Information on regulations, news and alternatives related to restraint and seclusion in schools.

Collection of Resources Related to Restraint and SeclusionEdit

Regulations, Policies, Forms and Laws Edit


MA Regulations on Restraints
Link to Physical Restraint Report form
PPT done by DOE on restraints

Other states Edit

DoE Review of laws and regulations in all 50 states from, 2009
Work of Legislative Committe in Maine
Extensive collection of resources put together by people in Maine
Nebraska, Developing School Policies & Procedures for Physical Restraint and Seclusion in Nebraska Schools
Proposed Arizona Legislation
NH Law
Texas regulations
NY State Time out room policy
Article on new law in Alaska:

National Edit

Updated How Safe is the School House report covering laws in many states

Federal guidelines and resource document from May, 2012
Review of pending law on restraints in Congress
Disability Scoop Web sites review of Restraint legislation in Congress
COPAA (committee of parents advocates and attorneys) resources
Great collection of resources from US HHS autism coordinating committee

Research Edit

Papers Edit

From: Media:Lebel_Restraint_Seclusion_in_Schools_2012.pdf

Article on analysis of OCR data and regulations by UNH, include link to study showing that regulations and law don't necessarily help:
Links to this research paper:

Alliance to Prevent Restraint, Aversive Interventions and Seclusion (APRAIS). (2010). [Letter to Rep. Miller and Rep. McMorris Rodgers in support of HR 4247]. Retrieved from

American Civil Liberties Union ⁄ Human Rights Watch (ACLU ⁄ HRW). (2009). Impairing education: Corporal punishment of students with disabilities in U.S. public schools. Retrieved from

Anthony, W. A., & Huckshorn, K. A. (2008). Principled leadership in mental health systems and programs. Boston, MA: Boston University Center for Psychiatric Rehabilitation.

Arthur, I. (2008). Time-out, seclusion and restraint in Indiana schools: Literature review. Retrieved from

Azeem, M. W., Aujla, A., Rammerth, M., Binsfeld, G., & Jones, R. B. (2011). Effectiveness of six core strategies based on trauma informed care in reducing seclusions and restraints at a child and adolescent psychiatric hospital. Journal of Child and Adolescent Psychiatric Nursing, 24, 11–15.

Barton, S. A., Johnson, M. R., & Price, L. V. (2009). Achieving restraint-free on an inpatient behavioral health unit. Journal of Psychosocial Nursing and Mental Health Service, 47, 34–40.

Bullard, L., Fulmore, D., & Johnson, K. (2003). Reducing the use of restraints and seclusion: Promising practices and successful strategies. Washington, DC: Child Welfare League of America.

Busch, A. B., & Shore, M. F. (2000). Seclusion and restraint: A review of recent literature. Harvard Review of Psychiatry, 8, 261–270. Butler, J. (2009). Preventing Harmful Restraint and Seclusion in Schools Act: What does it mean for children with disabilities? Retrieved from

Caldwell, E., & LeBel, J. (2010). Reducing restraint and seclusion: How to implement organizational change. Children’s Voice, 19(2), 10–14.

Center on Positive Behavioral Interventions and Supports (Center on PBIS). (2004). School-wide positive behavior support: Implementers’ blueprint and self-assessment. Eugene: University of Oregon.

Centers for Medicare and Medicaid Services. (2008). Hospitals –Restraint ⁄ Seclusion Interpretive Guidelines & Updated State Operations Manual (SOM) Appendix A: Interpretive Guidelines §482.13(e)(6). Author. Retrieved on November 15, 2011, from

Colton, D. (2008). Leadership’s and program’s role in organizational and cultural change to reduce seclusions and restraints. In M. A. Nunno, D. M. Day, & L. B. Bullard (Eds.), For our own safety: Examining the safety of high-risk interventions for children and young people (pp. 143–166). Washington, DC: Child Welfare League of America.

