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Restraints and other restrictive interventions of children in schools are abusive and must stop

Head of Leigh Day’s abuse team, Alison Millar, discusses the publication of an updated report into the use of restraint and seclusion in schools on children and young people.

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Alison Millar is a partner at Leigh Day and head of the firm’s abuse team. She represents survivors of child abuse and campaigns for reform in order to safeguard children and vulnerable adults. Follow Alison on twitter at @AllymMillar.
Restraints and other restrictive interventions of children in schools are abusive and must stop. That was the clear message given yesterday at the launch of the updated report “Reducing Restrictive Intervention of Children and Young People” hosted by Baroness Hollins at the House of Lords.
 
The report was jointly produced by The Challenging Behaviour Foundation (CBF) and Positive and Active Behaviour Support Scotland (PABSS). It is based on case study data collected by PABSS from 720 children and young people across the UK with a range of needs including autism; speech, language and communication needs; sensory needs; mental health needs; and learning disabilities or developmental delays. The data was analysed by researchers at the University of Warwick and exposed some shocking findings which include:
 
  • 87.6% of the families reported that, to their knowledge, their child had been restrained at least once and most families reported that their child had been restrained between 1 and 30 times, with one reporting their child had been restrained 350 times.
  • Over half of the children and young people had experienced seclusion at least once whilst they were at school.  16.4% of families reported their child had been secluded “multiple times”.
  • The majority of children started to experience restrictive interventions in primary school and the highest percentage of restraint was at just age 6.
  • The majority of reasons reported by family carers for the use of restrictive interventions were “unclear” and did not specify the behaviour that had led staff to intervene. 
  • Examples of such unclear reasons given to the family carers surveyed included “naughty”, “disobedience”, “refusal to comply”, “sensory overload”, outbursts and disruption; also “anxiety”, “upset”, “not coping”, “stubborn”, “cheek, “disrespectful” and “poor choices”.  Guidance on the use of restrictive interventions consistently maintains that the use of restrictive interventions for behaviours that challenge should only be used to reduce the risk of harm or maintain the safety of the child, young person and / or others, alongside proactive interventions to minimise behaviour that challenges (NICE, 2015).  These descriptions give rise to serious concern that restrictive interventions were being used to control or manage children inappropriately.  Similarly, where specific reasons were given, not all of them meet the criteria in the guidance of where it is “reasonable” to use restrictive interventions (restrictive interventions were employed for things like swearing or refusing to work).     
  • Most of the families (86.5%) reported that their children had been physically injured during restrictive interventions, with injuries including bruises, abrasions and scratches and even head injuries, broken bones and broken or chipped teeth.
  • Families also reported causes of injury which are also deeply concerning and raise questions as to whether more than ‘reasonable force to control or restrain pupils’ is being employed. These included being strapped into or kept in a chair, the use of spit hoods, wrist and Velcro restraints, and descriptions such as “teacher slapped [child’s] face”, “broken thumb (teacher bent it back to punish)”, “teacher smacked child” and “pulled hair”.
  • A wide variety of other impacts were reported by families including the child being removed from school, emotional injuries to the child, the child being hospitalised or given non-prescription medication, needing to see a doctor, incontinence and police involvement.    Family carers also reported being profoundly affected themselves by the consequences of restrictive intervention of their child.
  • This was despite most families reporting that, to their knowledge, their child’s school had training in restrictive interventions.  There must be concern that this training is either being misinterpreted / poorly applied or leading to perverse incentives (i.e. once staff receive training this is actually leading to greater numbers of restraints).
 
Another theme that arose from the report of the case study results was families reporting that records were not kept on the use of restrictive interventions in schools (75.8%) or, to their knowledge, of injuries following the use of restrictive interventions (96.5%).
 
The data also suggests that families are not being routinely informed when physical interventions have been used and some family carers have only found out that their child had been restrained and/or secluded after they directly asked someone at the school about injuries their child had returned home from school with.  Other families had only found out through making a formal request to see their child’s records.
 
I am not at all surprised by the findings of the report as this has been the experience of families in cases in which we have acted in bringing legal cases including on behalf of a 16-year-old boy with Autism and Down’s Syndrome whose family alleged he was subjected to excessive and unreasonable physical restraint at a private residential school for children with learning disabilities.
 
In this regard, I very much welcome the Equality and Human Rights Commission’s decision today to launch a formal inquiry into how schools are monitoring and recording their use of restraint.  I fear, like the CBF and PABSS, that it is possible that the case study data in their report may only be the “tip of the iceberg”.
 
The launch event yesterday started with an extremely moving presentation by @elly_chapple about the experience of her daughter Ella.  Elly urged us to #FliptheNarrative, understand that behaviour is communication and ensure that children with disabilities are seen as fully human, and not subjected to forcible and damaging physical restraints when they try to show us that they are anxious, uncomfortable or frustrated. Elly also stressed the enormous consequences – emotional and financial – of getting it wrong, as a child who has been traumatised will often need a high level of specialised support in consequence: funding that could have been much better applied at an earlier stage to ensure that their education and care were meeting their needs.
 
Nick Hobbs, Head of Advice and Investigations from the Children and Young People’s Commissioner Scotland, gave a great talk framing the use of restrictive interventions, including restraint and seclusion, in schools as a human rights issue.  I could not agree more and this is something that we have strongly argued in the civil legal cases we have brought including on behalf of an autistic child who was subjected to a spit-hood and another young boy with autism who suffered serious injuries whilst isolated in a ‘soft-play’ room at a specialist school.
 
 
The CYPCS has very much led the way in this area with the publication of the report ‘No Safe Place’ in December 2018, which, together with strategic litigation, led to the Scottish Government agreeing to produce human rights based guidance on restraint and seclusion, involving children, young people and their families in the drafting and review of the guidance – and to consider making it statutory if necessary to lead to change.  Notably, the First Minister has also committed to incorporation of the United Nations Convention on the Rights of the Child (UNCRC) into Scots Law before the end of the current Parliamentary session in 2021.
 
The Reducing Restrictive Intervention of Children and Young People report published yesterday ends with a number of recommendations, including strengthening the law to remove the powers of members of staff to use reasonable force to maintain good order and discipline and for the Westminster Government to produce statutory guidance about the use of restrictive intervention in all schools.  The current guidance is not adequate as it is non-mandatory and it does not cover mainstream settings and alternative provision.  As a member of the Reducing Restrictive Interventions and Safeguarding Children (RRISC) group, I thoroughly support these recommendations.  Crucially, the report states that “there is already a clear body of evidence about how best to support children with learning disabilities or autism whose behaviours challenge … there is no need for a new task force or report to reconsider the same issues – now is the time to take tangible action to stop harming children through the use of restrictive interventions”. 
 
I look forward to a future where we no longer have to discuss the use of restraint and seclusion in our schools and I have pledged my support to ensure that this happens.

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