ChildsWork News, May 18, 2012: Study on Siblings and Autism and Restraint and Seclusion Update

As we head into the weekend, I wanted to share two interesting stories. First is an overview of a study conducted by the University of Miami (UM) regarding the development and behaviors of children whose siblings have autism spectrum disorders (ASD). The research shows that one in three of these siblings will show signs of autistic-like symptoms and as many as one in five will have some form of ASD themselves. The next article is an update on an earlier piece I presented regarding the use of restraint and seclusion among special education students. Three years after the original letter by Education Secretary Arne Duncan discouraging the use of restraint and seclusion in schools, the federal government has issued its own guidelines which discourage the practice. Though the federal guidelines are nonbinding, meaning that they really just represent official suggestions, there is hope among advocates for special needs students that these guidelines will help to quell the practice in all states. Study Shows Delays in Siblings of Children with Autism Spectrum Disorders A new University of Miami (UM) study shows that one in three children who have an older sibling with an Autism Related Disorder (ASD) fall into a group characterized by higher levels of autism-related behaviors or lower levels of developmental progress. The study will be presented at the International Meeting for Autism Research (IMFAR) in May, 2012. ASDs are developmental conditions characterized by problems with social interaction and communication. Previously, an international consortium of researchers found that almost one in five of the younger siblings of children with an ASD themselves developed an ASD. UM's College of Arts and Sciences professor Dr. Daniel Messinger, presenting author of the study, says, "It is clear that the younger siblings of a child with an ASD may face challenges even if they are not themselves identified with an ASD. This new work identifies classes of outcomes in these children. We found that the majority of these high risk siblings appear to be developing normally. However, a higher than expected proportion of the children face challenges related to higher levels of autism-related behaviors or lower levels of verbal and non-verbal developmental functioning." The study reveals that difficulties faced by the younger siblings of children with ASD involve both lower levels of verbal and nonverbal functioning and higher levels of autism-related problems. Examples of a child's autism-related problems - which are not as severe as those of children with an ASD - include lower levels of back-and-forth play with others and lower levels of pointing to express interest in what is going on around them. Overall, the research says, the majority of high-risk siblings are developing typically at three years of age, but the development of a substantial minority is affected by subtler forms of ASD-related problems or lower levels of developmental functioning. Lower levels of developmental functioning and higher levels of autism-related problems in the at-risk siblings define what researchers refer to as the broad autism phenotype. [caption id="attachment_1233" align="alignright" width="150" caption="Image courtesy of nixxphotography"][/caption] Feds Offer Guidelines on Discouraging Restraints, Seclusion By Nirvi Shah for Education Week Nearly three years after U.S. Secretary of Education Arne Duncan first sent states letters asking them to review policies and guidelines on the use of restraint and seclusion in schools, the Education Department has issued its own nonbinding guidance on the practices. Restraint and seclusion, often used on students with disabilities, are intended to be used in emergency situations, when students are in danger of hurting themselves or others. But several reports, including one by the U.S. Government Accountability Office have found that the practices are being used inappropriately and incorrectly, leading to injuries, or even the deaths of students. "There is a difference between a brief time out in the corner of a classroom to help a child calm down and locking a child in an isolated room for hours. This really comes down to common sense," Duncan said in a statement. The Education Department said its long-awaited 15 principles about restraints and seclusion should be used as the foundation of policies and procedures created by states and districts, but it isn't binding or required. The principles were a collaboration between the department and the Substance Abuse and Mental Health Services Administration of the U.S. Department of Health and Human Services. "These principles stress that every effort should be made to prevent the need for the use of restraint and seclusion and that any behavioral intervention must be consistent with the child's rights to be treated with dignity and to be free from abuse," Duncan wrote in a letter at the beginning of the 40-page document. "The principles make clear that restraint or seclusion should never be used except in situations where a child's behavior poses imminent danger of serious physical harm to self or others, and restraint and seclusion should be avoided to the greatest extent possible without endangering the safety of students and staff." Among the principles:

• Preventing the need for restraining or isolating students should be a priority.
• Mechanical restraints should never be used to restrict a student's movement, and schools shouldn't use drugs or medication to control a student's behavior unless these have been prescribed by a doctor or other health professional.
• Students shouldn't be physically held down or restrained except when they are in imminent danger of hurting themselves or someone else.
• Policies restricting restraint and seclusion of students should apply to all students, not only kids with disabilities.
• Isolating or restraining students should never be used as a form of punishment or discipline, coercion, retaliation, or as a convenience.
• Restraining or seclusion of a child should not involve restricting his or her breathing or anything else that harms the student.
• Multiple uses of restraint or seclusion of the same student should trigger a review and if necessary, a revision of the strategies in place to address dangerous behavior; and,
• Teachers and other staff should be trained regularly about appropriate use of effective alternatives to physical restraint and seclusion, such as positive behavioral interventions and supports, and safe use of restraint and isolation.

The Education Department also suggests informing parents about policies on restraint and seclusion at their children's schools, when the practices are used, and all incidents should be documented. U.S. Rep. George Miller, D-Calif., who has pressed for federal legislation about restraint and seclusion, applauded the Education Department's new document. "Though some states have made progress developing policies on seclusion and restraint, the policies vary widely in what protections they afford students. A patchwork of protections, riddled with holes, is not acceptable when it comes to children. We cannot sit idly by as incidents of students being abused or inappropriately restrained continue to occur." He said the 15 principles outlined in "Restraint and Seclusion: Resource Document" support the bill he first introduced in 2010, the Keeping All Students Safe Act. The American Association of School Administrators, which has said it opposes federal legislation about restraint and seclusion, said it agrees with the tone and direction of the new guidance. "The department's tone that seclusion and restraint are for student and employee safety not student discipline was important," said Bruce Hunter, the group's associate executive director, for advocacy, policy, and communications. However the document may be overly reliant on the GAO report, he said, and AASA still prefers state-based policies on restraint and seclusion. "State policy is more informed by the full range of stakeholders," he said. In addition, Hunter said the federal discussion on restraint and seclusion hasn't focused enough on injuries to teachers and other school employees that are serious enough to merit workers' compensation claims and sick leave, which is something his organization is researching now. He said one of the best contributions the federal government could make regarding restraining and secluding students is by paying for training that would improve local practices and state policies.