What are your thoughts on the necessity of physical restraint in Asperger kids?

Question

My son was diagnosed with "Mild" Asperger's in May of this year …he turned 5 years old in June. I don't think I even want to know what "Severe" Asperger's looks like. I am not particularly impressed with the psychologist that diagnosed J___. His "Compliance Procedure" calls for physical restraint i.e. the basket hold procedure when there is not an absolute necessity for this procedure. (My personal opinion is there is never an absolute necessity), but the psychologist procedure says to use the basket hold to force compliance for a time out or whatever, if the child doesn't just follow those directions. To me this physical contact with a child that has sensory integration problems and Asperger's seems to only fuel the fire and cause the meltdowns to be prolonged. My observation is that allowing him to melt down on his own and try to protect him and the house while this is happening, we can generally get through an issue in 10 - 15 minutes and he is wanting a hug and telling me he is sorry.

I did in a counseling session with the psychologist finally agree after about an very tense hour that the basket hold may be appropriate if there was an immediate danger to person or property. Which the Dr also compromised his position for my son back to this limitation as well. My follow up to that is that it is still never necessary. I think I can keep a 40 - 50 pound 5 year old from doing too much damage to himself or others without escalating a problem. I am 6'4" and weigh nearly 300 pounds - at this point I can take whatever he's got.

What are your thoughts on the necessity of physical restraint in Asperger kids?

I have much enjoyed your weekly e-mails and online post video's etc. I am going to join Online Parent Support. I so much appreciate what you are doing.

Thanks,

R.


Answer

Restraining a child in the middle of a meltdown is a lot like hugging someone while they are having an epileptic seizure – it serves no real purpose. If the Aspergers (high-functioning autistic) youngster or others are in danger, then restraint is warranted; otherwise, it is nothing more than an odd parenting strategy with no real benefit (it’s a lot like “spanking” …it doesn’t really do any harm, but it doesn’t do much good either). When dealing with meltdowns, think in terms of PREvention. INTERventions are rather useless, because if the meltdown has already started – it’s too late!

While the meltdown is happening, remain calm. Anger and yelling only make a meltdown worse. Make everyone ignore what is happening and move away from the youngster. The Aspergers child does NOT like having these meltdowns anymore than an epileptic enjoys a seizure. Having others witness a meltdown embarrasses and humiliates the youngster.

The child in a meltdown is like a skittish horse, thus trust needs to be achieved. You are the person that your youngster trusts. After everyone else has moved away, have the person that the Aspergers child trusts get down on the floor at the same level as the youngster (a couple of feet away). Then speak to the child in a soft, somewhat slow, monotone voice. Ask him what's wrong, or what happened that made him upset. A normal voice may be too loud, and normal speech patterns may be too quick. Ask in as many ways as you can think of. He will eventually understand what you are asking and answer you. Be sure to leave plenty of time between questions so he doesn’t become even more overwhelmed.

The youngster will eventually move to a sitting position …you also need to move into a sitting position. Gradually move closer to the child and speak to him in your soft, slow, monotone voice. Try to attain eye contact, and once you have it, it's up to you to maintain it. Remember the eye contact is for your benefit, not the youngster’s – he doesn’t need it to communicate with you.

Once the child has started communicating with you, ask him if he would like to move to a safer and more comfortable place. He will usually want to be left alone once he has calmed down. Give him a safe spot in the house - and at school - where he can go to calm down. Make sure it's somewhere that someone can keep an eye on him, but gives him a sense of privacy at the same time. Give the youngster time to calm down. Every once in a while, gently ask the child if he wants to come out of his spot and join you, or rejoin his class.

Once he has come out of his spot, ask him if he would like to talk about what happened so you can fix the problem. If you're able to fix the problem, fix it – but don't make any false promises to fix something you can't. Be honest with your Aspergers child. A broken toy can be fixed, but a broken heart is much harder to heal.

Once he has decided to rejoin others, totally ignore the event; act as if nothing has occurred. If the youngster is at school, the teacher should inform the parent that a meltdown has occurred. Sometimes the effects of a meltdown can last all day, with the child being grumpy or unresponsive. He is usually trying to come up with a solution to the problem himself, and if there were witnesses (especially from his own peer group), he will be embarrassed, humiliated, and ashamed.

Punishment is not an option. If the Aspergers youngster could control these meltdowns, then they would never occur. I liken meltdowns to seizures and treat them accordingly. Punishing the child for a seizure/meltdown will only cause resentment and self-hatred. Remember: As the youngster ages, the meltdowns will occur with less frequency and with less severity.

Your biggest plus is a great deal of patience – use it. If you feel stressed out, you're perfectly normal in that regard!

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