(UPDATED) Locked in cramped, windowless rooms, tied in body-restricting bags, denied food, water and bathroom access: all of this is happening not to patients in the overlooked back wards of state mental hospitals, but to children as young as 5 in American public schools.
In the 2009-10 school year, some 40,000 children were restrained or isolated as discipline for bad behavior — most of these students had physical, developmental or learning and behavioral needs — according to Department of Education data. That research was cited in a revealing op-ed in Sunday’s New York Times written by a father whose daughter was deeply traumatized by such treatment. A 2009 Government Accountability Office report also found “hundreds of cases of alleged abuse and death related to the use of these methods on school children during the past two decades,” in both public and private schools.
Practices of restraint and isolation were long used to control resistant patients in psychiatric facilities. But following decades of tragedy and trauma — including hundreds of deaths of patients who were subjected to such treatment — these tactics are now heavily regulated. Federal law requires that the least restrictive measures always be deployed and bans the use of isolation and restraint outright in cases where the patient poses no danger to his or herself or others. In psychiatric centers, using seclusion or restraint for punishment or discipline is illegal.
In fact, in much of Europe and in some U.S. psychiatric centers, restraints and isolation rooms have been eliminated entirely.
Yet there is no federal regulation, let alone an outright ban, of the disciplinary use of these tactics in U.S. public schools. Nor is there any requirement that educators be trained in the use of positive techniques; in many states, teachers may even add corporal punishment like beatings and paddling on top of restraint and isolation. These methods fail to change student behavior, and the result is a horrifyingly similar pattern of trauma, abuse and death among students that ultimately led psychiatry to strictly limit physical seclusion.
Investigative reporter Bill Lichtenstein described in the Times how he discovered the maltreatment of his 5-year-old daughter, Rose, who suffered from speech and language delays, but was otherwise characterized as a “model of age-appropriate behavior” by her preschool. In 2006, Rose’s kindergarten called her parents to come pick her up because she had taken off her clothing:
At school, her mother and I found Rose standing alone on the cement floor of a basement mop closet, illuminated by a single light bulb. There was nothing in the closet for a child — no chair, no books, no crayons, nothing but our daughter standing naked in a pool of urine, looking frightened as she tried to cover herself with her hands. On the floor lay her favorite purple-striped Hanna Andersson outfit and panties.
Rose got dressed and we removed her from the school. We later learned that Rose had been locked in the closet five times that morning. She said that during the last confinement, she needed to use the restroom but didn’t want to wet her outfit. So she disrobed. Rather than help her, the school called us and then covered the narrow door’s small window with a file folder, on which someone had written “Don’t touch!”
We were told that Rose had been in the closet almost daily for three months, for up to an hour at a time. At first, it was for behavior issues, but later for not following directions. Once in the closet, Rose would pound on the door, or scream for help, staff members said, and once her hand was slammed in the doorjamb while being locked inside.
(NOTE: The New York Times has just appended an editor’s note to this story, saying that the child’s mother said in a deposition in a case related to the incident that her daughter was clothed when her parents retrieved her. The closet in question was actually located on a mezzanine floor, not the basement. The fact that she was isolated in a closet and wet herself is not contested).
Not only is there no government regulation of the use of isolation and restraint in schools, but there is also no requirement that parents be informed when it occurs. The use of these tactics has risen in public schools as children with developmental and learning disabilities have been increasingly included in mainstream classrooms. But sadly, their teachers are often not given enough training and support to use safer and more effective, positive disciplinary approaches.
These harsh methods have already resulted in death. In one case, described in testimony [PDF] given at Congressional hearings on the issue in 2009, foster mother Toni Price recounted the last day in the life of 14-year-old Cedric Napoleon. On the morning of March 7, 2002, as Cedric left for school, she said, her foster son had beamed, “You know I love you, Ma.”
Cedric had been abused and neglected from the beginning of his life: as a little child, he’d resorted to rummaging through the garbage to feed himself. And like many neglected children, he was slight and small for his age. Despite his size and history of starvation, however, his 8th-grade teacher found it acceptable to use food deprivation as a disciplinary tactic. He had never been aggressive or violent.
By 2:30 p.m., on the day Cedric died, he had been denied his lunch for more than two hours because he stopped working on his assignments. The boy stood up and tried to walk out of class, but his 230-lb. teacher threw him on the floor and sat on him when he resisted being forced back into his chair.
Panicked, Cedric said he couldn’t breathe. Price testified that the teacher “snapped, ‘If you can speak, you can breathe.’” Soon, the boy could do neither. By the time an ambulance was called, the Cedric was dead.
Over the centuries, psychiatrists learned that restraint and isolation are harmful and rarely necessary — and that simply allowing their widespread use is what what actually made these practices seem essential and important for discipline. But by prioritizing the effort to do away with them, facilities can often eliminate seclusion and restraint completely; many psychiatric institutions in the U.S. have now moved from restraining patients multiple times a week to using the tactic only once or twice a year. All such facilities report improvements in the health and morale of both patients and staff as a result: restraint and seclusion tend to traumatize not only the victims, but also those who must impose the punishment, as well as those who witness the related violence.
If psychiatric centers can do without restraint or isolation, there’s no reason schools should need them. Congress should ban isolation rooms and the use of restraint tactics in all schools, public and private, including “troubled teen” boot camps and wilderness programs, whose disciplinary tactics are also unregulated and have caused children’s deaths. Corporal punishment is banned in institutions housing the elderly, criminals and psychiatric patients, so it should be banned in schools as well.
Moreover, all teachers should be trained in positive behavioral techniques that have been shown to improve behavior in students with or without special needs, and reduce the need for extreme measures. If children display ongoing behavior problems that are so severe that they don’t respond to positive approaches, they need to be helped by specialists, not secretly subjected to repeated and potentially traumatic punishment.
As your elementary school history teacher probably taught you, if you don’t learn from your past, you are condemned to repeat it. We can’t continue to allow schools to resurrect the torturous history of maltreatment in the mentally ill in our most vulnerable children.
MORE: ‘Shock’ School Trial: Where Is the Evidence that Abuse Helps Treat Autism?
Maia Szalavitz is a health writer at TIME.com. Find her on Twitter at @maiasz. You can also continue the discussion on TIME Healthland’s Facebook page and on Twitter at @TIMEHealthland.