Health
4:21 pm
Wed April 2, 2014

Loophole Means Many Child Restraints Go Unreported In New Hampshire

Like many kids with autism, Hunter Picknell has trouble expressing himself.

“His primary form of communication is sign language, but there’s certain things he can’t do with his hands and fingers because of his motor-planning issues,” says Melissa Hilton, Hunter’s mother.

Melissa Hunter says she wasn't immediately notified of the school's use of seclusion on her son.
Credit Todd Bookman / NHPR

“He makes kind of his own sign language, which is very idiosyncratic. We often joke around and say it is sign language with an accent.”

When the 9-year old can’t share what he’s thinking or feeling, his frustration often leads to violent outbursts and dangerous behavior. He has a permanent mark on his forehead from smashing his head against the wall or floor.

These eruptions caused problems at Hunter’s elementary school, where he had a one-on-one education aide.

Hilton says he was secluded in his classroom, while staff waited for him to calm down.

“They would just watch him through this tiny window like he was a rabid monkey and instead of comforting him when he was upset, they would just lock him in this room, so he couldn’t get out,” says Hilton.

Using seclusion or physical restraint is a legal, if not favored, response when a child is in danger of self-injurious behavior or hurting others. Schools and residential treatment center staff are required to notify parents within 24 hours, and file a report with the state.

Hilton says she wasn’t alerted in that timeframe, which made it harder to help her son understand what was happening.

Hunter Picknell at age 8. He often gets frustrated by his inability to communicate, resulting in violent outbursts and self-injurious behavior.

“When a kid is the subject of some sort of physical intervention or isolation from their peers, that’s important for a parent to know,” says Mike Skibbie, policy director with the Disabilities Rights Center.

Students with disabilities are 25 times more likely to be restrained, according to the UNH Carsey Institute. That’s consistent with a 2009 federal investigation, which brought national attention to the issue. It highlighted hundreds of alleged cases across the country resulting in severe injury and death.

New Hampshire re-wrote its laws the following year, banning certain techniques and adding the 24-hour reporting requirement.

But, critically, the law also included an exception: any restraint that is considered “brief” doesn’t need to be reported.

In practice, this has led to very few instances inside group homes ever showing up in state filings.

“Obviously, you see all these zeroes. It is obviously not the case that all of those organizations had no physical restraints,” says David Villiotti, executive director of the Nashua Children’s Home.

“The exception around it was, frankly, wide enough to drive a truck through.”

Nashua Children’s Home is one of the few residential treatment centers in the state that didn’t simply classify every restraint as brief and leave it unreported. Documents from Health and Human Services show the facility has reported 110 restraint events in the past two years.

Villiotti says his staff is diligent about keeping parents informed. He also defends the use of physical restraints in volatile situations.

From a 2013 Department of Health And Human Services report. Many group homes define restraint incidents as "brief" allowing them to avoid reporting requirements.
Credit Department of Health and Human Services

“We know it’s serious business. We know whenever we put our hands on kids, with the resistance that kids offer, there is the risk of injury, and we know that that can happen…but when we do need to put our hands on kids, we do it in a way that is safe and non-harmful,” he says.

One institution that reports zero restraint incidents is New Hampshire’s juvenile detention facility in Manchester, called the Sununu Center.

“We document when it happens, and I think that at least weekly...and sometimes daily, a child or children have to be separated,” says Maggie Bishop, who oversees the Division for Juvenile Justice Services.

Bishop says parents do get notified, even if state officials don’t get a write-up.

The state is however backing a bill moving through the legislature that would make it easier to track the use of restraints, and close the loophole allowing “brief restraints” to go unreported.

It also sets strict guidelines for secluding children, and clarifies that neither restraint nor seclusion can be used as punishment.

Many close to this issue see the measure as progress. That includes Eric Herlan, an attorney who represents school districts.

He cautions, though, that this is a complicated issue, and that the new standards may put too much pressure on educators to record what may amount to normal contact with students.

“Our teachers should be teaching kids rather than writing reports,” says Herlan.

But advocates argue the tighter standards make clear exceptions for benign exchanges, like a kindergarten teacher hugging a student, or a coach interacting with an athlete.

And they say making more events reportable will make clear which institutions rely too heavily on potentially dangerous actions against children.

Right now, there’s no way to know. 

View Restraints Reported by School 2012-13 in a full screen map

DATA SOURCE: New Hampshire Department of Education