Violence usually triggers use of school seclusion rooms — but not always

School seclusion rooms — little known to most parents — usually are used as intended, to keep agitated students from harming themselves or others.

Elementary students were put into seclusion rooms for behaviors that included kicking, biting, hitting and throwing chairs, books and computers, according to The Gazette's review of more than 125 reports covering the first month of the 2015-16 school year in the Cedar Rapids and Iowa City districts.

But the reports also show times when staff put kids into seclusion for non-violent acts like refusing to trace in pencil, stepping out of line at recess and pouting.

'Sending a kid to a room because they don't want to do their work and they're having a meltdown but not hurting anyone, that's not a reason to send them to seclusion,' said Dr. Patricia McGuire, a developmental and behavioral pediatrician who has practiced 25 years in Cedar Rapids. 'There are concerns it may cause more harm than good.'

The seclusion reports, while capturing only a snapshot in time, provide a glimpse into the heart-rending challenges that teachers and parents face in educating and raising children with mental illnesses, developmental disabilities or trauma.

Tammy Nyden lost track of how many times her son was put into seclusion for throwing objects, hitting and screaming threats.

'He was put in seclusion constantly,' said Nyden, of Iowa City.

Her son, now an eighth-grader at Iowa City's Northwest Junior High, has Tourette's syndrome, is autistic and deals with other challenges including anxiety and compulsion.

'With some of his behaviors, he just wanted to get out of that environment,' she said, giving an example of a bustling cafeteria. 'He learned that if he yelled he was going to burn the school down, he would get out of there immediately.'

Being shut into a 6-by-6-foot cube didn't calm him, his mother said. The family switched schools six times in as many years, trying to find a solution.

Federal law entitles every student age 3 to 21 to a free, appropriate and local public education in a least restrictive environment.

Under state rules, if a student's actions in the school threaten harm, and attempts to defuse the behavior fail, staff are allowed to restrain a child and place him or her into seclusion.

'It's my job to ensure that we use time out, seclusion or restraints as a last resort,' said Carmen Dixon, special education director for the Iowa City school district.

See also: What are seclusion rooms?

The Gazette requested the seclusion reports after an Iowa City parent last spring questioned how the district was using the small rooms with padded walls that are in most Iowa City schools.

The Cedar Rapids and Iowa City school districts each charged The Gazette about $400 for reports showing each time educators confined an elementary student in a seclusion room during the first month of the 2015-2016 school year.

Students' names and any identifying information, including grade, school and teacher's name, were redacted to protect student privacy. The Gazette did not seek seclusion reports for older students because there were so few the information might identify specific students.

Twenty-four Cedar Rapids elementary students were placed in seclusion rooms from Aug. 24, 2015, through Sept. 23, 2015. There were 59 seclusion reports from that month, meaning some students had more than one visit. One Cedar Rapids K-5 student was put into seclusion 10 times in the first month of school last year, records show.

"It's my job to ensure that we use time out, seclusion or restraints as a last resort."

- Carmen Dixon

Special education director, Iowa City school district

The median amount of time kids spent in Cedar Rapids seclusion room during that month was 14.5 minutes. The shortest amount of time was two minutes; the longest was two and a half hours — but in the latter incident, the door was open most of that time.

Reports show a range of actions teachers or other employees first took to de-escalate a child's anger, including redirection, modifying assignments, empathetic listening, removing a privilege and seeking help from other staff.

Sometimes that doesn't work and the child's behavior reaches a flashpoint. In one report, a child bit a staff member's arm. In another, a child reached down an employee's shirt and grabbed her breast.

Disruptive or dangerous behavior doesn't always cease in the seclusion room. Sometimes it ramps up.

Screaming, cursing, kicking walls, doing headstands and karate kicks, threatening to harm someone and spitting were common behaviors in isolation, reports show.

In a handful of cases, kids called out for their parents and, in one case, a child cried, 'I want to see a dog!'

In most cases, Cedar Rapids students are required to sit quietly by the back wall of the room for two minutes before they get out.

'Some recognition that they are calm and safe is important,' said Wendy Parker, Cedar Rapids' executive director of special services.

The Iowa City district had 68 seclusion room reports for elementary students in the first month of the 2015-16 school year. Officials wouldn't say how many kids were put in seclusion to avoid potentially identifying students, but said some were isolated more than once.

