home

As a children’s mental health advocate in Iowa, I often comment on proposed legislation, rule changes, etc. I have decided to share publicly through this blog recommendations that I make, concerns that I have, and other things that seem useful to document as we continue this long struggle for Children’s Mental Health Justice in Iowa.  I hope that these posts will be helpful to other advocates, legislators, and policy makers.

For my first post, I will share the comments I sent in today to the Iowa Department of Education regarding the proposed rule changes regarding the use of seclusion and restraint in the schools. In summary, I think the proposed rules are an improvement on our current rules and recommend that they pass.  That said, I would like to see further changes as outlined below. (Note: a few details have been deleted to protect my son’s privacy, but the content is the same. All posts are approved by son beforehand if they involve information about him.)

 

Comments on Notice of Intended Action: Proposing rule making related to Corporal Punishment and providing an opportunity for public comment

By Tammy Nyden

Mother of a child with SED, Co-Founder and President of Mothers on the Frontline, and Associate Professor of Philosophy at Grinnell College

Click here to see the EDUCATION DEPARTMENT PROPOSED RULES

Context:

I regret that I cannot attend the hearing today. The issues involved in the rule changes on seclusion and restraint are importantly tied to the lack of a full array of education options for children with SED and the lack of mental health training in our schools, particularly among special education teachers teaching in Iowa’s “behavior classrooms”, where many of these kids spend their days. (SED = Serious Emotional Disruption – the phrase used for children with serious mental illness.) Over the past ten years this lack of training has caused unrelenting trauma in my son and family’s life, particularly in the form of inappropriate use of seclusion and restraint when he was in elementary school. I will not mince words. The school has abused my son. A parent would lose custody of a child if they treated a child the way the school district has treated my son and many other children with disabilities over the years.  I fear that without proper rules, clear guidelines and appropriate training, this child abuse will continue throughout our state.

I can tell you, both as a parent who has now worked with several different schools in our own journey and as an advocate who has worked with several families across the state – these are systemic and cultural problems in our state’s educational system, largely stemming from a rigid behavioral model that is uninformed with mental health training. Parents like me have no options in most of Iowa. Despite having a child with severe and complex mental illness, there are no medically appropriate educational settings available in my part of the state.  That is to say, there are no real therapeutic schools, in which the teachers have mental health training and work directly with doctors and therapists to create an environment that is both therapeutic and educational.

The result is overwhelmed and frustrated teachers who rely on the only tools they have been given – behavior modification techniques designed for neurotypical children with motivational issues: rewards and punishments, seclusion and restraint, and suspension. When the child’s behavior results from anxiety, psychosis, trauma, or depression, teachers fall back on these inappropriate and ineffective techniques, which often exacerbate the illness or trauma and therefore, ironically, the very behaviors they are trying to modify. The results not only put kids in danger but the teachers themselves. The constant use of seclusion and physical restraint is a symptom indicating that something is seriously wrong with how we are serving these kids (and their teachers) in our schools.

My Comments on the Proposed Rule Making:

Problems that need to be addressed in the current and proposed rules:

281.103.5 #1 bullet #4 – This section says that no employee is prohibited from using reasonable and necessary force “to remove a disruptive student from class or any area of the school’s premises, or from school-sponsored activities off school premises.”

• Given that many of the cases of abuse of seclusion and restraint that have been documented in Iowa and throughout the nation were done in the name of removing a “disruptive” student, I find the vagueness of this wording deeply concerning. There are documented cases in which students were seen as “disruptive” for rolling their eyes or speaking back to a teacher and then put into seclusion and /or restraint. The only form of “disruption” that should justify force is the disruption of a physically safe environment.
• Many symptoms of mental illness are “disruptive”, for example, ticcing from Tourette Syndrome or rapid and continuous speech during a manic phase. The problem is in Iowa, special education teachers do not directly teach the curriculum. So parents of children with SED are constantly put in the unacceptable position of having to choose between our child’s education and health. The expectation (which is entirely unreasonable when kids are very ill) is that the child go to the general education setting to receive the lesson, then return to an alternative setting to do their lessons. So the very kids that need fewer transitions during the day end up having more than the general education student. And when the very predictable escalated behaviors happen – either in the general education setting or in route in the hallway, the child gets punished. We need to have alternative settings with teachers directly teaching the curriculum for those students that need it.

281-103.7 (256B, 280) Reasonable and Necessary Force – Use of Physical Restraint of Seclusion – This section says that Physical restraint or seclusion is only reasonable and necessary

• (a) to prevent or terminate immediately threat of physical injury or
• (b) to prevent damage or property of significant damage, when the student is disrupting learning and when necessary for physical safety, and
• (c) less restrictive alternatives to seclusion would not be effective, feasible or have failed

(b) is not necessary (as physical safety is already included in (a)

(b) is confusing and likely to lead to seclusion and restraint for property damage alone or disruption alone. Any reference to property damage and disruption should be removed. Physical safety should be the ONLY reason for use of force – ever!

(c) concerns me given the context of children’s mental health negligence in our schools. My son only became aggressive in situations where the school kept putting him in inappropriate settings. When he was able to be in an appropriate therapeutic school environment during a 9 month residential stay, he had no incidents of aggression in the school environment. So what the untrained and under-resourced school officials see as feasible is not reasonable, given the utter lack of a complete mental health array for children in our state.

281-103.8 (256B,280) Training, documentation, debriefing, and reporting requirements

I am deeply troubled that the training listed here does not include mental health or trauma informed care training, particularly for special education teachers working with students identified as having mental health conditions or having experienced trauma. Again, we see evidence of an exclusively behaviorist model. While it is good that there is some move away from a punitive model to a positive model (such as PBIS), the consistent failure to address mental health and trauma is alarming.

Positive improvements in the proposed rules:

It is good that 281-103.6 (256B, 280) #4 adds that mental and psychological injury are factors that must be considered in determining reasonableness of force. We need to recognize the ACE’s (Adverse Children Experiences) being inflicted on children by schools and stop it.

281-103.8 (256B, 280)  #4 – When student exhibits pattern of behavior that result in multiple instances of seclusion and restraint the school must convene and meeting. This is one of the most important rules changes I see. It is a substantial improvement. However,  I am concerned that the “or” in this section makes a mental health expert optional. I think a “mental health professional” should be required to be part of such a meeting, at least in cases where there is a documented mental illness and when requested by parents or teachers because of a suspicion of mental illness. The language should say “professional” as opposed to “expert” in that it should require proof of adequate professional training in mental health.

 

Conclusion

I am grateful that the Department is considering this important civil rights issue of our time. This issue is an important part of the School-To-Prison pipeline.  The inappropriate use of seclusion and restraint as well as the lack of appropriate mental health and trauma informed care training in our state’s schools is leading to a specific form of school push out that is rarely acknowledged – parents left to homeschool their children because their available public schools options are not currently safe for children with mental health disabilities. I encourage you to continue your work to improve this situation by working with the Governor’s State Board charged to build a statewide children’s mental health system.