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Miss. to regulate controversial school practice

Emily Le Coz
The Clarion-Ledger

Cade Rhodes' screams penetrated the hallway at Longleaf Elementary School.

It was Nov. 13, 2013 — his 8th birthday — and he knew his mother was somewhere in the building with treats for his class. He wanted to find her. His teacher wanted him to sit down instead. The situation escalated into chaos.

By the time Heather Rhodes reached the door of the first-grade classroom, she said her son's screams transformed into pleas.

"Let me out," she said she heard him cry. "I want my mom."

Rhodes opened the door to see her child confined to what she describes as a box. In reality, it looked more like a three-sided, open-top pen straddling the wall and accessible by a gate. The school had touted it as a "chill zone" where students with sensory issues could take a break from the dizzying stimulation of a busy classroom.

On that day, Rhodes said, it served another purpose — a jail. Curled in a fetal position, banging his head on the floor, Cade allegedly screamed to get out while his teacher held the gate closed with her foot. The school dismissed the incident as no big deal, Rhodes said, but she was furious.

"If I had that contraption in my house," Rhodes said, "and my child told his teachers, 'My mom puts me in a box when I'm bad,' I would have been arrested and my kids would have gone to foster care."

Lamar County School District board attorney Rick Norton disputed Rhodes' version of events and noted a circuit judge dismissed her 2014 criminal complaint against the teacher.

"We deny and dispute everything that woman says," Norton told The Clarion-Ledger. "We do not consider her to be credible."

Rhodes filed a federal lawsuit against the school district this year in another court, where it's currently pending.

The case illustrates the emotional and controversial nature of seclusion and restraint in schools, a practice that can pit uncontrollable children against untrained staff with the potential for widespread abuse.

U.S. Secretary of Education Arne Duncan criticized its use in a May 2012 federal report, saying no evidence exists that restraining or secluding children reduces problem behaviors. The report nonetheless acknowledges its prevalence in schools nationwide and recommended states adopt best-practice policies and procedures to regulate it.

Mississippi could take that step this year.

"I think it's long overdue," said 3rd District U.S. Rep. Gregg Harper, the Reublican congressman who in 2013 co-sponsored federal legislation establishing minimum standards for the practice. It didn't pass.

Hundreds of incidents

Every year, Mississippi schools forcibly restrain and confine hundreds of students. It happened more than 950 times in the 2011-12 academic year alone, according to the most recent data from the U.S. Department of Education's Office for Civil Rights.

But those numbers could be much higher.

The federal agency lacks data for the vast majority of Mississippi's roughly 150 school districts. Whether that's because those districts had no incidents to report or because they don't monitor the practice — and therefore can't report it — is unclear.

Mississippi doesn't require schools to track incidents of seclusion and restraint, nor does it regulate the controversial practice, despite tragic cases of its misuse causing serious injury and even death among children nationwide.

In one such case, a 14-year-old boy died at a Texas middle school after a 230-pound teacher held him down and lay on top of him because he wouldn't stay seated. Despite the child repeatedly saying he couldn't breathe, the teacher remained on top of him for 15 minutes, long after he had gone limp. An autopsy showed the child died from mechanical compression of the trunk, according to a 2009 U.S. Government Accountability Office report.

The same report detailed the case of a 4-year-old girl with cerebral palsy and autism who suffered physical and mental trauma after teachers at her West Virginia elementary school repeatedly confined her to a chair with multiple leather straps and left her there for long periods of time because she was "uncooperative."

In Mississippi, the Jackson Public Schools' routine practice of handcuffing alternative school students to a pole as a method of punishment triggered a 2011 lawsuit by the Southern Poverty Law Center. The suit claimed students stayed shackled for hours at a time for offenses as minor as dress code violations.

JPS settled the claim two years later, promising to stop the practice.

Without statewide regulations and mandatory reporting, though, other schools could be using similar tactics without the public's knowledge.

That's what bothers Rhodes. Had she not walked in on her son's confinement, she said, she doubts the school would have told her about the incident. And because Cade's autism and other disabilities impair communication, he lacks the ability to tell her himself.

"That's the issue," Rhodes said. "I don't know how many times it was done."

Last resort

The Lamar County School District reported no instances of seclusion and restraint to the federal government in 2011-12. It had, however, reported 34 instances of physical restraint in 2009-10.

Although she couldn't comment directly about Rhodes' case, Lamar County School District Superintendent Tess Smith called the use of seclusion and restraint extremely rare. In her 23 years in the district, she said, she's seen it only a handful of times and only as a last resort in situations where students pose a risk to themselves or others.

