suffering, for the purpose of controlling or conditioning behaviors deemed unacceptable (like hand flapping or refusal to sit in a chair) by teachers or behaviorists. In general, aversive techniques include direct physical or corporal punishment: things like, spraying water at the person, Tabasco sauce in the mouth, slaps, pinches, blindfolds, hair pulls and rubber band snaps and isolation or confinement. The temporary but significant loss of movement, perceptual, or sensory ability; the disruption of basic emotional equilibrium and sense of safety; and the ongoing loss of freedom or of pleasure.


Some of the aversive techniques used were quite severe and in some cases resulted in injury and even death to a child. As sickening as this sounds, many special needs children were actually subjected to this type of treatment.


We have evolved enough as a society to recognize that aversive techniques ignore the neurological context of behavior and frequently target aspects of the disability that are not under the individual's control. We also realized that we were teaching our children that the bigger stronger person wins. We were not teaching them effective or appropriate ways to regulate their behaviors and were not teaching the skills necessary to resolve conflicts or solve problems without becoming combative.


Fortunately for our children, we also realized that there were better methods for teaching appropriate behaviors. This is where the "Best Practice" methods came into play in dealing with restraint, seclusion and aversive techniques.


The use of aversive techniques, restraint, and seclusion can lead to violations of the "free and appropriate public education" (FAPE) provision of IDEA. *
Under IDEA, an appropriate special education program must be designed to provide the student with meaningful educational benefit. However, students do not learn meaningful lessons about alternative ways of communicating and interacting when teachers and program staff respond to their challenging behaviors with aversive interventions, restraint, or seclusion. Often the frustration and anxiety caused by these negative procedures cause the child's original behavior to worsen, or to be replaced by other equally undesirable activities. When children suffer a high degree of anxiety and stress, their ability to process, retain, and act on new information is severely compromised, further undermining their ability to access the Free and Appropriate Public Education (FAPE) for which they are entitled.


The implementation of aversive techniques, restraint, and seclusion takes time and attention away from the child's IEP goals, so that educational progress is hampered. The use of these techniques, or even a request from the child's program for permission to use them, should immediately suggest that the student's program or services are not effective.


Parents can exercise their right to a new IEP meeting, at which time all aspects of the student's IEP and behavior support plan should be re-evaluated. Because of the dangers involved in using aversive techniques, restraint, and seclusion; programs wishing to use them must require the child's parents or guardians to give "informed consent" and parents have the right to deny consent.


Some parents may pre-emptively deny permission for their child's school or program to use these methods on him or her by using a letter stating "No Consent for Physical Restraint or Aversive Techniques." But even in the absence of such a letter, a special education program developed without parental input is in violation of the procedural requirements of IDEA.


In summary: No informed consent = No physical restraint, aversives or seclusion.


I hope this information is helpful to those that did not quite grasp some of the legalities involved in the use of restraint and seclusion. All readers are welcome to comment. My next blog will focus on the Best Practice methods that the Child Welfare League of America has established.


Please note: This information is in no way provided to be construed as legal advice. If you require legal advice, please contact a qualified attorney.


*Portions of the above text have been copied with permission from The Alliance to Prevent Restraint, Aversive Interventions, and Seclusion (APRAIS). Reproduction of this publication all or in part is authorized for noncommercial advocacy or educational purposes with full attribution to APRAIS.


*Originally published in the Courier Post, Autism Blog, Kathi Magee: On Autism 10/24/07.

Cherry Hill's Chokey!

We have an area in our home that my son calls his "safe zone." If he feels overwhelmed or stressed he goes there and sits to regain his composure. He initiates it and it is just a quiet area in our living room at the far end where the lighting is dimmer and the distractions are fewer. I call it a "reverse time out" because it eliminates the problem behaviors that would result in a time out for a typical child. It is a means of proactively addressing the triggers that would have resulted in rage type behavior.

I am highly sensitive to the subject of physical restraint and or physical seclusion. When my son was in Kindergarten he had been physically restrained quite often because of explosive behaviors. The end result was that his self confidence was reduced, he was embarrassed and humiliated in front of his classmates and began to have a negative attitude towards woman -- since it was always a female that restrained him. He became so frustrated by this that he often said that he wanted to die. He eventually began making suicidal threats. The physical restraint did nothing to prevent the explosive behaviors or teach him the skills necessary to regulate his behavior. After witnessing these behaviors first hand, our then Director of Special Education, Charlie Lang, ordered a new FBA and the Behavior Analyst carefully constructed a "positive" Behavioral Intervention Plan. The new plan is focused on teaching the skills for which he is deficient, rather than punishing the resulting behaviors.

