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Reducing Restrictive Intervention of Children and Young People

Case study and survey results

This work was undertaken due to significant concerns about harmful restrictive intervention of the disabled children and young people whose families we support. The report shares data collected by two small family-led charities (A survey by the Challenging Behaviour Foundation (CBF) and case studies collected by Positive and Active Behaviour Support Scotland (PABSS)). Both the CBF survey and the PABSS case study data have revealed concerning results regarding incidents of, and attitudes towards, restrictive intervention. Overall the data showed a high number and regular occurrence of restrictive intervention cases.

• 88% of the 204 respondents to the CBF survey said their disabled child had experienced physical restraint, with 35% reporting it happening regularly.

• 71% of families completing the CBF survey said their child had experienced seclusion - 21% reported that this was taking place on a daily basis.

• Of the respondents to the CBF survey 50% of children had been prescribed medication to manage challenging behaviour.

• Most of the restrictive interventions reported in the CBF survey were taking place in schools; for example 68% of the physical interventions.

• The PABSS collection of case studies included 1058 reports of restraint and 544 reports of seclusion.

Over half of the cases of physical intervention or seclusion reported were of children between the ages of five and ten. The youngest case involved a 2 year old child.

The negative physical and emotional impacts of restrictive intervention on both children and their families are significant. 58% of families whose child experienced restraint said that it led to injury.

“Unexplained bruises, what looked like carpet burns to knees and ankles, unexplained broken wrist”

91% of CBF survey respondents reported an emotional impact on their child.

“Incontinence, meltdowns, shutdowns, unable to communicate as overloaded with emotions and information”

78% of families said that the use of restrictive intervention had made their child’s behaviour worse. The deterioration in behaviour associated with experiencing a restrictive intervention casts doubt on the claim that restrictive intervention can be used as a behaviour management tool.

Restrictive intervention also had a significant impact on families with respondents reporting mental health impacts, family breakdown and financial strain. Yet, only 32% of parents were offered emotional support.

Accountability regarding incidents of restrictive intervention and the impact on children and their families is highlighted as a key area for improvement by the data. Families stated that recording and reporting of restrictive intervention and associated injuries is very rare. From the 566 case studies collected, only 19% of families reported that injuries were recorded and only 17% reported that the restrictive intervention was recorded.

The PABSS case study data found that more restrictive interventions were recorded where staff had received training. More work is needed to understand this correlation and the nature of the training staff received. 61% of survey respondents felt that Headteachers were using restrictive intervention as their main method of addressing behaviours that challenge among disabled children. 42% felt that staff were trying to punish their child.

The report concludes with changes that families want to see. 91% of families who completed the survey called for better training for teachers and school staff in learning disability, autism, challenging behaviour and Positive Behaviour Support (PBS). 84% also called for more accountability for harm caused and stronger safeguarding arrangements.

The findings from both the survey and the PABSS case studies raise major concerns about the use of restrictive intervention with disabled children in the UK and cast doubt on the assumption that it is being used only as a last resort.

The evidence families have presented to us suggests that restrictive interventions are being used too readily and are happening at a frequency that reflects a lack of planning or a focus on children’s rights. Parents are concerned that restrictive interventions are seen as the main method for addressing challenging behaviour within children’s service settings.

There is a clear need for action on this issue. We have called on key organisations with responsibility and expertise to work with us on a strategy to reduce restrictive intervention and safeguard children and young people (Rrisc) across the UK.

Our recommendations are:

• Government action: For the Government to take action to better understand the scale and nature of this problem across the UK and to take action to safeguard disabled children in schools and children’s services.

• Skilled staff: For Headteachers and service leaders to ensure staff have the skills, values, training and supervision they need to support children with learning disabilities and autism whose behaviours challenge.

• Family support: Provision of skilled trauma support for those disabled children who have experienced traumatic restrictive interventions at school or in children’s services settings, including effective support for their families.

• Accountability: Better accountability is required at all levels including: reporting and recording within settings; effective data collection by local authorities and the Government; inspection and a review of the way restrictive intervention cases are handled by the justice system.