Smith described one incident when a tantruming student kicked and flailed near a tall bookshelf that wasn't secured to the wall and could have collapsed on him, books and all.

Teachers tried to calm the student, Smith said, but he refused to settle down. They told him they were going to physically restrain him if he didn't stop.

The student finally calmed down without restraint, Smith said, but the case illustrates when — and why — teachers sometimes use such tactics.

"Our overall goal is to protect the students," said Smith, who also is a board-certified counselor.

The district's own restraint policy, adopted in December 2007, limits its use to situations in which students endanger themselves or others, when they refuse to move from one location to another after being so ordered, or to prevent the destruction of property.

It expressly prohibits staff from restraining students as a means of punishment. And it requires them to immediately produce a restraint report detailing the event, including what precipitated it and the method of restraint used.

Other school districts have policies, too, but the U.S. Department of Education recommends statewide regulation. So far, 37 states have adopted laws or mandatory policies, according to a national analysis by attorney and special-education advocate Jessica Butler.

Butler's report, "How Safe is the Schoolhouse," notes that nine other states have voluntary guidelines that school districts can choose to adopt — or not.

Five states, including Mississippi, have nothing.

A good start

That could change.

On April 16, the Mississippi Department of Education announced it will establish a statewide policy.

A six-page draft presented at the state Board of Education outlines when and how school districts should physically restrain unruly and uncooperative students, and when and how to seclude them.

"Unfortunately when things go badly at school, you need something there to control what happens," said Pat Ross, MDE chief school performance officer.

The draft policy bans chemical restraints, such as sedatives and other medications, and mechanical restraints like straps, harnesses and handcuffs. It also prohibits any restraint that obstructs the airway.

It restricts the use of seclusion and restraint to trained staff, and it requires incidents to be recorded in a student's file, as well as reported to parents.

Like Lamar County, the state also seeks to limit restraint to when students endanger themselves or others, refuse to move or destroy property. It wants to limit seclusion to emergency situations or when a student's behavior unreasonably interferes with learning.

Butler, who read the draft at The Clarion-Ledger's request, commended Mississippi for its interest in adopting a policy.

"It's got terrific provisions to protect students, such as a ban on mechanical restraints like strapping them into chairs. It has data collection. It has parental notice, which is extremely important," Butler said.

But she cited concerns about the policy's "loopholes" that could lead to misuse and potential tragedy. Allowing staff to restrain students who destroy property opens the door for abuse — like restraining kids for breaking pencils or slamming doors, she said.

Ditto with secluding students who disrupt learning.

"For children with disabilities that can't control their behavior — they may talk out loud, they may hand flap — putting a child in seclusion as any kind of response to educational disruption is really out of line with trend in the country," she said. "Where the trend has been going is to limit seclusion to emergencies threatening physical harm."

The Mississippi Department of Education knows this, Ross said. It has studied the national policy recommendations, as well as policies adopted by other states. The document presented last month is still a work in progress, Ross said, and likely will change several times before adoption.

"We're going to take that document and work from it, involving a number of people," Ross said.

Not the first time

This isn't the first time MDE developed such a policy. It convened a task force of experts to craft a model policy in late 2009. The 14-page document, completed in early 2010, mirrors the most recent draft with the exception of being far more comprehensive.

It's unclear why MDE didn't adopt the early version, but former task force member Danita Munday believes it's because of the group's disagreement over key issues — namely, whether to define the tactics as the last resort in a long list of positive behavior interventions or as just another tool to subdue unruly kids.

The policy reflects a hybrid of both philosophies. But since neither side was happy, Munday said, MDE shelved it.

Similar philosophical disagreements have emerged in response to MDE's new draft policy, which Ross said took inspiration from previous version. MDE plans to invite back to the table some former task force members who can hash out the issues again before a final draft goes out — tentatively in June.

Even then, he said, the public will have at least one month to comment on the policy before the Board of Education adopts it. And even then, there are sure to be disagreements.

"It's impossible to be all-encompassing in your verbiage, hence the importance of properly trained individuals who are monitoring or managing these procedures," said Joe Olmi, University of Southern Mississippi chairman of the Department of Psychology and faculty member of the School Psychology Training Program.

"In the absence of properly trained individuals," Olmi said, "these procedures shouldn't be used at all."

Positive behavior and special needs

Also key, Olmi said, is that schools consider seclusion and restraint not by themselves but as a component of a larger system of interventions and support that foster positive behavior. Schools that adopt such systems rely far more on the carrot than the stick and, as a result, have fewer incidents.