My son's behavior plan is very consistent with the procedures outlined in the book "The Explosive Child" by Ross Green, PhD. Dr. Green, along with some other psychologists from Boston General and Harvard University put together a behavioral program called the Collaborative Problem Solving (CPS) approach. The CPS model is based on the belief that challenging behavior should be understood and handled in the same manner as other recognized learning disabilities. In other words, difficult children and adolescents lack important cognitive skills essential to handling frustration and mastering situations requiring flexibility and adaptability. The CPS model helps teachers (and parents) to teach these skills and it also helps children to realize the importance of problem solving and conflict resolution. We have seen tremendous results using this plan for my son.

There is information available online regarding the CPS approach. Here are a few links:
Center for Collaborative Problem Solving
The Explosive Child
Foundation for Children with Behavioral Challenges

Late last year, after a terrible experience in the mainstream setting, my son was placed back into a self-contained special needs classroom. They had an area in the classroom used for sensory breaks. The area is about the size of a double bed. The wall is recessed and makes up an area of about 6' wide by 4' deep. There was a duvet cover on the floor filled with chunky foam blocks. It provided cover for the floor and I guess some padding. I believe there was something over the concrete walls, too. It was a very dimly lit area that was obstructed by large storage cabinets. They were strategically placed to provide an opening to the area of about 2 to 3 feet wide. It was used when children needed a sensory break and was similar to our "safe zone" at home. I was aware that my son had been in this area several times. But again, this was used for children that requested a sensory break.

Last night I attended the Parents Forum held by the Cherry Hill Special Education PTA. At one point during the "parents only" portion of the meeting, someone mentioned a similar technique that was being used at Russell Knight School. Apparently they have a "closet" that has been padded with gym mats that they are calling a "Quiet Room." It turns out there is also one at Kilmer School. When the parents began talking about this I quickly realized that it was not being used as a "Safe Zone." It is being used to place children in when they have meltdowns or become non-compliant.

I asked the parent that mentioned this to clarify how this was used. I thought, I must be hearing this wrong! She said that it was a closet, with a door, no windows and padding on the walls! When a child became non-compliant one day, the child was placed in this closet. To make matters worse, the woman that spoke about this has a non-verbal child. Her child would have no way of telling her if placed in a closet.

I cannot even begin to describe the emotions in the room as parents listened to this Mom speak. Some looked horrified, others were holding back tears and there was anger and pain on the face of every parent in the room. My heart broke for this parent that became aware of this by accident. She had no way of knowing if it had been used on her child; and if so, had no opportunity to dispute the use of such aversives because no one had ever mentioned this type of procedure being used in Cherry Hill. I began to think about the tremendous psychological impact this must have had not only the child placed in the closet, but on the others that may have witnessed this.

During the question and answer session with Israela Franklin and Jim Gallagher they addressed this concern. They admitted that they had knowledge of a "Quiet Room" being used in at least two schools in our district -- Kilmer and Russell Knight. Jim Gallagher did his best to cast this in a positive light. He said that sometimes it is necessary to escort a child having a meltdown to the "quiet room." He did not mention the other uses, such as non-compliance, task avoidance, etc.

While all of this may sound perfectly acceptable to administration with their well chosen words of explanation -- the only words that ran through my mind were "why and how."

First, the "why" questions:
Why were these closets turned into "quiet rooms" without telling parents in advance?
Why was this procedure not explained to parents in an IEP meeting if there was even the slightest chance that it may be utilized?
Why would a child be allowed to reach such a high level of distress?
Why would a child prone to meltdowns not have a positive behavior plan in place?
Why would we not have trained staff to spot the child whose frustration is escalating and intervene before a crisis?

Perhaps it did not occur to anyone that the best way to handle a crisis is to prevent it from happening in the first place!

Now on to the "how" questions:
How do you justify the use of aversives when you did not make a plan to avoid this?
How is it that you go about "escorting" a child in a full blown rage out of a classroom? When they reach that level they are extremely combative. The mere act of trying to relocate them could bring injury to the child or even the staff attempting to physically move the child.
How is it that parents were not made aware of these questionable techniques prior to their use? How are these "quiet rooms" actually used? Are non-compliant children placed in these padded cells (for lack of a better phrase!) or is it just for full blown rages? There seems to be some indication that they are used for more than "meltdowns."
How is this explained to the other children in the room. Surely they are fearful and perseverating on the fact that it "could" be them next!

I am urging every parent that reads this blog to pass it along to other families. Mr. Gallagher indicated last night that some school principals are setting up these secluded areas in their schools. Please ask at your child's school if there is a "Quiet Room" or "Quiet Area" or any type of secluded setting, even if it is only used for a "sensory break." If there is, request to see that area so you know in advance what could happen. And please alert other parents to the existence of such an area.

I would also encourage parents to send a written letter indicating that you are against the use of physical restraint and the use of aversives such as these "quiet rooms" if you do not want this used for your child. Obviously, there may still be occasions when a child would react in such a manner that it would become necessary for their own safety for some type of preventative action by a staff member. But this needs to be clearly defined in a Crisis Intervention Plan and limited to true emergencies.

