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


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.




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!

My Aspergers Child: Preventing Meltdowns in Aspergers Children


Denice said...

Really excellent advice. My husband and I had to learn those techniques in the trenches, as it were, and I think it is great to put it out there so others can benefit. One of the greatest benefits to the parent, or other supervising adult is that they do not have to engage in any sort of battle. I agree that the holding technique can be useful for a child who is endangering themselves, but otherwise it has never been a help to us.

Anonymous said...

Excellent article - thank you for posting - agreed on all... son has been in "therapuetic school" that used restraint and it always escalated issues - was horrible and taken years to get past -

Anonymous said...

Kathy Foster excellent article - thank you for posting - agreed on all... son has been in "therapuetic school" that used restraint and it always escalated issues - was horrible and taken years to get past -
Yesterday at 11:09am · Like
Gina Sanchez
This is THE WORST think to do to an Aspies child!!!!! The same thing happened with my son when he was 5. It made everything worse. We ended up taking him out of that school. He was anxious, depressed. It has taken almost a year to repair the damage done to his psyche. I believe that a meltdown needs to be treated like a seizure: allow it to play itself out, prevent harm and be there for recovery phase. In doing this, along with other treatments, we are doing a million times better!
23 hours ago · Like
Crystal Amstutz
Personally, I think it depends on the child. Some children does need it while other's does not. And it depends on what kind of restraints, some are good and some are bad. I also don't think that educators should make the call on using restraints, but it should be up to the parents because the parents knows if the child would benefit from being restraint or not. For some children, it would cause them to escalate, but for other children, it would help them but only the parents who knows their child best should be the one to decide what helps and what doesn't help.
23 hours ago · Like · 1 person
Sherri Caldwell
It should never get to that point. Physical restraint is not necessary if action is taken before child is at the point of meltdown (for most kids) -- whatever is necessary for that child to recover himself, a walk, a quiet space, an understanding adult, etc. Will they never learn?! We have had incidents and have structured the IEP/warned the school we will take legal action if they put their hands on our child again. Some people seem to get off on winding them up & setting them off -- an asst principal, in our case, someone who should know better.
22 hours ago · Like
Chris Peters My son is restrained, safely and correctly, 2 to 3 times a week. He needs it and i have no issue with it. The basket hold is now considered ineffective. Meds only help a little. I need to learn how to do restraint holds since my son is now bigger than me.
22 hours ago · Like
Chris Peters
I should add, restraint holds are never used for compliance. (that is absurd!). they are used because my son, who is 15 yrs old and 190 lbs, is aggressive and violent. sometimes he can be calmed by talking it out and he is learning to use calming techniques or simply to use words to express his anger. but I don't want to think of all the damage he could have done - to himself or accidently to other students - if he had not been safely restrainted. and my son immediately stops when restrainted, like he needs to 'feel' the limit since he can not control himself. it is a release for him, not a tantrum.
21 hours ago · Like

Anonymous said...

Carol Morris I agree with Chris. I was taught restraints holds as part of gaining compliance with my very strong-willed (now bipolar) young daughter; it was the idea of training a stallion while he's a colt and you're still bigger than him. I used it rarely, and I cannot imagine it doing one whit of good for my Aspie son. His fight-or-flight would just escalate if that were done. But, if he were violent, I would certainly want to learn some safe restraint techniques to avoid harm to all involved.

Unknown said...

Your response to the behavior needs to match the cause. So if it's attention seeking restraint usually will not work. If it's escape of demand or situation then you want to keep him in demand and not allow that escape. I wholeheartedly believe in restraint. I work with severely intensive adults. It does not get better with age without early intervention (intervention not necessarily restraint). I have clients whom have hospitalized their family members, staff, teachers. No its not for everyone. Proper intervention strategies should fit your child. My basic guidelines for restraint are continuous aggression, continuous self-injury, or continus high-magnitude disruption. Yes restraint may increase the behavior but that's not necessarily bad. Behavior gets worse before it gets better. Without going through an extinction burst, the behavior isn't actually better. It's only that the people around them have learned to isolate and protect them from these triggers. This does not lead to normalization and inclusion in their community, which should be the ultimate goal for every therapist working with your child.

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