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Foul Practice of Restraint Not Considered Foul Play in Death of Student with Autism

RestraintAs sheriff's detectives investigate the incident, they say that there appears to be no evidence of foul play or criminal intent at this time. 

AT. THIS. TIME.

This boy was 13 years old. Perhaps he was prescribed Risperdal, an anti-psychotic drug given to people with autism to "help" with behavior. One side effect is severe weight gain. The boy was tall, but 280 pounds is more than just a tall kid. Restraint is difficult. If you train in martial arts, you might call a restraint a "submission."  Rhonda Rousey used to break arms with hers. You can break bones. Suffocate. It's called "choking out" when you apply pressure to the throat, neck or temple.  A restraint is a weapon.  I call this aggravated assault, not a school safety technique.

###

From ABC10.

EL DORADO HILLS, Calif. -- A 13-year-old student died after being restrained at an El Dorado Hills school.

The student was described by officials as being six feet tall, 280 pounds, and diagnosed with “severe autism.”

The El Dorado County Sheriff’s Office responded to Guiding Hands School in El Dorado Hills on November 28. According to the sheriff's office, the boy had become violent and was restrained by school staff to prevent injuries to other staff and students.

While being restrained, the student became unresponsive and a teacher provided CPR until medical aid came. The student was taken to Mercy Folsom in critical condition and would later be transported to UC Davis.

The sheriff’s office was notified of his passing on November 30. As sheriff’s detectives investigate the incident, they say that there appears to be no evidence of foul play or criminal intent at this time.

This is a developing story.

Comments

Beleaguered Autism Mom

I got this in my email today:

SCDD MOURNS DEATH OF STUDENT IN EL DORADO COUNTY

SACRAMENTO - The State Council on Developmental Disabilities (SCDD) mourns the death of the student at Guiding Hands School in El Dorado Hills who reportedly stopped breathing after being placed in a prone restraint for over an hour and died at the hospital.[1] A prone restraint involves immobilizing a student in a face down position.

"The news reports that the school placed the student in a prone restraint for over an hour. An emergency does not last an hour. I cannot fathom any reason this student would be a danger for an hour. We cannot expect students to learn if they go to school and fear for their safety. The death of the student warrants a full and robust investigation," stated Sandra Smith, SCDD Chairperson. SCDD opposes all forms of restraint and seclusion in schools.

The California Department of Education has suspended the certification of the Guiding Hands private school. The K-12 school provides special education and related services to children with disabilities. State records show the school had 137 students and 16 full-time staff as of the 2017-2018 school year. In 2018, the County Sheriff's Department has been called to respond to incidents at Guiding Hands School a total of 27 times for a variety of reasons. According to court records, the school has been sued before for restraining a student. In 2002 and 2003, the school staff forcibly restrained another teenage student multiple times.

This past year, Governor Brown signed AB 2657 which looks to prevent and reduce the use of restraint and seclusion in schools except in cases of serious physical harm. While prone restraints are banned for use in schools in other states, they are still legal in certain circumstances in California, but the student must be monitored. Both the California statute and the proposed federal legislation, the Keeping All Students Safe Act (H.R.7124 / S.3626) prohibit the use of any physical restraint that restricts breathing. The dangers of physical restraint are well-documented. A 2002 investigation by Disability Rights California into the use of restraints in schools and other institutions found that "prone restraint," is a "hazardous and potentially lethal restraint position" that puts people at risk of asphyxia.

"The use of restraint is serious and pervasive problem that deserves a systematic and comprehensive response. Every student must be treated with dignity and be safe in school," stated Aaron Carruthers, Executive Director of SCDD. The U.S. Department of Education shows 122,000 students across the nation were restrained or secluded in 2015-2016.[2] The use of restraint and seclusion disproportionally impacts students with disabilities. "This is unacceptable," stated Carruthers.
________________________________________
[1] https://www.sacbee.com/news/local/education/article222733345.html
[2] https://www2.ed.gov/about/offices/list/ocr/docs/school-climate-and-safety.pdf

Close to 50 years ago, Congress established the State Councils in every state and territory. The Councils are authorized in the Developmental Disabilities Assistance and Bill of Rights Act of 2000 to ensure that individuals with developmental disabilities and their families design and can access services and supports that "promote self-determination, independence, productivity, and integration and inclusion" in community life. The Lanterman Act establishes the SCDD in California to be comprised of 31 members appointed by the Governor, including individuals with disabilities, their families, other partners and state agencies. The SCDD develops a five-year state plan to implement the DD Act through the work of 12 regional offices in California. The plan is developed with stakeholder input and is focused on addressing systemic barriers to employment, housing, education, community supports, health and safety for persons with developmental disabilities.