I think it is also important to recognize that in certain situations there may be children who have such severe sensory integrative dysfunction, that they may need an area for which to escape. In that situation however, it should NEVER be used as a punishment area. The child needs to be taught to go to that area independently and be permitted to leave that area willingly.

Any parent that is concerned with the possibility of disruptive behavior by their child, should have this addressed in a formal Behavioral Intervention Plan (BIP). I cannot stress enough the importance of the BIP! It tells the staff working with your child what is and isn't appropriate for your individual child. You most certainly do have a say in this! The behavior plan should be consistent with interventions used at home. Consistency is the key to effective behavior plans.

The Autism National Committee has had this to say on the use of such aversives as physical restraint and quiet rooms:
"[Physical restraint] should only occur when there is substantial threat of injury to self and others. Behavioral restraints are neither treatment nor education."

"The use of restraints should be considered a failure in treatment. We totally condemn the use of behavioral restraints. "

"The use of aversives is a human rights issue and a civil rights issue. When we allow punishments to be used on persons with disabilities which would be illegal if used on persons without disabilities, we are denying them equal protection under the law. Even our other devalued populations - people who are elderly, homeless, or in prison - cannot legally be "treated" with aversives, nor do we permit animals to be trained or treated by these means."

Additional Info is available on this subject at:
Autism National Committee
Asperger's Express
Kids in Confinement
Autismvox

A parent sent me this this morning: Remember the novel Matilda? The evil headmistress Agatha Trunchbull puts children in a horrific torture closet called The Chokey! Chokey is British slang for a prison. Trunchbull's treatment of her students is nothing short of child abuse and she seems to believe intimidation is the best method of teaching.

Is this really how we want to teach our children appropriate behaviors, social and communication skills?

This is an important issue that parents of both special needs children and typical children need to consider. If our school district is going to implement such aversives than every parent in the school district needs to know about this!

*Originally published in the Courier Post, Autism Blog, Kathi Magee: On Autism, 10/18/07.

The World of Autism

Imagine living in a world where you felt different than everyone else, a world where you simply did not fit in. You frequently misunderstood others, and therefore could not respond appropriately. What if those around you misunderstood you and as a result you were constantly frustrated? Now, on top of all this, let's set your frustration tolerance down to zero. Oh, you are in for quite a ride!

As if this world isn't difficult enough, let's play with your ability to reason things out or think logically. What if you could not learn things intuitively like most other people? What if you could only mentally process things one small step at a time and therefore frequently misunderstood directions? You would most likely feel more frustration and remember -- in this world you have zero frustration tolerance!

What if your brain could not process sensory input appropriately? What if every sensation was so severely intensified that it affected your nervous system? What if certain lighting conditions bothered your senses to such a degree that you simply could not tolerate it. Imagine not being able to eat certain things because the texture, smell or taste was always off. Imagine not being able to walk barefoot in the grass or sand because the sensation drove you mad! Imagine if your senses were so highly acute that loud noises, like a fire alarm or a vacuum cleaner, caused physical pain. Imagine if your sense of touch was so heightened that something as minor as a tag on your clothing or the touch from another human being threw you into a tailspin.

Imagine if there were times when this sensory integration dysfunction worked in the total opposite way? What if you did not feel certain things? What if you could not feel pain and did not realize that you were injuring yourself? Or if it was 10 degrees outside and you did not feel cold? You would surely be at risk for frostbite!

Imagine not being able to differentiate between negative feelings. Sadness, disappointment, fear, embarrassment -- all translated into anger. Imagine how angry you would feel most of the time. Then imagine the behavior you would display if you were constantly feeling angry. What if others did not realize that this was a problem for you and you were constantly disciplined for that behavior?

Imagine what this world would be like if you did not have the skills to articulate your needs, feelings or concerns. What if you simply could not use your words to tell someone that you were having difficulty and needed help? What if you were unable to solve some of the most basic everyday problems? You would surely walk around feeling overwhelmed.

What if you did not have friends because you did not know how to make them? Imagine living everyday without having a friend to bounce thoughts or ideas off of. What if you did not have the skills to enter into a group activity? Imagine how isolated you would feel being constantly left out of group activities.

Imagine not understanding the feelings of others or not knowing how to express your own feelings. Imagine a world where you took things so literally that you often did not get the implied meanings, or didn't see the humor in a joke or a pun.

Imagine a world where everything happened spontaneously, as it often does in our world. However, what if we took away your ability to adapt to changes? What if you could only function by following a strict routine or schedule and others were constantly changing your routine?

What if you had episodes of frustration or fear that overwhelmed you so badly that you just wanted to run? Remember, you have no basic reasoning skills anymore, so you cannot make good decisions during these episodes of flight. Imagine running aimlessly down the street without being able to factor in things like strangers passing by, trip hazards or traffic!

Welcome to a world where 1 in 150 of our children live everyday! This is the world of autistic disorders.