The use of restraint and seclusion places children at risk of physical and emotional harm. Children with disabilities, including those who have emotional, behavioral, or communication challenges, are more likely to be restrained or secluded than other children.
Restraining or secluding a child can traumatize or injure the child as well as the staff who are involved. Since both restraint and seclusion can be harmful and even fatal, New Hampshire law limits their use in certain facilities operated, overseen, or licensed by the State of New Hampshire, including youth detention centers, hospitals, child care agencies, group homes, crisis homes, and other residential treatment centers.
What is Restraint?
A restraint occurs when a person uses their body or a device in a way that immobilizes or otherwise prevents a child from moving their torso, head, arms, or legs. Restraint does not include briefly touching or holding a student to calm or comfort them, certain physical escorts, seat belts, or certain medical devices.
What is seclusion?
Seclusion occurs when:
- A child is involuntarily placed in a location where they are alone and from which they are unable to exit, due to a lock, other device, or physical manipulation by a person (such as holding the door shut).
- A child is involuntarily placed in a location where they are alone and from which the child ‘reasonably believes’ they are not free to leave.
- A child is involuntarily confined to a room or other area, separate from their peers, with one or more adults who are preventing them from leaving and not engaging in a therapeutic intervention.
When IS restraint or seclusion allowed?
Restraint and seclusion can only be used by trained personnel in situations when necessary to prevent injury to the child or to someone else.
- Restraint can only be used in an emergency. Under the law, an emergency is when there is a “substantial and imminent risk of serious bodily harm” to the student or another person. Restraint is allowed only “when all other interventions have failed or have been deemed inappropriate.”
- Seclusion may only be used when there is a “substantial and imminent risk of physical harm” to the child or others. Seclusion is allowed only after attempting other approaches to control the child’s behavior, or if trained personnel have determined that, based on the history of actual attempts to control a particular child’s behavior, that alternative approaches to control the child’s behavior are unlikely to succeed.
Facilities subject to the law limiting the use of restraint and seclusion are required to have written policies and procedures for supporting and managing children’s behavior. These policies must describe how and under what circumstances the facility will use restraint and seclusion. Facilities must provide these policies and procedures to each child’s parents, guardians, or legal representatives.
When is restraint or seclusion NOT allowed?
- Neither restraint nor seclusion can be used to punish or discipline a child.
- Intentionally ridiculing, humiliating, or causing emotional trauma is not allowed.
- The use of unpleasant substances to punish or control a child is also banned.
- It is illegal to use dangerous restraint techniques, such as prone restraint, that obstruct the child’s breathing or circulation, or compress their chest, lungs, sternum, diaphragm, back or abdomen, or cover their face or body with anything.
- Mechanical restraints like zip-ties, handcuffs, and straps are not allowed.
- Medicinal restraints like giving a child a sedative or other medication without a medical provider’s prescription, are also illegal.
Additional limitations on the use of restraint and seclusion
Restraint
- A child may not be restrained for more than 15 minutes unless approved by a supervisor or director.
- A child may not be restrained for more than 30 minutes unless the facility director, or specifically designated and trained supervisor, completes a face-to-face assessment of the mental, emotional, and physical well-being of the child to determine if the restraint is being conducted safely and for an authorized purpose.
Seclusion
- When a facility secludes a child, it is required to designate a “co-regulator” to monitor the child, help the child regain their composure, and return to a less restrictive setting. Co-regulators shall be selected and designated in the following order of preference:
- A trusted adult selected by the child.
- A clinician or counselor trained in trauma informed practices.
- A staff member known to have a positive relationship with the child.
- A staff member who was not involved in the incident leading to seclusion.
- Any room used for secluding a child must have adequate heating, cooling, lighting, ventilation, and a ceiling as high as other rooms in the building. The child must be observed continually. If the room is locked, there must be a way for the child to escape if there is a fire or other emergency.
What MUST a facility do if it restrains or secludes a student?
Notification: Unless prohibited by a court order, facilities are required to notify the parents or guardian of any restraint, seclusion, or intentional physical contact in response to a child’s behavior as soon as possible. The notification must occur before the end of the business day. The facility employee who used restraint or seclusion must notify the director of the facility.
Written Report: The facility employee must write a report describing the incident within five business days and provide it to the director of the facility. The director must send that report to the parent within an additional two business days, unless there is a court order against notification.
An alternative to restraint and seclusion
Restraint and seclusion are rarely necessary to control a child’s behavior or effective in preventing challenging behaviors in the future. Instead, facilities should address the causes of behavioral problems and use proven strategies like Positive Behavioral Interventions and Supports (PBIS) to de-escalate these situations. For more information, visit the PBIS Technical Assistance Center at https://www.pbis.org/.
If you believe a student’s rights have been violated, you can:
- Request a meeting with the facility to discuss the child’s challenging behaviors and to develop a plan to address them.
- File a complaint with the Office of the Ombudsman within the NH Department of Health and Human Services.
- Contact DRC-NH for more information or to speak with an attorney free of charge:
- Phone: (603) 228-0432
- Email: mail@drcnh.org
- Website: drcnh.org/contact-us
If a student has been assaulted or harmed, file a complaint with the police department or talk with a lawyer.
