One Cannot Prevent Meltdowns By Using Restraint

A Theoretical Aside

This post comes from my experiences the last few weeks. I have been working with a number of students that have been a danger to themselves and others. As such, I have had to use physical restraint to ensure maintained safety of students and others around them.

Fewer people were injured because I used restraint methods, but I still feel terrible for having to use MANDT restraints after my preventative strategies proved ineffective. I have found that school teams often have difficulty in understanding why I feel like an abject failure whenever I have to restrain students. To the untrained eye, the intervention worked-and it is hard to understand why I am so disappointed.

This post is my explanation.

The Escalation / Crisis Cycle

escalation

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I start with two diagrams to show that escalation is not an all or none phenomenon. We all go through several steps.

  1. Calm or Baseline Phase
  2. Triggered or Stimulation Phase
  3. Agitated/Acceleration or Escalation Phase
  4. Peak or Crisis
  5. De-Escalation Phase
  6. Recovery or Stabilization/Post Crisis Phase

The important components of this post are as follows:

The Calm or Baseline phase is not the same for everyone. In fact, in my experience, there are a surprisingly large number of children that do not have the luxury of having a true baseline level. If they have a hard home life, trauma in their past, or some conflict with and adult or other students, they may actually start the day at the Triggered phase.

The Triggered phase of the crisis cycle is deceptively named. For most people who start at a Calm baseline, the Triggered phase does not involve outward signs of agitation or stress. When a child is triggered, this sets the stage for responses to stimuli that are of a much greater amplitude than they would be had the student not been triggered.

The Agitated phase is when the child moves beyond simply being Triggered and begins to show outward signs of stress and annoyance. The child will become intolerant to stimuli they would otherwise tolerate. This is actually the phase most children are in when we erroneously say they have been Triggered.

The Acceleration phase is when the Agitated phase starts to self-perpetuate.

The Peak or Crisis stage is, in my opinion, by far the most  misunderstood stage. At this stage the child is disconsolate. Meaning there is NO WAY anyone can intervene to “bring them down” – and yet this is the stage most adults start to intervene.

The De-Escalation phase is deceptively tricky. Most adults do not  realize that a student fresh off a Crisis are very easy to re-escalate back into Crisis.  The De-Escalation Phase is oftentimes even closer to Crisis than the Acceleration phase.

Recovery is a refractory period between Crisis and Calm. It is only at this phase that it is appropriate for an adult to intervene and discuss the Crisis with the child.

How Should We Handle a Student in Crisis?

Optimally, we don’t let things escalate this far. We back off earlier in the escalation or crisis cycle, either by anticipating the Trigger or recognizing the Agitation phase for what it is.  The easiest way to do this is to back off. Give the child space. Most of the time your help is not actually  helpful at this point.

That said, backing off is not an option if a student uses violence or aggression during their Agitation, Acceleration, or De-Escalation phases. In these cases, intervention is unavoidable. Below I will explain how we can intervene. But first, I will cover how our interventions are often the coup de grace or straw that breaks the camel’s back that sends the child into full-blown crisis.

What Do We All Do Wrong

The diagram below describes the cycle that adults and children get into when there is a conflict. As adults, we often fail at taking the perceptions and feelings of others into account when we work with them.

why-conflicts-escalate

When a student is Agitated or in the Accelerating phase of the crisis cycle, they perceive intervention from an adult as a threat rather than as help. Because the child perceives a threat, the child either goes into a fight or flight mode or else they get angry. This means the student will react to the adult as an enemy rather than a friend-regardless their relationship 5 minutes or even 5 seconds earlier.

Well, because as the adult we fail to account for this side of the cycle, we react to the student’s reaction by getting escalated ourselves, and we go through the same behavioral cycle as the child. This turns into a vicious feedback cycle that results in both the adult and the child saying and doing things they will later regret and would not normally do.

How Do We Do It Right?

I distinguish the above cycle of conflict of serial reactions to stimuli from an adult taking a step back and responding appropriately. My operational definitions for these words are reaction = acting upon stimulus without prior thoughts. Response = acting upon stimulus with prior consideration of multiple options and antecedents.

When we find a student that has been Triggered, we need to take a step back and ask ourselves some questions.

  • Did I just do something that triggered the student?
  • Did something happen to the student at school today that might have triggered them?
  • Did something happen in the student’s home life that might have triggered them?

If we do not know the answer, there are two things we can do. We can – I know this is revolutionary – ASK THE STUDENT how they are feeling. If they are unable or unwilling to answer, that is why we have phones. Reach out and communicate with the child’s family or other teachers/paraprofessionals that may have some information.


