Sunday, April 10, 2011

Orange County, Fla., school district tops state in restraining children, many of whom have disabilities

From the Orlando Sentinel:

Alex Ortaliz was a poster child for the United Cerebral Palsy charter school, with his photo gracing a promotional flier the school put out last summer.

Born prematurely, Alex suffered brain bleeds as an infant and, as a result, has developmental delays and difficulty controlling his behavior.

Alex had thrived at UCP's east Orange County campus since age 2. But two weeks into his kindergarten year, school officials sent Alex home after an incident.

His parents were stunned when, as they were helping him into the car that day, the 5-year-old told them one of his teachers "pulls my arms. She hurts me."

They were furious when school officials confirmed that their 42-pound son had been restrained — physically held against his will by staff for behavior they claimed was out of control and dangerous.

Orange schools have used restraint on Alex and 195 other students 1,910 times this school year — representing nearly a quarter of the 8,222 cases in Florida. No school district employed the method nearly as much as Orange, where some students were restrained repeatedly, according to new data from the Florida Department of Education.

Statewide, 2,944 disabled students were restrained by teachers who used various holds to force them to sit or to lie facedown on the floor. Sometimes a strap-and-mat contraption was used to immobilize the children.

Also, DOE reported 3,386 incidents of seclusion involving 1,047 students from the start of 2010-11 school year through the end of March.

The new data on restraint and seclusion — the practice of isolating students, sometimes in special rooms — are Florida's first attempt to quantify the use of the controversial practices. The state began collecting the information this year under a new state law aimed at limiting both practices.

Many parents, disability advocates and lawmakers want an end to restraint and seclusion, arguing they traumatize and injure students.

State Sen. Anitere Flores, R-Miami, has proposed new legislation this year that would all but end both practices, and a U.S. congressman last week called for similar action, saying both techniques were too often used by poorly trained staff and led to "torture and abuse in America's schools."

Orange educators say they use the techniques only in emergencies with children who have complex behavioral problems and engage in acts such as hitting, kicking and biting others, or slapping themselves in the face.

Though worried about the high number of incidents, they say they restrain only their most challenging students and only when needed.

But the data raise a lot of questions for experts. They doubt whether all schools and districts are accurately reporting their cases, but they are also alarmed that the current numbers show some students are restrained repeatedly or for long periods of time, sometimes more than an hour.

"That's proof that what we're doing isn't working," said Ross Greene, a psychiatry professor at Harvard Medical School.

An expert on child behavior, Greene works to reduce restraint at schools and residential programs.

"Restraints are inappropriate 99.9 percent of the time they are used," he said.

Green and others call repeated restraints a "red flag" that suggests a lack of sound strategies for preventing troublesome behavior and the likelihood that some schools are restraining students for reasons other than true emergencies.

The issue gained national attention in 2009 when a federal report found hundreds of cases of alleged abuse — and some deaths — resulting from restraint and seclusion. It found restraints that impede breathing, often when students are held prone on the ground, can be the most dangerous.

Patricia Ortaliz and her husband, Joe, filed a complaint with the Education Department in October, arguing that UCP had restrained their son for what they viewed as "noncompliance," which is not an emergency.

The school said Alex was kicking and hitting furniture and walls, ran from his teachers and was climbing a stairway railing. He kicked at staffer who tried to get near him, and eventually the staff restrained him for nine minutes.

But the school's incident report suggests he was restrained after he left the stair railing, seemingly after any danger had passed.

In December, the department found in the parents' favor, criticizing the school for how it handled Alex. The state noted that the school had not reported the incident — as well as a second restraint of Alex in September lasting 45 minutes — to the state as required by law. The school, which did not respond to requests for comment from the Sentinel, filed the needed reports in January.

Alex's family pulled him from the UCP school after the second restraint and have him enrolled in a traditional public school near their east Orange home. Now nearly 6, Alex is bright, curious and loving and doing well in his new school.

He has not been restrained since those incidents at UCP, but his parents said the events at the start of the year deeply troubled him.

He was frightened to go to school for a while, and his behavior regressed, as he wouldn't get himself dressed. The district, based on the department's finding, is now providing him therapy.

Sylvia Smith, director of legislative and public affairs for Disability Rights Florida, thinks schools are using restraint too often on Alex and other children. And though 8,222 incidents may seem a lot, she thinks schools are underreporting.

"We don't think it's all being captured," Smith said.

But Smith said her agency, which gets frequent calls from parents upset that their kids were restrained, is thrilled the state is finally tracking the information and happy the Education Department has urged districts to limit both practices.

"It is a huge improvement and huge step forward," she said.

Anna Diaz, who oversees disabled-student education in Orange, said the district is concerned about its restraint numbers and dispatches behavior analysts to figure out what isn't working when a child is repeatedly restrained.

"There are kids who do respond to the restraint," Diaz said, "but it should only be used as a last resort. We take that seriously."

Bambi Lockman, bureau chief of the Education Department's exceptional-student division, said the system is so new that she couldn't yet say whether districts were underreporting incidents or explain the wide differences in cases among school districts.

Miami-Dade, the state's largest school district, reported 115 restraint cases, while Hillsborough documented 841 cases, the second-highest number next to Orange.

"We are looking very closely at what is being reported, and we're continuing to have conversations with districts," Lockman said. The data, she added, are "opening some eyes."

In a document sent to districts in September, the department made its views clear: "It is important that such interventions be used only in emergency situations when an imminent risk of serious injury or death to the student or others exists."

Orange educators say restraint allows them to control students who are a danger to themselves or other students.

They point to Hannah Briegel, 14, a seventh-grader at Meadow Woods Middle restrained 35 times this school year. She's a success, they say, because she is being restrained much less now and is doing well in school.

Stricken with meningitis as a toddler, Hannah sometimes lashes out physically when she can't express herself, said her mother, Liza. Hannah has thrown books, overturned desks and once injured a beloved teacher.

Restraint "was a necessary tool, not a punishment," Briegel said. "It's a way to remove her safely to isolate her in another classroom, so she couldn't hurt anyone else."