Morag

A truly raw tragedy for that young lad needing support,his family, and also staff left dealing with that fatal, behavioural incident.
Life Threatining -Serious Medical Emergency from
Acute Respiritory Distress Syndrome [ARDS] From restricted airways and normal breathing, during Physical restraint of a person in acute distress .
Staff need to get trained to spot and divert Flashpoints for challenging / distressed or disruptive behaviour. The behaviour unwanted, itself is a communication of extreme distress!
Good training examples available to look at .
Helen Sanderson Associates UK , USA, Canada .
The Challenging Behaviour Foundation Uk . Good information about what's working what ain't working ?
I am alarmed and very sorry for teachers /support workers being left to support behavioural issues with only control and restraint, in-service training, of what? 1-2-or 3 days instruction? Which in the Learning Disability/Difficulty Zone is akin to a Knee jerk reaction of someone [well meaning] but throwing a basin of water, on a commercial, size deep fat fryer, that has just burst into flames and expecting a good outcome from doing so ?
See Slow -Motion Water on "Chip Pan" Fire Demonstration by London Fire Brigade. Youtube

Michelle

My understanding is that this boy was actually high functioning and not at all “severely autistic”. Additionally, he was not 280 pounds nor was he 6 foot tall, according to medical records. The school, or someone, is using the false information of saying that he was 280 pounds and 6 foot tall to justify the restraint. The restraint is not justifiable. Something went terribly wrong. The Sacramento Bee reported that another child witness this event ( and undoubtedly was traumatized by this) and stated that the boy (who ultimately was killed) was kicking the wall when the staff restrained him. The staff reported that he was restrained for an hour. Restraint used was one in which the child is face down on the ground. This is uncalled for! In many states this restraint is illegal. It should be in California too. Stop these tragedies! Stop restraint! If there was another child in the room at the time staff was restraining the boy who dies, there was obviously other avenues of dealing with his behavior. If he was so violent, why were the other children still in the room?? I realize there was no foul play in the sense that the staff didn’t intentionally kill the poor boy. However, when a motor vehicle accidentally hits a pedestrian, the driver is still culpable for the death. In the same way, the staff is responsible for this child’s death.

Concern Mom

This child was restrained and killed by school personnel, not police officers.

Their deliberate acts to restrain this child in a prone position for any time led to his death.

Prone restraint is known to cause positional asphyxia and this happens more often in individuals with autism due to low muscle tone.

Another cause of death in these types of restraint situations or where a person has an extreme fight/flight/fear response is called excited delirium. The individual’s body temperature will rise to the point where the organs will fail, including the heart and this will cause heart failure.

We may never know what transpired for this child and what caused his death, but we do know that if the proper supports were in place upfront, this would not have happened most likely at a school that was suppose to be able to meet this child’s need set due to his disabilty.

Lastly, we really need to know all that is involved in such circumstances to work toward ensuring another child is not killed in this manner by anyone.

Marie

A statement of "the boy had become violent" is irresponsible reporting. It could say he displayed behaviors of violence and there is an investigation ongoing if the violence was a result of "defensive" behaviors of self-protection after he was subjected to a situation of being overloaded in some way, resulting in a violent expression or eruption. Most often, people who have not themselves experienced the severity of disconnected misfiring senses that a person with severe autism has been enduring, cannot imagine the ongoing state of overload that a person with severe autism is existing in. This is beyond tragic and inferring that a child who is existing with a severe injury should have any blame is simply not acceptable.

Even if the intent was not to harm, the liability is with the school whose care he was in, regardless of the act or severity of violence of the impaired and registered disabled person. The school was receiving money to be keeping him safe. They could not do it. Regardless of impairment the law is non-discriminatory and allows for that person to be in school and there are insurance policies that must pay the money to the family for their failure to prevent a preventable death under their care.

