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Prone Restraints in Florida: Palm Beach Post Series

October 10, 2010

This weekend, the Palm Beach Post is doing a series on the dangers of prone restraints. Although prone restraints are illegal and completely banned in several states for any purpose, they are not illegal in Florida, but there is a strong push to have them banned in Florida. Note that even the people in favor of prone restraints are against using them for anything except an immediate, imminent threat to physical safety, not to show the student who is boss or teach the student a lesson in any way. The controversy is about whether prone restraints need to be used at all. No one, not even the pro side, is arguing in favor of so-called therapeutic restraints. The article also notes that this brutal form of restraint is used almost exclusively on special needs children.

Here are some excerpts from the series:

From: Florida Gutted Child Restraint Bill of most important protections, mother of restrained child says:

Florida was one of just 19 states with no law on restraint or seclusion of schoolchildren. In guidance sent this month to school districts on how to interpret the new law, Florida’s Department of Education wrote that restraint is meant to be used only when there is “imminent risk of serious injury or death” to the student or others. The document reminds educators that the procedure is never to be used “to punish a student, or as a deterrent, or to ‘teach a student a lesson.’ ”

Also until now, there were no statewide requirements that schools keep records on when restraint was used, much less notify parents – and without data, Hukill faced skepticism that a problem existed. “People’s initial response is this can’t be happening, so you have that hurdle to overcome, that yes, it is in fact happening,” she said. The data collection provision, she said, “gives us back-up.”

Even so, parts of the new law may not be as effective as hoped. Take training. Provisions call for enhanced training to offset risk. When it comes to prone restraint, though, Ohio’s search of national literature doesn’t support that idea, said Michael Rench, Ohio Rehabilitative Services Commission Administrator. Ohio last year banned prone restraint by most government employees, including teachers. “Everything we found was that it just is not safe even when applied by well-trained individuals,” he said. As an example, Mark Kamleiter, a St. Petersburg lawyer and former public school behavioral specialist said prone restraint frequently calls for two or more people to apply force. One person may know the amount of force he is applying, but wouldn’t necessarily know how much force the other person is applying. “You can hurt the child by accident,” he points out.

For instance, 12-year-old Michael Wiltsie died in an Ocala youth camp in 2000 after a counselor pinned him to the ground. A grand jury found that the counselor was following proper procedures.

“You cannot train a person how to safely do a prone restraint,” said Barbara Trader, executive director of TASH, a Washington advocacy group for people with disabilities. “It’s not possible.”

Wisconsin’s Crisis Prevention Institute Inc. doesn’t try. The international training firm teaches everyone from corrections officers to those caring for autistic children how to defuse tense situations. But they don’t teach prone restraint. “We had continued concerns on how to manage risks on the floor,” said president Judith Schubert.

From: Pinned Down:

Yet versions of prone restraint have been linked to the deaths of six adults in Florida’s mental health facilities, cited by a federal report in four student deaths and implicated in many more. Miami-Dade, the state’s largest school district, no longer uses prone restraint, and critics say there’s a reason to do away with it: “It is deadly,” said Barbara Trader, executive director of TASH, a Washington-based international association of people with disabilities. “It should be absolutely illegal.”

‘Not defensible’

Prone restraint is used to immobilize an out-of-control student. Typically, two or three adults pull a student from a standing position down to a mat or other surface onto his stomach, and hold his limbs down .

It’s almost exclusively used with special education students.

Injury can occur several ways. Adults may accidentally compress a child’s chest, cutting off his air supply: A Cornell University study cited asphyxia in 28 deaths of children or teens after prone restraint. Because the child is face down, it can be hard to see signs of distress. Improperly applied pressure can bruise, or break a bone. Students with cardiac or respiratory conditions such as asthma are at special risk of injury or death.

“The national research was just overwhelming,” said Michael Rench, Ohio Rehabilitative Services Commission administrator and a player in Ohio’s decision to ban prone restraint. “We could not imagine why we would do that to people. It just was not defensible.”

Even absent physical harm, a child’s experience of being pushed to the ground and forcibly held can trigger emotional trauma that shows up as depression, increased anger and fearfulness, according to studies by national disability rights groups.

Full text available:

The articles certainly present compelling, evidence-based arguments against the use of prone restraints from individuals who could hardly be considered “fringe”. The movement to ban prone restraints in Florida has been an uphill battle but it sounds as if more and more people are becoming aware of the evidence and progress is being made. Hopefully, soon, they will follow in Ohio’s footsteps and recognize what Ohio’s Rehabilitative Services Commissioner administrator has already identified, that a thorough search of the evidence found that prone restraints are dangerous, even when done correctly, therefore they ought to be banned and safer alternatives used.

Here is the article presenting the pro-prone restraint side, which was met with a public outcry in the comments section. The public is beginning to be educated and to know better than to just take the word of certain authorities that prone restraint is the only alternative for protection. It simply isn’t so and the evidence shows that prone restraints have killed people, even when done correctly.

Again, I have to wonder, if they are this dangerous even when used “correctly” under highly supervised conditions, what does that say about parents using it at home alone with their child with no formal training?

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