State Board Votes to Ban “Prone Restraint”

Prone restraint: Should this technique for controlling violent students be banned from schools?

The Virginia Board of Education voted last week to limit the use of seclusion and restraint of students in public schools, specifically prohibiting the use of “prone” restraint, or forcing a student to lie face-down to the floor. Board members expressed concern that the practice could limit a student’s breathing, reports Community Idea Stations.

“Too many children have been subjected to fear and trauma caused by prone restraints; some have been injured or killed,” responded Rachael Deane, Legal Director of the Legal Aid Justice Center’s JustChildren Program, in a press release. “We are pleased the Board has recognized the dangerousness of these restraints and urge the Governor to sign the regulations so that our schools will be on notice that these restraints are dangerous, unnecessary, and unlawful.”

The action came in response to a law enacted earlier this year directing the board to identify and prohibit seclusion and restraint practices that posed a significant danger to students.

Bacon’s bottom line: It’s hard to know what to make of this vote. I’ll admit, my gut reaction was that the decision, if approved by the governor, represents another step in the steady erosion of the ability of educators facing challenging conditions to maintain discipline in schools. But I acknowledge that my gut reaction is uninformed by hard data, so I remain non-committal.

The article reported no evidence presented during the board’s hour-long discussion that would help citizens understand its decision. Among the things we don’t know:

  • Under what circumstances is prone restraint called for in Virginia schools, and how often is it used? Does the state even compile data on the use of the technique?
  • How many students have suffered injury as a result of being held in prone restraint? Is this a real problem or a theoretical one?
  • The article does refer to alternative forms of restraints but quotes Sam Hollins, assistant superintendent for special education and student services, as saying that they, too, have risks. What are those risks?

I don’t see how the board could make an intelligent decision without knowing the answers to these questions.

The Crisis Consulting Group, a Richmond-based firm that provides “de-escalation and conflict resolution” training, provides some helpful background about “standing restraint” versus “prone restraint.”

A large percentage of physical interventions end up going to the ground, states the CCG website. However, the firm does not endorse the use of prone restraint techniques. Statistically, the majority of injuries occur when forcing someone from a standing position to the ground. Once an aggressor is forced to the ground, responders have limited ability to move him. And “all too often, the responder’s hands end up on the thoracic cavity (chest, lungs, or lower back area), risking positional asphyxia and death.

On the other hand, the unnamed website commentator well understands the temptation to use the technique.

From over 8 years of experience working in a highly volatile locked psychiatric hospital with over 400 documented crisis incidents (each of which I was personally involved). Unfortunately, my coworkers and I at the time had no effective alternative, leading us to do exactly as stated above. We did not have any other effective technique, even after going through years of alternative crisis intervention training programs. During those years, staff were often injured. Patients were often injured. I was personally injured. Looking back, I have to ask myself “Were we wrong?”  If one does not have any other effective technique to use during emergencies and acts with the best intentions for the greater good, I believe that it was the right thing. However, the reality is that there is now a better method; a safer and more effective intervention technique.

The preferable alternative is standing restraint, states CCG. It’s difficult and requires practice. But it has many advantages: It eliminates the risk of injury from a take-down or pressure to the thoracic cavity; it allows the individual to better maintain his dignity; and it is easier to escort the individual from the area.

Whether any of these issues were discussed in the board of education meeting, I cannot tell from the Community Idea Stations article. It’s easy for board members to ban prone restraint when they aren’t the ones trying to quell a violent student. But if standing restraint is a valid alternative, and if the requisite training is provided, then the decision is defensible. If training is not provided, teachers may be put at risk.