They are fiscally responsible. Whether intent is involved is another aspect. He died under their care. They have liability. The amount of liability will be dictated by intent and if situation was mishandled.

It will be an even greater tragedy if this even spurs more chemical lobotomies via powerful psychotropic drugs which do not cure, but rather drive the aberrations deeper and not resolving the original sources of tensions and trapped suffering of the person existing in that misunderstood and deeply suffering state.

This school and its employees did not apply them with consideration to the individual and his individual medical condition and circumstance. They violated a human being resulting in his death which may or may not be considered manslaughter depending on if intent was involved. Any way it is looked at, they violated the law.
The question after that is how to continue to work towards an appropriate understanding instead of stories blaming ill people who cannot control themselves. A tragedy like this demands real solutions with compassion for someone suffering so, not fear based ones. Work is hard. Earning money is hard. Caring for people with disabilities is hard but caring for the most vulnerable people in society is a true privilege, albeit an underpaid and challenging one. Those that keep people of any age and suffering condition safe on a daily basis are unsung heroes.

There are solutions.

Not an MD

This is horrific, no matter the reason for the outcome. This child's death may not have had anything to do with the way the restraints were placed on him or where they were placed on him, but everything to do with the battle to get him into the restraints and the cardiac stress it placed upon him. I knew a person with ADD on Risperdal who said the drug made him feel brilliant and capable, but he had to stop taking it as it spiked his blood pressure to dangerously high levels. Perhaps this death was due to a heart attack from the stress of the event plus the dangerous drug in the child's system. I hope that the investigation will shed some light on what actually caused the death.

That said, a friend's son who has slightly verbal autism, and incredible strength (as he loves playing basketball--- for many hours every single day) grabbed hold of my hand once and squeezed it-- not with the intent of hurting me, but to take me outside to play basketball with him, as that is what he wanted to do. As I felt my bones being crushed, I had to do some quick thinking about how to get him to release my hand. My hand was throbbing as he was actually hurting me. I told him that if he let go of my hand, I would play basketball with him outside later. His mom was not in the room at the time this occurred. She was on the phone in another room. If her son had not understood what I said, accepted my offer, and released my hand in that instant, he would have broken several bones in my hand. I am so grateful that I used my language to avert this problem, because if I hadn't, he would have definitely crushed the bones in my dominant hand.

That situation I found myself in, unexpectedly, made me wonder if his mother understood that her son was indeed capable of causing injury to one of his teachers which had previously led to her son's expulsion from public school. I will say that I sure did see, and understand, the teacher's side of things that day (she had claimed injury to her eyes, and head when he struck her in class), after experiencing her son's extraordinary strength firsthand. His mother had told me previously that she doubted her son had hurt his teacher as significantly as the teacher claimed.

I feel for all students with autism, and I think that if our children were uniformly spoken to like human beings at critical moments rather than like subhuman beings (something many of us have witnessed), less actions of violence would probably ever manifest. At the same time, I also feel for and can empathize with those whose job it is to teach our children with autism in school. Sometimes bad things can and do happen to good teachers who have done nothing wrong and nothing to provoke violence from a student.

Luis

Having a 19 YO child; 280 lb and almost 6' tall, I know that people consider him to be a big young man. He is verbal and high functioning autistic. A person who is not of his size is going to see him as a big, big guy. My son doesn't know violence but if he raises his voice and/or slams my car door, people who don't know him might think he is either violent or has a bad temper. Confusing.
A police officer will react in a way that he or she is trained to when encountering an outlaw.
I wonder how much training do police officers receive to deal with individuals with disabilities. I personally believe it is very little, 10% or less. I hope I'm wrong and the percent is higher than that.
In moments of crisis, what's in the mind of any law enforcement officer in a very critical situation is to avoid harm done to himself/herself, the people around the area of crisis and the individual. Sometimes things turn out differently and in the end, the individual with disabilities ends up the be the one with all the harm done.
We may state our opinions about incidents like this but, we have to think that there are people who still don't know much about autism or other neurological disorders, needless to say, if we, as a community, know how to handle those individuals unless we live with one of our own.

