In The Politics of Autism, I discuss the use of restraint and seclusion.
Each year, nearly 20,000 youngsters with severe disabilities like Adam’s are sent to live at special education schools at public expense. Federal law gives parents that option when local public school districts can’t or won’t accommodate their children. But there’s little to guarantee that such vulnerable students — some are unable to speak for themselves — receive safe or humane treatment. As Kennedy-Shields would learn, standards for such programs are so loose, monitoring so inconsistent and penalties so rare that some have escaped serious repercussions even for repeated or egregious lapses.
AdvoServ cares for 700 disabled children and adults at 77 facilities in three states, with Carlton Palms by far its largest campus. State officials and advocates for the disabled have long known of its aggressive use of restraints — holds or devices that limit residents’ ability to move their heads, torsos, arms or legs. In particular, the company became known for embracing so-called mechanical restraints, such as straps on chairs or beds, wrist cuffs or “wrap mats” that resemble full-body straitjackets. Most providers stopped using such measures long ago, after concluding they were risky and often ineffective over the long-term.
Restraints were ingrained in the company’s culture, but there was more than that at work, added Glen Gandy, who worked with residents at Carlton Palms for several years. High turnover meant workers often didn’t know residents well enough to calm them, and they would turn to restraints instead, Gandy said. He was fired in 2012 after an incident in which he and other workers attempted to wrestle a thrashing resident into a wrap mat. As Gandy held the resident’s head, the man bit down on Gandy’s finger. Gandy broke the man’s jaw — accidentally, he says — getting his finger out of the man’s mouth.