In Mississippi and elsewhere in the nation, the go-to system is called Positive Behavior Interventions and Supports, or PBIS. Dozens of schools statewide have adopted PBIS. Among them is Lamar County's Purvis Middle School.

"We saw tremendous reduction in disciplinary incidents," Smith said.

When other principals in the district saw the transformation, they wanted to adopt PBIS, too. All three high schools now are working toward full implementation," Smith said. So is one of the lower elementary schools.

But incidents still happen. And schools still rely on seclusion and restraint. When they do, it's usually on students with disabilities.

Fifty-seven percent of Mississippi's reported incidents involved children with special needs, even though they account for just 12 percent of the state's K-12 student population.

"As a parent, you want to make sure the ones who are the most vulnerable — special needs children — are dealt with in a very loving and appropriate fashion," Harper said.

That's why in addition to training, Olmi recommended school districts fully disclose their seclusion and restraint policies with parents and students at the start of each school year and even seek their approval of such procedures.

Had Longleaf Elementary done that for her, Rhodes said, she might have been made different educational choices for her son. Instead, she said, Cade suffered unnecessary emotional distress that ultimately prompted her decision to homeschool him.

Norton again disagreed. He said Rhodes withdrew her son, not because of the incident, but because the school learned she and her family lived outside the district and thus violated its residency policy, a point Rhodes disputes.

Whatever the truth, it's clear what happened to Cade that day triggered a series of unfortunate events for both his family and the school district, all of which would seem to reinforce the need for a consistent, statewide policy.

"What we've seen is that a lot of the children where this is done — and I understand all the sides — but actually sometimes this action can be more traumatic and really make the behavioral challenges even more difficult in the long run," Harper said.

The proposed policy "is a good first step," he said. "This tells you we're moving in the right direction. I hope it gets implemented."

Contact Emily Le Coz at (601) 961-7249 or elecoz@jackson.gannett.com. Follow @emily_lecoz on Twitter.

Seclusion and Restraint Model Policy

The U.S. Department of Education urged all states to adopt laws or policies regulating the use of seclusion and restraint in schools. Each one, it said, should follow 15 guiding principles:

1. Every effort should be made to prevent the need for the use of restraint and for the use of seclusion.

2. Schools should never use mechanical restraints to restrict a child's freedom of movement, and schools should never use a drug or medication to control behavior or restrict freedom of movement (except as authorized by a licensed physician or other qualified health professional).

3. Physical restraint or seclusion should not be used except in situations where the child's behavior poses imminent danger of serious physical harm to self or others and other interventions are ineffective and should be discontinued as soon as imminent danger of serious physical harm to self or others has dissipated.

4. Policies restricting the use of restraint and seclusion should apply to all children, not just children with disabilities.

5. Any behavioral intervention must be consistent with the child's rights to be treated with dignity and to be free from abuse.

6. Restraint or seclusion should never be used as punishment or discipline (e.g., placing in seclusion for out-of-seat behavior), as a means of coercion or retaliation, or as a convenience.

7. Restraint or seclusion should never be used in a manner that restricts a child's breathing or harms the child.

8. The use of restraint or seclusion, particularly when there is repeated use for an individual child, multiple uses within the same classroom, or multiple uses by the same individual, should trigger a review and, if appropriate, revision of strategies currently in place to address dangerous behavior; if positive behavioral strategies are not in place, staff should consider developing them.

9. Behavioral strategies to address dangerous behavior that results in the use of restraint or seclusion should address the underlying cause or purpose of the dangerous behavior.

10. Teachers and other personnel should be trained regularly on the appropriate use of effective alternatives to physical restraint and seclusion, such as positive behavioral interventions and supports and, only for cases involving imminent danger of serious physical harm, on the safe use of physical restraint and seclusion.

11. Every instance in which restraint or seclusion is used should be carefully and continuously and visually monitored to ensure the appropriateness of its use and safety of the child, other children, teachers and other personnel.

12. Parents should be informed of the policies on restraint and seclusion at their child's school or other educational setting, as well as applicable federal, state or local laws.

13. Parents should be notified as soon as possible following each instance in which restraint or seclusion is used with their child.

14. Policies regarding the use of restraint and seclusion should be reviewed regularly and updated as appropriate.

15. Policies regarding the use of restraint and seclusion should provide that each incident involving the use of restraint or seclusion should be documented in writing and provide for the collection of specific data that would enable teachers, staff and other personnel to understand and implement the preceding principles.