Margaret Jaeger, grandma Peg

I, too, fear...that kids with regressive Autism aren't viewed any differently than any other person who becomes violent in a school, any school. People trained in restraint training, I'd hope they also receive schooling in the psychology of the developmentally disabled..I'd think it was a requirement myself. To that end, as my grandchild got older and taller, I bought the books and any papers I had, on the behavior of law enforcers and encounters of d.d. people with the law, by Dennis Debaught and gave to a local detective I knew with the expressed desire he'd see that..he read them and that they got to the head authority for considering training all officers in the recognition and handling of the d.d. Person. I don't now recall but hope I also remembered to give the papers written by 'Bill'... Davis, I think is his last name, the ex fireman who has a son with Autism. Hoping these two groups would engage in exchange of info and maybe joint classes, I don't know if they did follow thru or not. But I suggest all concerned people do the same in their area. Maybe then those assigned to be restrainers in schools could also, be Required to attend said classes.

Hera

Bob Moffitt,
yes, I agree all the facts are needed; what happened, what the "aggression" looked like, and what precipitated it, and why the child died ( may he rest in peace.) A terrible tragedy for his family.
Richard Gamble;
yes, life has a lot of gray, and it might take a lot of people to figure out the answers. The parents are probably the best people to talk to about how to calm their child down. What works? Does it take music? Being left alone? Who does the child respond best to at school? Can the parents come in if the child is starting to be upset?What are the signs that things are starting to escalate, and how do you stop it before a full fledged meltdown? Are certain sounds or situations extremely painful for the person? And if they can communicate, find out from the person themselves what best calms them down. Getting it all worked out before hand makes life a lot easier.
When I was growing up, remember being in a room where an autistic boy tried to choke his much younger brother, so I agree that despite best efforts and alternative ways to sooth, imo there may be times when restraint is needed to protect someone else from a physical attack, and from the attackers victim being hurt or killed themselves. But the idea of restraint is that everyone walks away unharmed.Restraint that kills, something went wrong.
Sometimes the problem is bad teaching of restraint techniques. Did the person who trained you teach you how to protect the person during the restraint? How do you assess their airway, comfort level etc? As Kim says,some techniques are very dangerous. You can kill someone by cutting off blood supply to the brain, or crushing the windpipe etc. Imo, throat techniques should never be part of restraint. Also, when in the middle of an adrenaline rush where someone is trying to hurt you, control can be hard, and needs to be practiced. If you intend to physically restrain someone, my suggestions ( for what they are worth) are know exactly what you are doing,in detail, having had a lot of practice, and know how to keep it safe for everyone. if someone is choked, squashed so they can't breathe etc, then that is not restraint, it is attack. Sometimes just escorting the person to a safe place may be an answer. And try and talk them down, even if doing a restraint.. make your voice gentle. Hey Harry ; we are just going to rest together here for a little while, then we will be letting you go, okay. Have you seen ( movie, favorite train, favorite pokemon conversation etc) . Give them a chance to find their normal again. A kid being restrained is going to panic , maybe have an asthma attack. You need to watch for this, and to be in charge of their safety if you are restraining them. It is not an easy job; in fact it is extremely hard.
Some martial arts, like hapkido teach joint manipulations, some dangerous,and some much less so. If you think you are going to be needing to restrain someone, then knowing how it feels when done to you, and also what is fairly safe, and what is not , may help. Disclaimer; any of my ideas may not apply at all to your situation, so talk with a professional who knows how to keep people safe.

Beleaguered Autism Mom

Richard, calmly talk to him. "___, what do you need? Show him the visual aid that his teacher or therapist has made of his preferred choices (Drink water, eat, bounce on ball, use hand sanitizer, jump, squeeze something, bite a chewy, listen to music, take a break in the quiet room, etc.) Talk to his teacher or therapist if the visual aid hasn't been updated based on his preferences. He should have visual choices he can point to in frantic circumstances and he should be given a set amount of time to complete his choice (1 min.). Show him a countdown/stop watch on your phone. Autistic guys I know appreciate clocks because they are consistent, reliable, and measured (not chaotic). If you want calm - demonstrate calm. The people who know him best or who are aware of the circumstances prior to the escalation should be involved to identify the problem and solution. (no Goldfish available: (the staple of his diet), the iPad was not re-charged?, noise cancelling headphones needed)? Some rule that has been guiding his life has been broken. When my son reached 208 lbs and 5 inches taller than me in middle school I focused on basics - taking as many deep breaths as needed to calm down, counting to 10 (I counted out loud while he used his fingers), alternately touching his knees. These techniques should be practiced at every sign of frustration. I realized my son did not like being out of control and he appreciated support in learning how to calm himself down.

