This study explored administrators’ attitudes about the use of physical restraint in their school settings. Administrators of day treatment and residential programs for elementary students with emotional and behavioral disorders in the Mid-Atlantic states were surveyed on their attitudes toward, and the use of, physical restraint within their programs. Results showed that the use of physical restraint varied widely, ranging from 0 to more than 3 instances per day. About one third of the sample reported between 1 to 3 physical restraints per week. School size was found to be positively correlated with number of restraints. In schools that used physical restraint, more than half employed basket holds and prone restraints, most commonly following physical aggression. Administrators were divided in their opinions about the therapeutic utility of physical restraint, although most stated it was needed to keep schools safe. Recommendations for future research in the area of physical restraint are presented.
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References
1.
AllenJ. J. (2000). Seclusion and restraint of children: A literature review.Journal of Child and Adolescent Psychiatric Nursing, 13, 159–167.
2.
American Academy of Pediatrics Committee on Pediatric Emergency Medicine. (1997). The use of physical restraint interventions for children and adolescents in the acute care setting.Pediatrics, 99, 497–498.
3.
American Medical Association. (2001). Seclusion and restraint of children and adolescents.AMA (Medical Science) Report 10 of the Council on Scientific Affairs (A-99), 1–3. Internet site: http://www.ama-assn.org/ama/pub/article/2036-2339.html (Accessed May 14, 2004).
4.
BarlowD. J. (1989). Therapeutic holding: Effective intervention with the aggressive child.Journal of Psychosocial Nursing and Mental Health Services, 27, 10–14.
5.
BathH. (1994). The physical restraint of children: Is it therapeutic?American Journal of Orthopsychiatry, 64, 40–49.
6.
BellL. (1997). The physical restraint of young people.Child and Family Social Work, 1, 37–47.
7.
BorgW. R., & GallM. D. (1983). Educational research: An introduction (4th ed.). New York: Longman.
8.
Child Welfare League of America. (2002). Advocacy: Seclusion and restraints: Fact sheet (pp. 1–2). Internet site: http://cwla.org/advocacy/secresfactsheet.htm (Accessed February 25, 2004).
ColtonD. (2008). Leadership's and program's role in organizational and cultural change to reduce seclusions and restraints. In NunnoM. A., DayD. M., & BullardL. B. (Eds.), For our own safety: Examining the safety of high-risk interventions for children and young people (pp. 143–166). Arlington, VA: Child Welfare League of America, Inc.
11.
CottonN. S. (1989). The developmental-clinical rationale for the use of seclusion in the psychiatric treatment of children.American Journal of Orthopsychiatry, 59, 442–450.
12.
DayD. M. (2002). Examining the therapeutic utility of restraints and seclusion with children and youth: The role of theory and research in practice.American Journal of Orthopsychiatry, 72, 266–278.
13.
DukeD. (1986). School organization, leadership, and student behavior. (ERIC Document Reproduction Service No. ED 318 091)
14.
GallagerM. M., MittelstadtP. A., & SlaterB. R. (1988). Establishing time-out procedures in a day treatment facility for young children.Residential Treatment for Children & Youth, 5, 59–68.
15.
GarrisonW. T. (1984). Aggressive behavior, seclusion and physical restraint in an inpatient child population.Journal of the American Academy of Child Psychiatry, 23, 448–452.
16.
GarrisonW. T., EckerB., FriedmanM., DavidoffR., HaeberleK., & WagnerM. (1990). Aggression and counteraggression during child psychiatric hospitalization.Journal of the American Academy of Child and Adolescent Psychiatry, 29, 242–250.
17.
GorenS., AbrahamI., & DoyleN. (1996). Reducing violence in a child psychiatric hospital through planned organizational change.Journal of Child and Adolescent Psychiatric Nursing, 9, 27–38.
18.
GorenS., SinghN. N., & BestA. M. (1993). The aggression-coercion cycle: Use of seclusion and restraint in a child psychiatric hospital.Journal of Child and Family Studies, 2, 61–73.
19.
