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Tuesday, May 31, 2016

Physical Restraint Common at (Georgia's) Psychoeducational Schools

From The Atlanta Journal-Constitution

By Alan Judd
May 8, 2016

With a tiny sliver of students, special behavioral programs record five times more restraints than all other Georgia schools combined. 

Chaos erupted one day last October at a special school for behaviorally disabled children.

A student at the Harrell Learning Center in Waycross threatened a teacher and tried to push through others to get at her. The boy repeatedly struck one staff member in the head and neck “at full force,” the school reported. “The student also was attempting to scratch the staff member’s eyeballs out.”

Under attack, staff members reacted by grabbing the boy and holding him against his will. They let him go only when he stopped resisting. By then, paramedics had arrived.

Scenarios much like this have played out nearly 10,000 times since 2014 in Georgia’s psychoeducational programs, the schools of last resort for children with severe behavioral and emotional disorders, an investigation by The Atlanta Journal-Constitution found.

Last year alone, the 24 psychoeducational programs, with 3,400 students, recorded almost five times more restraints than all 2,300 of Georgia’s other public schools combined.

State education regulations permit physical restraints only when a student’s behavior causes “immediate danger.” Teachers and other school employees must discern, in an often-heated moment, whether an outburst truly imperils the student or others.

That decision can have profound consequences. Trying to restrain a child may escalate the conflict. Excessive force could result in abuse charges against school personnel. Not acting could cause a student to spiral out of control. And experts say any physical restraint presents the opportunity for harm.

“Any time you put hands on a kid, there is some level of increased risk of someone being hurt,” said Dan Crimmins, director of the Center for Leadership in Disability at Georgia State University.

Yet the Georgia Department of Education does not routinely review restraints. In fact, it gathers no data on the practice from the psychoeducational programs, even though abuses there inspired adoption of the restraint regulations.

This absence of oversight underscores the leeway that officials grant to the psychoeducational programs, formally known as the Georgia Network for Educational and Therapeutic Support, or GNETS. No other state operates a separate school system for students with disabilities.

Georgia does not compile test scores or graduation rates or other school-performance measures for GNETS programs. It does not track racial disparities in GNETS enrollment. It does not collate the programs’ reports of student injuries or arrests or other data, as it does to determine whether regular schools operate safely.

Such information would seem relevant, considering that a majority of students in GNETS programs have emotional or behavioral disorders and many are autistic. Often, unwanted contact from another person can trigger outbursts.

“We’re talking about really vulnerable kids,” said Leslie Lipson, a lawyer with the Georgia Advocacy Office, which represents disabled people in institutions. “The more vulnerable the kids are, the less information is collected.”

“It’s not just that they’re not counting,” Lipson said, “they’re not analyzing.”

Using open-records laws, the Journal-Constitution collected summaries of restraint episodes from 23 of the 24 GNETS programs. (One said it could not provide the data in a format similar to the others.) The newspaper also examined court cases and other documents concerning restraints as part of a broad review of the GNETS programs.

Georgia places a disproportionate number of African-American children in the GNETS programs, the review found. After a separate investigation, federal authorities last year accused the state of violating the rights of students with disabilities by relegating them to schools with no children who aren’t disabled. Together, the two examinations depict widespread segregation in the GNETS programs, both by disability and by race.

State education officials defend their oversight of the programs, which are considered among the most-restrictive alternatives for Georgia’s special-education students.

GNETS programs award no diplomas, so there is no graduation rate to calculate, officials say. All data on individual students — test scores, absentee rates, safety information, and more — applies to the schools they previously attended, not to their GNETS programs. Consequently, the programs don’t appear at all in the state’s school-accountability reports.

School districts have the responsibility to track the progress of students they place there, said Debbie Gay, the state’s special-education director. And because state officials don’t consider placing a student in GNETS to be punitive, Gay said, there is no need to supervise how school districts choose students for the programs.

She used an often-repeated description of the psychoeducational network:

“GNETS is a program,” she said, “it’s not a place.”

The Journal-Constitution found in a recent investigation that, in practice,
the GNETS programs segregate students not only by disability but also by race.
But in school-accountability reports, state officials don’t even acknowledge
that GNETS exists.
Photo: Hyosub Shin / AJC


It is, however, where Jonathan King died.

The 13-year-old from Hall County attended the Alpine GNETS program in Gainesville, which served students from 14 school districts in northeast Georgia. (Alpine is now known as Futures and is based in Cleveland, Georgia.)

Jonathan’s teachers said they sent him to “time out” 19 times over 29 days in the fall of 2004.

Actually, they locked him behind a metal door in an 8x8 concrete-block room that most resembled a police station’s holding cell. It had no windows or furniture, no bathroom or running water.

On November 15, 2004, a staff member gave Jonathan a multicolored rope to hold up his drooping pants. Shortly after that, a teacher sent him, yet again, to seclusion.

Even though Jonathan had threatened suicide twice, no one took away the rope when he entered the seclusion room. He used it to hang himself.

The state Board of Education alluded to Jonathan’s suicide when it approved the restraint regulations – nearly six years after he died.

The regulations — which apply to all schools, not just psychoeducational programs — permit physical restraints only after other behavior-management strategies fail and only in emergencies. Students may not be held in a prone position or in any other way that might restrict breathing. Restraints must end as soon as a student stops resisting.