The median amount of time children spent in seclusion during the period reviewed was 13 minutes.

Several Iowa City reports documented no aggressive or violent behavior before an elementary student was placed in seclusion.

On Sept. 21, 2015, a student wanted something at recess and was asked to wait his or her turn, one form notes. The only aggressive behavior the child showed before being restrained, according to the form, was pouting.

While being restrained and taken to the room, the child kicked and hit before spending 20 minutes in isolation.

On Sept. 15, 2015, a student was secluded for seven minutes after 'elopement from the line toward exiting building.' On the line for listing aggressive behavior triggering the seclusion, staff wrote 'N/A.'

Jane Fry, the district's human resources director, said it's hard to know whether these forms adequately describe what led to the seclusion, but said the principal should probably follow up with staff.

'On the surface, this looks like we need to say, 'Let's take a look at this one,'' she said. 'It could be a teachable moment for adults, too.'

Parker is abolishing paper seclusion reports in Cedar Rapids this fall.

'We're moving it to an online form so it can be reviewed more quickly,' Parker said. 'Then right away we can provide coaching and training.'

Not only will principals review the forms that day, Parker said, but the district will analyze the reports overall to look for patterns, such as if there are certain classrooms or times of day when seclusion is more likely to happen.

Unless your child has been in seclusion rooms, you probably don't know about them.

'Most parents had no idea they existed,' said Megan Schwalm, of Coralville. 'They feared their child would be put in the room and they wouldn't know it.'

Her son, Maddox, 6, has diagnoses of autism, attention deficit and hyperactivity disorder and disruptive behavior disorder. Schwalm was glad to learn last spring that seclusion rooms aren't part of his Individualized Education Plan, a legal document describing a student's needs and the district's plans to meet the needs.

"Being taken away from peers is incredibly damaging. It tells them that what they're feeling isn't valid."

- Jessie Wetherell

Iowa City mother

Some students' IEPs might call for seclusion if the child's actions threaten the safety of him or herself or others. But any child — even those in the general population — could go to seclusion if behavior warrants it.

Some parents say seclusion rooms can be oases.

See also: Iowa City fixing problems with special education program

Renee Speh, of Iowa City, said her now 13-year-old son used a seclusion room on his own will when he was in elementary school and needed to calm down.

'I discussed how he might use it beforehand with the special education teacher,' Speh said. 'She assured me she would not use it to punish him, but rather that it is available to him if he needs a place to escape the stress of busy classrooms.'

Jessie Witherell's son, a kindergartner diagnosed with autism, has permission from teachers to work quietly in the hallway if he gets upset. But the Iowa City mom worries about the long-term effect of forced seclusion.

'Being taken away from peers is incredibly damaging. It tells them that what they're feeling isn't valid,' she said.

Several parents said in interviews they'd like to see seclusion rooms replaced with sensory rooms with gym mats or climbing toys — things that help kids burn off negative energy — or calm-down rooms with beanbag chairs, blankets and soft lighting.

These approaches are already used to varying degrees in Eastern Iowa districts, but schools must carve out money and space.

Nyden, whose eighth-grader often acts violently when he's overstimulated or teased, has found comfort in a therapeutic classroom at Iowa City's Northwest Junior High.

There are fewer students and teachers and paraeducators tailor their educational strategies specifically to the students' diagnoses.

Training is also critical, said McGuire, who has trained special education personnel in Iowa, Indiana, Connecticut and New Jersey.

'Part of the pressure they (teachers) feel is not having enough tools,' she said.

All Cedar Rapids staff serving a behavior-focused or autism program are required to get training from the Crisis Prevention Institute. Iowa City administrators and front-line special ed staff also take CPI.

Some Cedar Rapids staff are trained in the MANDT System, which focuses on de-escalation and support, and all Iowa City schools employees learn about Positive Behavior Interventions & Supports, which stress positive reinforcement.

Some parents would like to see all school personnel — not just front-line educators — take crisis intervention training so they can defuse disruptive behavior at recess, lunch, gym or music class.

CEDAR RAPIDS SCHOOL SECLUSION REPORTS:

CR-Seclusion-Reports-1-4 (PDF) CR-Seclusion-Reports-1-4 (Text)

IOWA CITY SCHOOL SECLUSION REPORTS:

School seclusion rooms - Iowa City (PDF) School seclusion rooms - Iowa City (Text)