If this proves fruitless, we move onto the next step. If the student is triggered or agitated, we can still engage them in a dialogue. Importantly, the adult must take care to not take a dictatorial tone. The adult is on a fact finding mission, not on a quest to solve any problems. In fact, if an adult tries to impose a solution on the child at this point, it will likely be interpreted as either unfair, controlling, or demanding…and the child will escalate toward the Accelerating phase.

If, however, we let the student talk (and this does often involve a fair amount of cursing and swearing), they often can de-escalate themselves or else discover their own trigger. Since they are in control, they can be receptive to an adult guiding them to a Calm state. Letting the child express themselves in a free and safe environment will often naturally guide them into a Calm state, but if you, as the adult, impose yourself and try to correct their language or minimize the child’s emotions, you are not recognizing how the child feels and they will likely escalate.


Let us assume we cannot help at the Agitation phase. If a student is at the Accelerating phase (or the De-Escalation phase as they are handled the same way), BACK OFF. Literally. BACK OFF. Give the child as much space as possible and do not bother them. You can only make things worse at this point. Even proximity will result in further acceleration toward a crisis.

Sometimes body blocking is necessary, so we do it. But it is obligatory we KEEP OUR MOUTHS SHUT. If we have to take something away from the student, we do so SILENTLY or just say with a flat affect, “Not an option”. Nothing more. Even this runs a major risk of driving a student toward crisis. We cannot give any emotional fuel to the hell fire in potentia.

If the student has an option of a safe space, dark spot, or quiet corner, this is a good time to remind a student (REMIND, never demand), that they have the option of separating themselves into their special space. Again, if we demand the student do this or tell them to go over there to cool off, we probably just ticked them off. The Accelerating phase is typified by a defiant attitude and self-preservation – not taking advice.


Now to the hard part. Crisis. What do we do when there is crisis. I wish I could say, “Run away”, but that is not always an option.

monty-python-run-away-o

So, if running away and giving oodles of space fails, we are left with one of the hardest things we can do. KEEPING A CHILD IN CRISIS SAFE. Most of the time this takes the form of clearing the classroom or else getting the student to a safe space where they cannot hurt anyone.

Amazingly, that is the easy part.


If the above fails, we have another responsibility-and this is the hardest bit-we have to make sure the student does not hurt themselves or others. This is where restraint methods come in. And the probability of both the adult and the child getting seriously hurt goes off the scale.

Restraint is not to be taken lightly and is the absolute last resort in any crisis situation. Touching a student in crisis is often not a great idea and is almost always dangerous, both to the adults and to the child. This is why every other option needs to be employed prior to even considering restraint. In fact, even grabbing a student’s hand or using an arm to prevent an elopement can cause problems.

I say backing off and letting the kid blow off steam is the easy part because it does not involve a physical interaction, Whenever a child is escalated, even if they are in the Accelerating or De-Escalating phase, touch will often send them from 0-100 in a microsecond.


This video below shows one of my behaviorist heroes, Cesar Milan, making a mistake of touching an animal in crisis. Everyone was safe until he touched the dog. Cesar carefully took the dog through the escalation cycle from Calm, to Triggered, to Agitated, to Acceleration, to Crisis, and to De-escalating phases. However, even though it was during the De-escalating phase, as soon as Cesar touched the dog, everything became complicated. I particularly like this video because it explains the dog behavior along the Escalation/Crisis cycle.

I Feel Terrible When I Lose Control Of The Situation

Whenever I restrain a student, I lose. They lose. We all lose. The student ends up a sweaty mess of emotions and snot, and I often end up bruised and bitten. I have to use restraint, I feel like Cesar in the above video explaining to the people around him how he screwed up and missed something. Then Cesar had to walk away and lick his wounds. Additionally, the dog learned nothing from the experience other than he was able to bite Cesar (which will increase the probability of it happening again).

I feel terrible for all the reasons displayed in this video. Cesar missed something because he was distracted and it resulted in injury to himself and complete loss of control of a situation. I always ask myself, “What did I miss? What could I have done to prevent this? Where did I screw up?” immediately followed by an, “is the student okay? Are they hurt? Are they still freaking out? DO they understand what just happened?”. Then I ruminate and perseverate on the experience for a few hours.

EVERY. SINGLE. TIME. I have to use restraint methods I am able to find something that I missed during the escalation/crisis cycle that would have prevented further escalation. There is always something I did not notice. Some tone of voice I missed. Some frustration I accidentally projected.  Some accidental sarcasm on my part. An eye roll. A smirk. A mistake. An oversight. A lack of control over my surroundings that resulted in an additional trigger.

How Do I Do Better?

