Can you restrain a child who is Mentally Retarded?

This is an ld forum, not that you can’t post here but if you can find a forum for severe profound or multihandicapped you might get more response. I don’t know where to lead you here. You could check out CEC, which has (had?) a severely handicapped group.

From my understanding, you can, in an extreme emergency, use physical restrain involving using your hands and body if there is eminent harm to you or the child without an IEP. However, after that you would need to get together with the IEP and behavioral team and write a behavioral plan that would allow use physical restrain.

You can NOT just put the kid in handcuffs (isn’t this a bit old fashioned— I would think there is some degree of physical trauma involved in this and you would want to find something a bit less nasty??) I will say that I worked with severely autistic adults who were sometimes severely aggressive. We NEVER used handcuffs or any physical means aside from holding.

IF you need to use any sort of physical restrain you and your associate need ot take a course (available at the state level) in dealing with aggression. There are many ways to defuse situations and prevent them that you should know. You should also learn how to protect yourself and handle the child without injury. This is serious stuff. There are cases fo deaths from staff handling a physically aggressive child inappropriately (usually involving chest holds, which are a no-no). Also you need to learn how to teach such a child appropriate ways of dealing with frustration and aggression. For example, language can be a powerful deterrent. I reduced an autistic adult’s self-abuse dramatically by just teaching him to sign “finish” and use it to get out of things that were unpleasant. I then allowed him to use this as it was a way of doing so in an appropriate way.
There are also weighted blankets, that need to be prescribed by an OT. They are not a form of restraint, but a way of providing soothing pressure.

—des

Restraint is a very serious issue demanding much thought and preparation. You must go to the pros to determine the extent of your involvement. My background is in behavior disorders and I’ve had to do TOO MANY restraints in my life. I do not have the hours to respond - nor the information from you necessary to really help - 3 things I’ve always kept in mind - One - the safety of the class - TWO - the safety of the offending (out of control) child - and THREE - my own safety.

I worked with many sexually abused children with relatively normal IQs. I was hurt more times than I care to remember, but NEVER was a child hurt under my care. I was very well-trained in restraining techniques.
Best of luck, God Bless, Ken

Restraint is an evil necessity that despite the best of intentions will pop up now and again during the tenure of Sped teacher as well as Sped students. I will caution you that the use of restraints is a common vehicle for injuries to staff and student alike as well as the single most common cause of death for MR and AU persons in both school and residential settings.

Before restraint is even thought of, proper de-escalation techniques must be used. Your district should be able to give you training in this; if not I would see to it that they locate proper resources and use them.

One of the greatest mistakes adults will make is failure to understand the thought processes of the MR or AU person. It is unreasonable of us to expect them to respond in “rational” manner to our instructions/requests/demands. So once a meltdown is in full swing, grabbing them, forcing them to the floor (or whatever) and then shouting at them to “calm down and I will let you go” will not work. And the use of “gestapo” type holds and takedowns is the way in which bad things happen quickly (the worst being child face down, arms hammerlocked behind them and then weight placed on the small of the back to contain them).

I realize that there are occasions when the situation gets out of control and you have to do the best you can to protect all persons in the vicinity. The key to successful restraint is in recognizing the boiling pot before the metldown occurs and de-escalating. Some children respond well to a kinetic alternative to tantrumming (such as a small trampoline to jump on, etc.) Some respond to being offered a safe “time out” area where they can go till they calm themselves down.

I question very strongly the appropriateness of using handcuffs on any child. Period. If that is the best your school has to offer then it is time to strip it down to the primer and rebuild.

I am curious tho… How old is this child with psychosis? It is so very rare to see true psychosis in someone who has not come of age that for you to have one would be a most singular event.

I suspect that what this child actually has is autism and that the violence that is triggering the desire to restrain is the result of overstimmulation by the environment coupled with innapropriate response by staff to the beginnings of a meltdown. Has a proper FBA been conducted to determine what is preceding the outbursts?

Dad wrote an excellent post here. Some things I want to emphasize of what he said: training is really necessary! They should teach you as much how to restrain as how to avoid restraining.

>child face down, arms hammerlocked behind them and then weight placed on the small of the back to contain them).

Though this is an extreme position (except for the weight on the back) it is easiest for a smaller person, though ideally it should not be a one person task anyway. And really it is better done by those who have the strength to do it effectively without trauma.
A tight hold done effectively is really the best as it gives the child the deep pressure that may actually calm him/her down. I mean best of evils as that’s what it is.

>The key to successful restraint is in recognizing the boiling pot before the metldown occurs and de-escalating. Some children respond well to a kinetic alternative to tantrumming (such as a small trampoline to jump on, etc.) Some respond to being offered a safe “time out” area where they can go till they calm themselves down.

Some excellent ideas here.

>I question very strongly the appropriateness of using handcuffs on any child. Period. If that is the best your school has to offer then it is time to strip it down to the primer and rebuild.

I do too. I haven’t even heard fo this in maybe 30-40 years. And even then it was one school that used a lot of adversives (slapping, shock, etc.) I can’t see any reason to use them. There are safer physical restraints if they were absolutely necessary, but I think they are seldom necessary.

>I am curious tho… How old is this child with psychosis? It is so very rare to see true psychosis in someone who has not come of age that for you to have one would be a most singular event.
I suspect that what this child actually has is autism and that the violence that is triggering the desire to restrain is the result of overstimmulation by the environment coupled with innapropriate response by staff to the

My thoughts when I read this as well. They used to commonly call autism childhood psychosis or schizophrenia. Real psychosis is extremely rare.

I think that severe aggression is also more common in children who have been institutionalized. (And often had inappropriate or lacking social and environmental stimulation with rushes of overstimulation.) We had several adults out of institutional settings who were severely aggressive and self-abusive, this commonly settled down within a few months of appropriate behavioral techniques that included time out (max) and LOTS of positive reinforcement and work in language skills.

Dad also mentioned the FBA, It’s important— you need to figure out what is happening right before these if you want any chance of preventing them.

—des