Couvillon, M. A., Bullock, L. M., & Gable, R. A. (2009). Tracking behavior assessment methodology and support strategies: A national survey of how schools utilize functional behavioral assessments and behavior intervention plans. Emotional and Behavioural Difficulties, 14, 215–228.

Daffern, M., Howells, K., & Ogloff, J. (2007). What’s the point? Towards a methodology for assessing the function of psychiatric inpatient aggression. Behaviour Research and Therapy, 45, 101–111.

Day, D. M. (2000). A review of the literature on restraints and seclusion with children and youth: Toward the development of a perspective in practice. Toronto, ON: The Intersectorial ⁄ Interministerial Steering Committee on Behaviour Management Interventions for Children and Youth in Residential and Hospital Settings.

Day, D. M. (2002). Examining the therapeutic utility of restraints and seclusion with children and youth. American Journal of Orthopsychiatry, 72, 266–278.

Day, D. M. (2008). The literature on the therapeutic effectiveness of physical restraints with children and youth. In M. A. Nunno, L. B. Bullard, & D. M. Day (Eds.), For our own safety: Examining the safety of high-risk interventions for children and young people (pp. 27– 44). Washington, DC: Child Welfare League of America.

Department of Education. (2010). Digest of education statistics: 2009. Retrieved from

Diament, M. (2010a, August 3). Restraint and Seclusion Bill hits bumpy road on path to Senate. Retrieved from

Diament, M. (2010b, November 17) Time runs out for school restraint, seclusion bill. Disability Scoop. Retrieved from

Domjan, M. (2010). The principles of learning and behavior (6th ed.). Belmont, CA: Wadsworth.

Donat, D. C. (1998). Impact of a mandatory behavior consultation on seclusion ⁄ restraint utilization in a psychiatric hospital. Journal of Behavioral Therapy and Experimental Psychiatry, 29, 13–19.

Donat, D. C. (2003). An analysis of successful efforts to reduce the use of seclusion and restraint at a public psychiatric hospital. Psychiatric Services, 54, 1119–1123.

Duncan, A. (2009, July 31). Press release. Secretary Duncan sends letter to chief state school officers on restraint and seclusion in schools. Retrieved from

Duncan, A. (2010, February 24). Press release. U.S. Department of Education makes public state-by-state restraint and seclusion information. Retrieved from

Dunlap, K., Goodman, S., McEvoy, C., & Paris, F. (2010). School-wide positive behavioral interventions & supports: Implementation guide. Lansing, MI: Michigan Department of Education.

Garinger, G. (2009). Annual report 2008. Boston, MA: Office of the Child Advocate. Retrieved from about/annual_report.pdf

Gershoff, E. T., & Bitensky, S. H. (2007). The case against corporal punishment of children. Psychology, Public Policy, and Law, 4, 231–272.

GovTrack. (2011). Text of H.R. 1381: Keeping All Students Safe Act. Retrieved from h112-1381

Haimowitz, S., Urff, J., & Huckshorn, K. A. (2006). Restraint and seclusion: A risk management guide. Alexandria, VA: National Association of State Mental Health Program Directors.

Medical references to danger of prone position Edit

These need clarification and summarization (GS 10/6/2014)
Anaesthesia. 2006 Feb;61(2):138-41.

Haemodynamic effects of the prone position: We conclude that turning healthy patients prone produces a clinically significant reduction in cardiac output

Department of Anesthesiology, Loyola University Medical Center, Maywood, IL 60153, USA. Prone positioning decreases blood pressure and cardiac function. Several studies have evaluated changes in cardiac function after prone positioning, and linked them to reduced venous return and ventricular compliance

Advocacy and News Edit

Advocacy Group with many resources
US Congress group working on restraint and seclusion
Senate Hearings on Keeping Schools Safe Act
Bill Lichtenstein's page of news and resources
Links to ground breaking news story by Hartford Courant in 1990s
Keeping All Students Safe group
Stop hurting kids web site TASH and other groups share a collection of great information and a video]
Families against restraint blog

Alternatives, Training and Ways to Reduce Restraints Edit

Positive Behavioral Supports Edit

The primary way to reduce restraints in a school or district is to implement positive behavioral intervention and support (PBIS or PBS) AKA School Wide Positive Behavioral Support (SWPBS).

