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Article of Interest - Restraint

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Shaken and Stirred
Auditi Guha, September 23, 2005
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Jamaica Plain parents charge that a special education teacher at the Mary Lyon School in Brighton used a illegal, improper and possibly fatal basket-hold restraint on their 5-year-old daughter last year.

After a year of pleading with school, city and state officials and trying to get her transferred to another school, the two parents began home-schooling their special needs daughter this month.

The school, and Boston Public Schools officials, refused to speak on the allegation except to deny that the incident occurred.

"Confidentiality issues preclude me from discussing one individual issue," said Deborah Rooney, principal of the Mary Lyon School. "We deny the allegations, but I can't speak to the specifics of this case."

School system spokesman Jonathan Palumbo also dismissed the charge.

"The staff and teachers are saying there is no way this student was restrained at all," Palumbo said. "I don't think we can talk specifically about this incident."

Beginning school

Anaya Grushkin started kindergarten at the popular and prestigious Brighton public school last year as a happy child, after two successful years of preschooling at the Temple Israel's Frances Jacobson Early Childhood Center in Boston, according to parents Barry Grushkin and June Loeffler.

They were very concerned about choosing a new school because Anaya has Asperger's syndrome, a form of autism. This meant that Anaya had developmental and sensory disorders that affected her thinking, feeling, language and the ability to relate to others.

Anaya was assigned to the Lyon School, and her parents were concerned to find their special child would not be given a one-on-one aide in class, as recommended in her Individualized Education Program, a federally mandated tool which guarantees students with disabilities a tailored education plan to meet their special needs. Since the staff assured them that they have the experience and because the classes were small, they decided to go ahead and enroll her.

The Lyon School's inclusion program integrates students with moderate to severe special needs into regular classes, Rooney said. While the school was originally designed to integrate students with emotional and behavioral disorders, the student population over the years has shifted to include students with atypical neurological developments.

"It had a reputation of being a good school, but that's all we knew," said Grushkin. "The school told us they had lots of experience in such problems, but counselors and teachers wouldn't say if they had any special experience in autism."

They met one teacher who had some experience with autistic children, but not with experience with Asperger's syndrome, the parents said. Rooney said every teacher in the elementary school is trained in regular and special education, but did not provide the kind of training or certification earned.

"All of the Lyon School staff are certified in regular and special education, hold master's degrees and are trained annually on the use of restraints and other techniques allowed by state law and which have been reviewed and approved," Palumbo said. "This is above and beyond what the state requires which is one [trained staff] in each school."

The incident

They were not told the Lyon used restraints, Grushkin said, until he witnessed it himself. He said he saw it first after dropping in on the school to check on her in class last spring.

It was an hour before school was out. Anaya was not only relieved to see him, she wanted to go home with him.

"I told her she had another hour, but she kept fussing," Grushkin said.

Anaya showed signs of anxiety by talking aloud and going round and round in a circle, he said. He tried to calm her down, but "the teacher came and asked me to leave, saying she would take care of it."

Grushkin said the teacher used a basket-hold restraint on the 5-year-old. The instructor crossed the girl's arms about her and held her from behind, working like a straitjacket. The teacher then pushed her down, Grushkin said.

He was alarmed, but did not know much about it and said the teacher told him to trust her and said she knew what she was doing.

Palumbo said the school denied this incident ever happened. "The accusation is absolutely false," he said.

On restraint

State law prohibits the use of restraint as a disciplinary measure and allows restraints to be used only when students pose a serious threat to themselves or others, after other less intrusive alternatives have failed, according to the Department of Education Web site.

"Students turning over desks or throwing papers or even throwing a chair" isn't enough, said Tim Sindelar, an attorney specializing in child disability law recently told the Boston Herald.

Restraining children with Asperger's syndrome or other forms of autism may even cause more harm than good, Sindelar said.

"Most schools have found much better intervention techniques than restraint," said Mary Cerreto, associate professor of family medicine and director of the Center on Self-Determination and Health at Boston University Medical Center.

