Regulations that take effect Jan. 1 will limit how children can be physically restrained in Massachusetts public schools, at a time when alleged violations at a Holyoke school have shined a spotlight on the use of force to control unruly students.
The new rules, approved by the Board of Elementary and Secondary Education late last year, are the first update to state policies on the use of restraint since 2001.
The regulations will add restrictions on how unruly students can be held down for their protection, and bar the use of devices or medication to subdue an agitated child — two tactics that previously were permitted with the consent of a parent and a doctor.
The rules also require for the first time that students assigned a “time out” to calm down be continuously monitored by school staff and that principals grant approval for any “time out” lasting longer than 30 minutes. In addition, principals must approve restraints lasting longer than 20 minutes.
Most students who are subjected to physical restraint are children and teens with behavioral or emotional disabilities. Advocates are lauding the upcoming changes.
Rick Glassman, director of advocacy for the Disability Law Center, said it is particularly helpful that the regulations allow a student to be pinned to the ground face-down — called a “prone restraint” — only when rigorous standards are met.
Those conditions include parental consent, the failure of other attempts to subdue the student, a documented history of behavior endangering the student or others, and the absence of medical conditions that could be worsened, such as asthma, heart conditions, obesity, or seizures.
“Basically, any floor restraint is dangerous, but prone restraints have been shown to be especially dangerous,” Glassman said. “There’s a lot of clinical literature showing . . . . an increased risk of injury or death from positional asphyxia as a result of using prone restraints.”
The law center issued a report this month alleging that workers hired to calm students with emotional and behavioral disabilities at the Peck Full Service Community School in Holyoke instead berated, slapped, tackled, and physically restrained the children, violating existing regulations on the use of force.
Sergio Paez, who was superintendent during the time the abuse allegedly occurred, has repeatedly defended his handling of reports of abuse that crossed his desk.
Another significant change in the new regulations, advocates say, is the requirement that any use of restraint be reported quickly to the school’s principal and to parents, and that principals review individual student data on restraints each week and schoolwide data each month.
The rules will also require that all uses of physical restraint be reported to the state. Previously, schools were required to report restraints to the state only if a student or school staff member was injured or the student was restrained for more than 20 minutes.
“Reporting can be particularly important . . . . so the parents know what’s going on and whether a child has suffered an injury as a result of a restraint, and why,” Glassman said. “Reporting is important for schools so that school supervisory personnel know what’s going on in the classroom.”
Programs around the state that work with special education students have been training employees this fall to prepare for the new regulations, said James V. Major, executive director of the Massachusetts Association of Approved Private Schools, which represents private, state-funded, special education schools.
‘Any floor restraint is dangerous, but prone restraints have been shown to be especially dangerous.’
He said the changes are prompting some schools to update their own policies in ways that are even more restrictive than required by the new rules.
“Even though prone restraints are allowed under restricted circumstances, I think most of our members will be moving away from using them at all,” Major said.
In pacifying children who are out of control, he believes, schools will elect to hold them in place while standing or pin them to the floor facing up. Both techniques require an additional staff member.
“Schools and providers are going to have to figure out how to get the additional staff,” he said. “That’s going to mean more money and additional changes in staffing patterns. There’s also a potential for increased injury to staff, which is why they were using prone in the past.”
With proper training, Major said, staff should be able to avoid injury.
The new reporting requirements will also require additional staff time, but they will provide schools with better information about their own procedures and how to avoid situations that escalate to the point that a child needs to be restrained, Major said.
Because the new requirements impose greater rigor, he said, they could ultimately affect enrollment policies for schools serving children with special needs.
“I think there may be an unintended consequence of tightened admission criteria and procedures as schools really scrutinize their ability to meet the needs of students,” Major said. “There might be some students that will find it more difficult to get appropriate placement.”Jeremy C. Fox can be reached at firstname.lastname@example.org. Follow him on Twitter @jeremycfox.