Bill

Weight gain is not the only consequence of Risperdal. Risperdal is a powerful neuro-toxin, which does result in sedation. It's in a class of drugs that used to be called "major tranquilizers", although that term is less often used today in 2018. "Anti-psychotic", or "atypical anti-psychotic" is also a relevant term, although I can't recall whether Risperdal is an older, typical anti-psychotic, or a newer, atypical. Regardless, long-term Risperdal use can and will result in akathisia. Persons on these types of neuro-toxic drugs have developed akathisia, and then committed suicide in order to escape the agony of akathisia. In some people, the direct chemical effects of Risperdal and other drugs like it, can result in agitation, or even violent behaviors. No doubt the Risperdal was given to this young man as a form of behavior control, or "chemical restraint". There is virtually NO legitimate research showing the effects of Risperdal on persons diagnosed with autism. The article states that a Sheriff's deputy was sent to the school, but that the young man was restrained by "school staff ". That may have been the case. But if the young man was successfully restrained by school staff, why call the Sheriff's? If the Sheriff's showed up, the Sheriff's probably also attempted to restrain the young man. The school staff MIGHT have had the intensive and specific training required to safely control out-of-control behavior, but the Sheriff's deputy almost certainly did NOT have such training. Law enforcement training, which the Sheriff SHOULD have had, for subduing violent criminals, is very different than that for working with disabled persons. But, the Sheriff's deputy can ONLY treat the young disabled man as if he were a violent criminal. A Sheriff's deputy is authorized to use deadly force if necessary. A school staffer is NOT authorized to use deadly force.
I'm saddened by this story, and I'm trying to make sense of it, by writing my thoughts down here. I hope AoA will keep us updated on this story. We don't really know what happened here, and we may never hear the full story. But Rispredal is a psychiatric drug, and psychiatric drugs are rarely, if ever, appropriate for even a "severe autism" diagnosis. Autism is NOT a "psychiatric disorder". It's physical and neurological. Try to have a good weekend, anyway, people. And,
KEEP UP the GOOD WORK

Richard Gamble

I'm in the process of learning how to better deal with these situations. I would like for someone to comment on the scenario that if a student poses a serious, physical threat to staff and others, what would be the protocol in that situation? I am restraint trained in an alternative school setting and am trained to use the techniques only when the safety of myself, staff, students, or the perpetrator is at risk. I have had to restrain several autistic students, several trying to stab me with pencils or hit me with chairs. Once you go into a restraint situation, it's like a real fight. Although I am using the techniques suggested by our guidelines, you have to realize it is somewhat of a self-defense situation. The student being restrained often is trying to inflict bodily injury upon me or another student. I have read several comments on various message boards, this one included implying that restraint is not the answer. If restraint is not the answer in the situations I have posed, I want to know or receive information on how to differently treat the situation. Thanks for your time.

Will

Let us all talk about how these psychiatric drugs like Ripserdal make the person morbidly obese and increase the risk of heart disease with or without the wait gain. These drugs are over prescribed in autism and make pharmaceutical companies billions. These private school are less accountable than public schools and even parochial schools. Going back on the obesity issues many DD people have conditions that make obesity more common and this issue ignored by doctors as not to offend people.

bob moffit

I think it unfair to all involved in this tragic incident .. to form an opinion based upon the scant facts presented in the article. Such as .. "the boy had become violent". It requires due diligent investigation to determine what "violent" in this case means? From the scant information available .. the boy's death is evidence of the "violence" he was obviously subjected to.

As a former police officer .. I believe these types of tragic encounters with police officers ought to be resolved in a court of law .. rather than the court of public opinion … where all involved are not given ample opportunity to defend their actions.

Indeed ..having a non-verbal grandson who is 19 and could easily be seen as threatening due to his size and weight .. I shudder to think his "non-compliance" with an officer's orders would be misconstrued as him becoming "violent".

Heart breaking tragedies no matter what the extenuating circumstances.

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