I have spent a lot of time mulling over in my mind what I can do better to help de-escalate kids when they are not in control of themselves. By applying my background as a behaviorist to the situation, I have a few notes for myself – and I hope they will be helpful to others. When one has to restrain or seclude students for their own or other’s physical safety:

  • Never invalidate a student’s emotions. They are feeling what they are feeling, there is no point telling them they are wrong or shouldn’t feel a certain way.
  • Never hover over a student. If a student is on the floor or in a chair, do not use your mass to intimidate them. It is intimidating.
  • Never repeatedly bring up a student’s mistake. Move on. You are only going to make them self-conscious and reduce their self-esteem.
  • If a student asks for space, GIVE IT TO THEM so long as it is safe.
  • Do not chase/run after a student if they elope. Follow SLOWLY and at a distance. Catching the student does not earn any prizes.
  • Watch your tone of voice. The student is paying attention. They know if your tone is aggressive they are unsafe.
  • Never use sarcasm. If words do not match the tone of voice, you are confusing the student.
  • Never dictate terms. The student will balk at orders when escalated and become defiant on principle.
  • Never lie to the student. They will call you on it. They will remember. They will hate you for it.
  • Never talk about the student in a negative way in front of them to another teacher. In fact, this is NOT the time to give an update on behavior unless you are handing off responsibility for the student to a specialist.
  • Never give ultimatum. These never work, less so when a child is escalated.
  • Never give an emotional response to swearing or physical aggression. The student is not entirely in control of themselves and trying to get the adult to move away from them, by whatever means necessary.
  • Never argue with the student. They will contradict and defy you. Don’t take the bait.
  • In fact, Never try to start a conversation. This will not end well. There is nothing you can say that will fix the situation.
  • Never touch the student to calm them down (pat on back, etc.). This will be misinterpreted.
  • Never distract yourself with a phone, etc. You will miss important signs.
  • Never show frustration, anger, etc. Your emotions are not helpful. They do not contribute anything other than fuel to the already highly combustible situation.
  • Never, Ever, under any circumstances retaliate against any of the violence committed by a student being restrained. I wish this went without saying. It doesn’t. I am saying it. We are the adult. We MUST act like it.

Some of these may seem counterintuitive, but they are all important. The best advice I can have for anyone is to avoid restraint or seclusion as consequences for behavior.

The solution is for us to focus on prevention instead. Help the student meet their needs before we turn the escalation cycle into an escalation spiral.

Help Autistic Kids Help Themselves

A Personal Aside

Note: I choose to avoid person first language at the direct request of autistic individuals with whom I interact in real life as well as on the internet. I choose to err on the side of referring to autistics in the way they tell me to rather than follow a political convention.

Today I had to apply the CPS model, described here, with two autistic students. Both of these students have demonstrated major behavioral issues this school year and were even worse today, the first day back from a 10-day spring break.

The TL;DR of this post is that communicating with autistic kids is the best way to help them solve their own problems, rather than trying to impose solutions upon them.

How I approach working with autistics

Based on my life experiences with my twin brother, Kyle, I have learned to never underestimate an autistic. In fact, I often favor assuming autistics have a much greater ability than what is immediately apparent. I also wholeheartedly believe that the basic human need for compassion, understanding, and communication is stronger in autistics than any of us realize.

That being the case, I approach any behavioral issue with an autistic student as I would approach an issue with myself at that age. They either lack the ability to communicate what they need or what they lack in a way that the rest of us understand, or else they are feeling some emotional state that needs a resolution–again lacking the communication skills to access their needs. These two options apply both to Kyle and myself, so I go with it as a rough guide.

When I see a student misbehaving–one student today was trying to hurt others and to cause chaos in the classroom and the other student was running out of the classroom–I approach them for a conversation. I do this paying no regard to the student’s communication skills. I consider it my job to understand what they are communicating, not their job to make me understand.

Specific Example

Student 1

I will call this student Erin. I walked into a classroom and this student was peeling the name cards off the tables in the classroom. They then ran across the room and punched two students, and ran behind the teacher’s desk. I went over to Erin and got on their level. I asked them what they needed in order to work.


Erin said, “Toys”.

“Toys?” I said. ‘Tell me, what does [Erin] need to do to get toys”

Erin: “[Erin] needs to work first, then toys. Work first, then toys. [Erin] needs toys to work.”

DH (me): “So [Erin] needs toys to work. Do you need to see toys to earn? What do you mean? How can I help you? What do I need to do to help you work?” (I know this is too many questions, but they are rephrases of the same questions, I was hoping Erin would answer one of them).

E: “[Teacher] erased my board. [Teacher] broke the rules. No toys. No toys. No work for 5 minutes. No first work then toys. No!” (At this point Erin sprinted across the room and tipped a chair with a student still sitting in it while staring at the teacher).

DH: “[Erin], do you need to come talk to Dr. H in private?”

