Why Physical Restraints Are Not A Good Idea
©2003 Teresa Kellerman

There may be times when physical restraints may become necessary to prevent serious injury to the person or to others. But physical force should not be used as a means of controlling a child or adult with difficult behavior or as a means of discipline. Anyone who finds it necessary to resort to physical restraints should be trained in the correct, safe way of applying this procedure.

Children who were prenatally exposed to alcohol may have neurological damage that is seen in difficult behaviors. This brain dysfunction also impairs the child's ability to learn and remember rules. These difficulties do not disappear when the child grows up, and may even appear to become more evident in the adolescent and adult years.

The person with FASD learns best by imitating others, and by repetition. If the child with FASD learns one way to respond to certain behaviors (like being teased or being shoved), that response can become a learned behavior. When a child is young, and the child learns to respond to behaviors with physical aggression, this places the child at risk of violent behavior in the future. When a child is spanked as a means of discipline, the child learns that it is okay to inflict pain or to lash out physically when one is angry or frustrated.

It is extremely important for parents and siblings to express healthy behavior as they are primary role models for the child with FASD, and the child will invariably imitate the behavior he or she sees at home in the family. If the child learns healthy ways to respond to potentially abusive behavior of others in the home environment, that child is less likely to become aggressive or violent in situations away from home. This can be carried out with role playing and with practicing the healthy response over and over. Making a game of this practice can help relieve the tediousness of the repetition.

My first child Karie has a disability that includes a genetic predisposition toward aggression and a low tolerance for frustration, not a good combination. I was forewarned that this might increase the risk for violent behavior. The first time Karie raised her fist to me in a threatening gesture, I addressed the issue on the spot. She was such a little thing, that her gesture seemed almost comical. But I knew that as an adult, this behavior could cause serious problems for her. I was firm but gentle. I did not touch her, but explained to her at length what could happen if she did that to the wrong person in some other social situation. I explained the psychological factors, the legal ramifications, and all the negative consequences I could think of. Then we talked about other ways to act when we get angry or frustrated. I encouraged her to express her feelings in a more socially acceptable manner. And we practiced healthy ways to relate to others.

By the time John started to grow up and display his low frustration tolerance and inability to deal with anger, he had several healthy role models, and we continued to talk about "what if" situations that might occur if we acted on our impulse to lash out. I believe that because I was able to catch John at an early age, he learned the healthy way to cope with anger and frustration from the very beginning. For the child who has already learned unhealthy ways of responding to frustration and anger (hitting, biting, shoving, or other means of physical aggression), it is more challenging to teach healthy behaviors, because we will need to help the child unlearn the behavior that was first learned before we can reteach the behavior was want them to use. But it's not impossible. It helps to follow guidelines for Positive Behavior Support.

Here is an observation by another parent:

My son has severe FASD and RAD. I tried violence and God knows his school and work programs have used physical dominance and pain to try and control him. IT DIDNíT WORK. Just made him more violent and eager to resist. Thank God I came to my senses when I found out about FASD, educated myself and was able to turn our relationship around. Just havenít found a work program that will work. When the going gets tough he becomes very oppositional and verbally abusive and can even start to be destructive if not deescalated, which few bother with. When someone does use de-escalation techniques he responds very well and will be very successful. --Eva Carner
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