Positive Behavioral Support Seclusion and Restraint Policy

One implementation of positive supports is called responsive classrooms.

Functional Behavioral Analysis Edit

The primary way to change problem behavior of a child which may lead to a restraint is called Functional Behavioral Analysis/Assessment (FBA).

FBA is sometimes considered part of Applied Behavioral Analysis (ABA), an intervention or strategy most commonly used to help children with Autism Spectrum Disorders.

An FBA typically results in a behavior intervention plan or behavior support plan.


There is significant controversy about whether restraint should be included in BIPs or IEPs. IMHO restraint should not be part of either.

Reports Edit

Investigation and story about restraints in Lynn from Disabilities Law Center

Keeping Schools Safe for Everyone, report from Oregon

2009 GAO report on SECLUSIONS AND RESTRAINTS Selected Cases of Death and Abuse at Public and Private Schools and Treatment Centers

School is Not Supposed to Hurt report by National Disabilities Rights Network

A report on restraint, seclusion and aversive procedures one year after the passage of the Keeping All Students Safe Act in the U.S. House of Representatives This bill was not passed by the Senate yet. This report includes many distrubng media stories.

US Office of Civil Rights Data collection include incidents of restraint. Data for 2009 and 2011-2012 school year data is available. Not all school districts report this data so don't assume there were no restraints based solely on this information.

See: then find the school district, then find discipline and physical restraints.

Here's an example:

Restraint and Seclusion:Resource Document and other documents related to restraint and seclusion can be found at:

In 2009 the National Disability Rights Network published School is Not Supposed to Hurt: Investigative Report on Abusive Restraint and Seclusion in Schools. This report and others on the issue can be found at:

Report on danger of prone restraints: Media:DRCA_Prone_restraint_report.pdf

Town policies on restraint Edit

Newton Public Schools Policy on Restraint see Section VIII

Cambridge Public Schools Guidelines:
Cambridge Public Schools Policy:

Restraint in Hospital Settings Edit

Spring Harbor Hospital Edit

Add link to restraint data from Medicare/Medicaid reports here.

Other Useful Links Edit

Real Danger, documentary about restraints and risks

New links needing to be sorted Edit

Position of Disability Law Center on Mass regulations:

Comments from Doug Heffernan on Mass regulations:

Article on data from Ohio:

Article on Syracuse trial of principal for restraint: >br>

Editorial in Syracuse NY Paper:

NBC NY story on restraint of a 5yo boy put into mechanical restraints in NY City schools.

List of schools with restraint history posted in 2010:

Article on Cambridge Hospital ending use of restraints. Senate Report Disability Scoop coverage Report from NJ
"Act Now to Keep Students Safe"  (Truthout):

"Still a Terrifying Way to Discipline Children: One Year Later"  (Huffington Post):​

NPR story:

OCR Finding against use of restraint and seclusion in Virginia:

More restraint and seclusion legal references:

Research paper on Adverse Effects Associated With Physical Restraint, mostly in hospitals:

2014 article from Dairen CT

HB 81, Rep. Dorothy Hukill’s bill regarding the “use, prevention, and reduction of seclusion and restraint on students with disabilities in public schools,” moved to the PreK-12 Policy Committee Wednesday afternoon, three weeks after the bill’s first reading March 2.

Florida Families Against Restraint and Seclusion, co-wrote the bill and submitted it in 2007.

•The Substance Abuse Mental Health Services Administration •The National Association of State Mental Health Program Directors: Office of Technical Assistance •Pennsylvania Recovery and Resiliency: Statewide Initiative •National Disability Rights Network

Parents Restraint Working Group Edit