GutheilT. G., & TardiffK. (1984). Indications and contradictions for seclusion and restraint. In TardiffK. (Ed.), The psychiatric uses of seclusion and restraint (pp. 11–18). Washington, DC: American Psychiatric Press.
20.
JonesR. J., & TimbersG. D. (2002). An analysis of the restraint event and its behavioral effects on clients and staff.Reclaiming Children and Youth, 11, 37–41.
21.
MageeS. K., & EllisJ. (2001). The detrimental effects of physical restraint as a consequence for inappropriate classroom behavior.Journal of Applied Behavior Analysis, 34, 501–504.
22.
McAfeeJ. K., SchwilkC., & MitruskiM. (2006). Public policy on physical restraint of children with disabilities in public schools.Education and Treatment of Children, 29, 711–728.
23.
MillerD. N., GeorgeM. P., & FogtJ. B. (2005). Establishing and sustaining research-based practices at Centennial School: A descriptive case study of systemic change.Psychology in the Schools, 42, 553–567.
24.
MohrW. K., & AndersonJ. A. (2001). Faulty assumptions associated with the use of restraints with children.Journal of Child and Adolescent Psychiatric Nursing, 14, 141–151.
25.
MohrW. K., MahonM. M., & NooneM. J. (1998). A restraint on restraints: The need to reconsider the use of restrictive interventions.Archives of Psychiatric Nursing, 12, 95–106.
26.
National Alliance for the Mentally III. (2001). Where we stand: Seclusion and restraint. Internet site: from http://www.nami.org (Accessed June 16, 2004).
27.
National Alliance for the Mentally III. (2003). Seclusion and restraints: Task force report. Internet site: from http://www.nami.org (Accessed June 16, 2004)
28.
PettiT. A., MohrW. K., SomersJ. W., & SimsL. (2001). Perceptions of seclusion and restraint by patients and staff in an intermediate-term care facility.Journal of Child and Adolescent Psychiatric Nursing, 14, 115–127.
29.
RomanczykR. G. (1990). Aversive conditioning as a component of comprehensive treatment: The impact of etiological factors on clinical decision making. In HarrisS. L., & HandlemanJ. S. (Eds.), Aversive and nonaversive interventions: Controlling life-threatening behavior by the developmentally disabled (pp. 11–35). New York: Springer.
30.
RozalskiM. E., YellM. L., & BoresonL A. (2006). Using seclusion timeout and physical restraint: An analysis of state policy, research, and the law.Journal of Special Education Leadership, 19, 13–29.
31.
RuhlK. L., & HughesC. A. (1985). The nature and extent of aggression in special education settings serving behaviorally disordered students.Behavioral Disorders, 10, 95–104.
32.
RyanJ. B., & PetersonR. L. (2004). Physical restraint in school.Behavioral Disorders, 29, 154–168.
33.
SchlossP. J., & SmithM. A. (1987). Guidelines for ethical use of manual restraint in public school settings for behaviorally disordered students.Behavioral Disorders, 12, 207–213.
34.
SelekmanJ., & SnyderB. (1997). Institutional policies on the use of physical restraints on children.Pediatric Nursing, 23, 531–534, 537.
35.
SilverP. F., & MoyleC. R. (1986). School leadership in relation to school effectiveness.Educational and Psychological Research, 6, 125–144.
36.
SinghN. N., WintonA. S., & BallP. M. (1984). Effects of physical restraint on the behavior of hyperactive mentally retarded persons.American Journal of Mental Deficiency, 89, 16–22.
37.
SteeleR. L. (1993). Staff attitudes towards seclusion and restraint: Anything new?Perspectives in Psychiatric Care, 29, 23–28.
38.
TaxisJ. C. (2002). Ethics and praxis: Alternative strategies to physical restraint and seclusion in a psychiatric setting.Issues in Mental Health Nursing, 23, 157–170, Therapeutic Crisis Intervention. Internet site: www.rccp.cornell.edu/TCIpage1.htm (Accessed October 29, 2005).
ZieglerD., & SilverD. (2005, June). Considering the literature on restraint and seclusion: Is there support that these interventions are harmful? Paper presented at the International Symposium on Examining the Safety of High Risk Interventions for Children and Young People: Ithaca, NY.