"Restraint doesn't do anything but stop an immediate situation," Cerreto said. "It does not teach the child what it is that she should do correctly. It does not prevent future occurrences of the behavior. Restraint, even when applied by trained professionals, can be lethal."

Extremely dangerous

Experts also say that the basket-hold can be extremely dangerous unless a person has been trained in its use. Several children have died from the improper use of such restraints, according to assorted news reports and information from organizations like the Citizens Commission on Human Rights.

In 1999, parent Jean Bowden testified at the State House against the Barnstable schools where her special needs daughter was illegally restrained. The case helped create the political momentum for state restraint regulations for public schools in 2001.

Having heard of the allegations surrounding Anaya, Bowden said, "You cannot restrain children without writing permission from the parents. If you use restraints on children in an emergency, they have to meet certain very strict criteria.

"I rather doubt they needed to do an emergency restraint on a child as small as [Anaya]."

Bowden also pointed out that in the case of a basket-hold, on no account should the subject lean forward and he must be standing; otherwise it could lead to asphyxiation and even death.

State law also says that identified staff should undergo at least 16 hours of training in order to use physical restraint. The Mary Lyon Web site indicates that four of eight paraprofessionals are enrolled in teacher training programs to be certified to teach both regular as well as special education students.

It also mentions that after-school teachers are trained in Therapeutic Crisis Intervention methods on how to de-escalate poor student behavior. Crisis Intervention methods include restraint use, Bowden said, but the basket-hold described by Grushkin is not even a part of the Crisis Prevention Institute's training, she added, having taken a CPI course herself last year.

Restraints are used

The Boston Schools' Palumbo said restraints, including the basket-hold, are used in public schools, including at Mary Lyon, to protect students.

"The use of restraints is allowable under the law," Palumbo wrote in an e-mail. "I think there is a negative connotation to restraints in this circumstance. A restraint is not a punishment, it's an intervention, used to prevent the student from harming him/herself."

The principal agreed.

"As an inclusion program, we take very seriously the importance of providing a safe learning environment for all of our students," Rooney said in an e-mail. "However, there are instances during which we must use hands on to prevent a student from hurting himself or others.

"This is always a last resort."

Other parents, who contacted the TAB at the school's request, said they've had good experiences with the school.

West Roxbury resident Susan Clancy, whose son, Timothy, is in the fifth grade and has an anxiety disorder, said he has performed wonderfully ever since he was transferred to the Mary Lyon two years ago.

"He has hope and confidence and faith in himself. He has blossomed there," she said. "This is one person who is upset, but I know so many families there who feel the same way that I do."

"I think it's a fantastic school," added James Cody, another West Roxbury parent whose son, John, has attention deficit hyperactivity disorder, which makes it hard for him to control his behavior or pay attention, and has been in the school for four years. "After we were able to place him here we've had a fantastic experience with them. He's made substantial academic and social progress."

Not specialized

Grushkin and Loeffler said that all special needs children are not the same, and they feel the school is ill-equipped to deal with the Anaya's issues. Rooney said there other autistic children there who have been well served by the school and pointed to their test scores and proven record of success.

"We work very closely with parents of special education children," she said. "Many come from other programs and schools because of the hard work of our teachers here."

There are a total of 116 students at the Lyon, of whom 45.6 percent are in special education programs, according to Palumbo.

Grushkin said his daughter never had behavior problems before she attended the school and enjoyed preschool and summer camps earlier.

After a semester at Mary Lyon, she became increasingly reluctant to go to school, often cried while at school and started having frequent nightmares.

In December, she had an accident in the bathroom at school. Hypersensitive to soiled or wet clothes, Anaya began to scream hysterically asking to be changed. Her teachers made her wait so that she learn the consequences of her action, which only made matters worse for a child on the autism spectrum, the parents said.

Grushkin learned this when two of Anaya's classmates asked why she screams in class, when he visited one day. Upset about the way Anaya was behaving and being treated in the classroom, he said he approached the principal. He said Rooney said they would look into it and told him he had no right soliciting information from other children, he said.