E: “Yes, now please [gives name of teacher’s room to go to] please.”

DH: “Okay, talk”

E: “Dr. H please work first then toys. Work first then toys. Work then toys. Work 5 minutes and then toys 2 minutes. [Erin] control the timer. Work first then toys. Please now.”

DH: “How do I do this. How can I help [Erin] do this?”

E: “Big marker and white board” (they brought me a sharpie and a whiteboard.) “No erase. Never”

DH: “[Erin] wants me to write words on the board?” (I wrote “First work 5 minutes, THEN 2 minutes toys” on the board).

E: (gives me a hug) “[Erin] will say sorry and do work for toys.”


Erin then proceeded to walk back to class silently, gave a personal apology to each teacher and student they had wronged, and asked a teacher to give them work so they could work for toys.

Importantly here, I did not give Erin any solutions. I did not tell them what to do, how to do it, and I certainly did not tell Erin to apologize to the peers and teachers that had been harmed during the incident in class. Erin had a solution in their mind already, but I was the only one willing to ask what they wanted and wait until they were able to formulate an answer I could act upon.  The moment I helped Erin achieve their solution, they ran with it and did not require further adult help.

Student 2

I will call this student Bryan. Bryan had a substitute teacher in their class. That being the case, Bryan ran out of class three times and refused to come in from recess. I was not involved in these incidents. I came in later.

The incident I dealt with was when Bryan ran out of music class. One of my students from last year found this student running down the hall and engaged them in a game. He then yelled down the hall to get my attention.

When I got there I let my old student go back to class. I sat down on a bench and looked at Bryan who was 10 feet away from me hiding behind a pillar.


DH: “[Bryan], can you come over here on the bench and have a chat with me?”

B: “F*ck no, you will grab me”

DH: “What if I sit on my hands?”

B: “Prove it”

DH: “Okay” (I made a show of standing up and putting my hands entirely under my legs and sat down)

B: “I am coming out!” (he walked VERY slowly until he was just out of arm’s reach of me) “What do you want”

DH: “I want to help you get back to class. Running out is unsafe and I cannot let that happen” (I don’t lie to kids, they see right through me. So I level with them, it has worked thus far).

B: “What”

DH: “I want [Bryan] to be safe and happy so he can go back to class. What does [Bryan] need, what does he want?”

B: “[Bryan] wants to be on his bed in his room playing Roblox on his laptop.”

DH: “Wait, what? This is about home?”

B: “Yes. Dad said I was naughty boy. He closed my laptop. He locked it in cupboard up too high for me”

DH: “So, dad said [Bryan] was naughty and took away the laptop so no Roblox”

B: “Yes. Mad. Angry.”

DH: “What does [Bryan] need to be able to go to class”

B: “Laptop”

DH: “Not an option”

B: “How can get Roblox back on laptop?”

DH: “Can you ask your dad how to earn it back? If he took it, then he thought you did something bad, maybe being good will help you get it back”

B: “Ask dad? Why? Dad closed laptop. Took roblox. Dad hates [Bryan]”

DH: “Dads do things that make them look like they are mean and hate kids, but it is because they love us and want to help us do good things. They take things so we learn to stop being naughty”

B:  “No hate?”

DH: “Nope”

B: “Good at school help laptop?”

DH: “Couldn’t hurt”

B: “OK. Hate class. Want games.”

DH: “I get that. But if you do not go to class can the teacher tell dad [Bryan] was good at school?”

B: “I go to class. Now. Hurry”


I then followed as Bryan slowly walked to class. He asked a number of questions about why parents are “assholes” and why they don’t understand his needs. I corrected the language since now we were not in problem solving mode and it was a teaching moment to teach expected vs. unexpected language in school.

He went to class and got his good report.

Why did it work

The standard adult tells student what to do model is less useful. It is because of this there are students that will punch their peers and say, “sorry” and assume all is well. They also develop a dependency on adults to solve their problems. They become powerless. They have no accountability. They have permission to misbehave so long as it is a new way of misbehaving. It is a vicious cycle I have seen over and over.

That was not what happened today.

I think today was illustrative because I worked with two students that have relatively low verbal language skills and underdeveloped coping skills. Both students were able to communicate in their own way the solution to their problem and engage with the solution. I did not spoon feed them. I just used a modified Rogerian psychology trick of restating what they just said as a question to keep them communicating. They did the work. They got their own needs met. They were empowered. They learned. They were accountable for their own solutions.

In short, by helping autistic students communicate to get their own needs met, they grew. They grew as students. They grew in character. They grew up a little. They grew as people. And that is my goal as a special educator. To build character and prepare autistic kids for the real world. Today I feel I helped, if only a little bit.