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It’s Time to Do Away with Seclusion and Isolation Rooms and Replace them with Compassion

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Recently, a 13-year-old autistic student died after staff members at his Northern California school physically restrained him for an extended period. And the parents of a non-speaking, autistic 12-year-old  have sued his school for placing him in a seclusion room after a behavioral outburst. Teachers forced the child to strip naked before they placed him in a small, locked room adjacent to his classroom. Not long after, they found him there, covered with his own feces.

These tragic stories both reveal an urgent problem facing our education and child service systems: many in positions of authority simply don’t understand what severely challenging behaviors represent or how to help children who exhibit them.

It’s incumbent on us to replace outdated notions with a new understanding of these behaviors based on current brain science. Too many people wrongly believe that when a child is harming himself or others, the solution is to restrain or isolate the child. This approach ignores neuroscience, which clearly explains what underlies such fight-or-flight behaviors: a child’s brain and body are detecting some kind of threat. Children in fight-or-flight brain states exhibit automatic, non-intentional, physiological (brain-based) behaviors.  Placing them in isolation serves to increase their fight-or-flight response.

Rather than isolate children, we should use humane and compassionate ways to keep them –and others—safe. We need to shift our paradigms, recognizing that these children don’t have volitional control over these behaviors. Rather, they represent a human response to a brain state.  Biologically based stress responses—when a child harms himself or others in a tantrum, rage, or other adrenaline surge—signal that a child needs help, and fast. Of course, our first priority should be to keep the child and others safe. But there are humane and considerate ways of doing so.

In the throes of such a difficult moment, a child cannot hear what you say, reason his way through it, or even ask for help. Using punitive measures such as isolation and restraint only serve to increase the stress in the child’s nervous system, priming the brain to amplify threat detection and over time causing the child to lose faith in the safety of human relationships.

Fortunately, neuroscience offers a roadmap to help these children: social engagement. A child experiencing severe fight-or-fight behaviors needs one thing: cues of safety that are tailored to the individual’s sensory profile and nervous system.

Ideally, every child or teenager who experiences severe behavioral challenges should have a personalized “instruction manual,” created by those who know him best, to instruct the adults around him how to de-escalate the child, keeping the child and those around him safe. To be sure, taking such a personalized approach requires effort and training, but it’s necessary.

As long as we misunderstand the nature of human stress responses—especially in neurodiverse and highly vulnerable populations, including those exposed to trauma and toxic stress—and continue using outdated and harmful methods, too many children will suffer.

To help vulnerable children, nothing can substitute for attuned, sensitive relationships. We need to ask: “What does the child need from the environment or from relationships at this moment?” The more desperate children feel, the more they need us to connect with them. In short, anyone who works with children who experience challenging behaviors should understand the clear message of contemporary brain-based science: the primary ingredient in supporting challenged children is human connection.

My upcoming book, Beyond Behaviors, describes how to create a personalized approach based on brain science and compassion.

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