Anxiety skyrockets

By April, Anaya's anxiety levels increased, according to her family. She was taking hours to fall asleep and was having nightmares that were keeping her and her parents up all night.

"She said she was being held down by giant sunflowers and being stung by bees - they were horrible, horrible dreams," Grushkin said. "She turned into a really frightened girl. My daughter wasn't socializing earlier and had problems, but she used to be a happy child."

After visits to counselors and psychologists, Anaya's parents were worried that her experiences at school were frightening her further and even causing her to regress from the progress she had made.

"The therapist said it sounded like post-traumatic stress syndrome," said Loeffler.

"The teachers and principal denied my request for training that I offered to pay for," Grushkin said. "When we started asking questions and talking to other parents and taking notes, teachers were getting upset. They were saying, 'How dare you get into the way of what we are trying to do.'"

Once they started asking questions and complaining, Anaya's parents said the school and teachers were most unwilling to let them observe class even though the Mary Lyon School Web site states: "Because the idea of integrating seriously disturbed students in regular education classes is new, we ask all of our parents to test us and come to our school unannounced, any time from 7:15 a.m. until 5 p.m. to observe our school progress."

But the Boston Public Schools' general policy on visiting is that all must be cleared through the principal's office in advance. Visitors must also sign in with the principal, Palumbo said.

"As a policy, we really can't allow anyone, parent or otherwise, to just show up at a school," he said, citing legal and safety issues.

Uphill battle

Unhappy with her progress and the school, the parents requested Anaya be transferred to another public school. They visited different schools and met principals they felt had good experience and could help their daughter. But their requests for a transfer, they said, fell on deaf ears. So they pulled their daughter out.

Palumbo said placements depend on the number of openings and on a case-by-case basis. "Transfers are granted in instances where the school requested has available seats," he said.

"She's my daughter. She was not having these problems before these incidents at school," Loeffler said. "The school wasn't very receptive to us ... The [public school] system just doesn't work [for Anaya]. I have always felt that Boston was never on my daughter's side."

Lyon parent Cody, who is very pleased with his son's experience at the school, also said he had a tough time working with the Boston Public Schools before being granted a transfer.

His son, John, who has been on an IEP since first grade, was also restrained at a public school in Boston and kept back, he said.

"We had substantial problems," Cody said. "They thought he was a problem child and kept him out of the classroom. We had to go through a lot dealing with the special education department. They blocked our every move and didn't cooperate at all."

Tough request

Grushkin said he has repeatedly asked that his daughter be transferred after the incident, preferably to the Mason Elementary School or the Baldwin Early Learning Center. Palumbo said those schools are among the city's most popular, so few spots are available for transfer.

Grushkin said he would have accepted a spot at another school, and that he is considering his legal options.

"Boston, as a school system, fights parents tooth-and-nail on special education issues," said Grushkin, who said he knows of parents who are suing the school. "They don't do anything until a lawyer steps in. We can't afford that.

"It is also true that, in all cases, this fight has nearly bankrupted the parents and torn them and their families apart emotionally. Parents have threatened all sort of things, but it is hard to get the school to stop. We are all perplexed as to why this school and, perhaps, now many other schools in [the Boston Public Schools] are doing this."

Not alone

Grushkin and Loeffler allege there are other parents who have similarly suffered at the school who are too scared to speak out.

Palumbo said he is not aware of any other issues or pending cases at the school.

"I don't think that two families out of over 45,000 necessary constitutes a lack of support in the district," he responded.

Loeffler said she is horrified at the way the school and Boston has treated them and their inquiries so far. "It's like as you they teach a kid to swim by throwing her in the water and if she doesn't swim, you can spend $20,000 in legal fees to stop her from drowning," Loeffler said, her voice breaking.

"I felt like my daughter was emotionally drowning in her last weeks there. I wish we had pulled her out sooner."

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