All mechanical restraints, such as handcuffs or chairs with locking seatbelts, are banned, as are chemical restraints, such as sedatives or other medications.

The regulations also prohibit seclusion if it “isolates and confines” a student in a place the student is “physically prevented from leaving.” Rooms like the one the Alpine Program called its time-out area are no longer allowed.

For the most part, the regulations are carried out through an honor system. The state education board could withhold funding from schools that violate the regulations, but it set up no way to monitor compliance. The Education Department tells schools to complete a report on each restraint and to produce monthly summaries, but it collects none of those documents; instead, they stay in the school districts where they originated.

Decisions on how to use information from the reports are “relegated to the local school boards,” said Gay, the special-education director.

Matt Cardoza, the Education Department’s communications director, said officials follow up on complaints about restraint of special-education students that are filed through a formal dispute-resolution process. He said the agency also trains GNETS staff members in proper restraint techniques. The training supplements instruction that some GNETS programs give their staffs in behavior-intervention strategies.

Although Georgia is the only state with a psychoeducational network, it is one of 18 that permit physical restraint only to contain immediate threats. Along with Hawaii, it is one of only two that ban seclusion for all students.

Most other states don’t regulate the practices at all. Neither does the federal government. Congress has examined restraint and seclusion, and a Senate committee issued a report in 2014 saying both techniques may cause physical or psychological harm. The committee recommended doing away with the practices altogether.

Two years later, Congress has taken no action.

Jonathan King committed suicide at
age 13 in 2004 after being sent to a
GNETS program's seclusion room.
Photo: Special to AJC
'Zen' and 'Opportunity'

Even with the regulations in place, it is not clear that physical restraints have become less common – or that prohibited practices have ceased.

Eight of the 24 programs restrained students at least 20 times a month in the past two years, according to data collected by the Journal-Constitution. Five programs documented at least 40 restraints a month.

Elam Alexander Academy in Macon, the largest GNETS program with an enrollment last fall of 371, averaged 80 restraints a month, its reports show. That amounts to about 21 restraints for every 100 students each month.

The smallest GNETS program — Woodall, based in Columbus — restrained students at a much higher rate.

Woodall’s enrollment, as of last October, was just 27. But over the past two years, it has restrained students an average of almost 23 times a month —the equivalent each month of 84 restraints per 100 students.

Some GNETS programs say they restrain students no more than a few times each month. One, the Flint Area Learning Program in southwest Georgia, says it hasn’t used restraint even once during the past two years.

But the restraint reports don’t necessarily give a complete picture.

At the Sand Hills program in Augusta, for example, sheriff’s deputies help maintain order. They respond to classrooms when a middle- or high-school student needs to be restrained, or to any classroom when a student is out of control for 10 minutes or more, according to a document Sand Hills filed with the Education Department.

State regulations do not require schools to report student restraints by police officers.

The programs often say they used restraints to stop “physical aggression.” Few reports reviewed by the Journal-Constitution, however, addressed the events that led to the aggression.

For instance, the NorthStar GNETS program, based in Jasper, reported only that it restrained students who tried to “avoid task” or “obtain attention.”

Many restraints clearly occur amidst violent episodes. But in some cases, applying restraint may have incited or intensified the violence.

In January, 2015, two students got into a fight at Harrell Learning Center. When a staff member intervened, one of the students “became extremely aggressive with staff and continued to go toward the other student and did not show any signs of de-escalation,” a report said. The same student, the report added, made “significant verbal threats.”

The fight became “so intense that there was a lot of blood involved,” the report said, “and staff was also attempting to get the student in control in order to get him medical attention due to the amount of blood he had coming from his nose.”

No GNETS programs acknowledged using seclusion or other banned techniques to punish or control students during the past two years. But court cases and interviews with lawyers who represent disabled people suggest that some programs have simply rebranded their seclusion rooms to sound less menacing.

“Zen rooms,” “be-quiet rooms,” “calm-down rooms” and “opportunity rooms” now keep students isolated, although not necessarily behind a locked door. GNETS programs may station staff members at the entrance to an isolation area to keep students from returning to their classrooms, said Chris Vance, an Atlanta lawyer.

“They hire big people to restrain little kids,” she said. “They call these things therapeutic placements. There’s nothing therapeutic about them.”

A locked metal door guarded the seclusion room
at the Alpine GNETS program in Gainesville
where Jonathan King hanged himself in 2004.
Photo: Gainesville Police Dept. / Special to AJC
Vance pointed to a case last year in which she represented the family of a10-year-old who had been repeatedly strapped into a chair in a Houston County classroom.

The boy, identified in court as “C.C.,” is autistic and has a speech impairment and attention deficit hyperactivity disorder. When he tried to leave his classroom or caused other disturbances, teachers sometimes placed him in a “calming area,” according to court records. Other times, they used a seatbelt to restrain him in a chair from which he could not escape.

A state administrative law judge, Kristin L. Miller, ruled that the school district violated the state’s restraint regulations. She scoffed at the district’s claim that teachers placed the boy in the chair for his own protection.

“Rather,” Miller wrote in an order last December, “its purpose was simply to secure C.C. in his seat as a convenience for his teachers.”

Part One of a Three-Part Series

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