Ending Restraints on Children with TS

The Tourette Association heads several initiatives to end restraints on children with Tourette. Through Tourette Association’s support, federal guidelines could be established to end the use of corporal punishment in schools. The Tourette Association also advocates for healthcare reform to assure people with Tourette and Tic Disorders can obtain high quality affordable health care. To stimulate research, the Tourette Association is actively garnering support for the Collaborative Academic Research Efforts (CARE) for Tourette Syndrome Act of 2014 (H.R. 4221).

On May 19, 2009, the Government Accountability Office (GAO) released a report regarding the use of seclusion and restraints in schools. It found that there were “no federal laws restricting the use of seclusion and restraints in public and private schools and widely divergent laws at the state level.”

When the Individuals with Disabilities Education Act (IDEA) was reauthorized, Tourette Syndrome was added under the definition of Other Health Impaired. “Including Tourette Syndrome in the definition of other health impairment may help correct the misperception of Tourette Syndrome as a behavioral or conduct disorder and prevent the misdiagnosis of their needs.” Change to §300.8(c)(9)(i).

Yet, many students with TS continue to be punished for involuntary symptoms caused by their disorder, including uncontrolled noises, vocalizations and body movement, difficulty with attention and focus, impulsivity, etc. The possible negative impact of restraints, seclusion and corporal punishment for students with TS, include:

  • Stress and anxiety which can exacerbate symptoms of TS.
  • Violent responses to avoid restraints.
  • Short and/or long term social and psychological consequences.
  • Increased obsessive compulsive symptoms, fears and anxiety.
  • Resistance to attend school/increased dropout rate.
  • Increase in oppositional and confrontational behaviors at school and at home.

The Tourette Association and its national Medical Advisory Board have long held that there is no benefit of corporal punishment in the school setting and should be prohibited. In fact, inappropriate and coercive interventions are in direct conflict with IDEA’s stated support of positive behavioral interventions when dealing with behaviors that interfere with the educational process. Numerous evidence-based strategies can be used in schools to manage disruptive behavior and to avoid the use of seclusion and or restraint.

The Tourette Association fully supports the use of functional behavior assessments and positive behavior interventions, as was intended by IDEA, and the use of best practices in all phases of behavior management in all settings.

Based on the information provided by the GAO, the TAA supports the development and establishment of Federal guidelines that would put an end to the use of corporal punishment. Moreover, we endorse the development of clear and concise restrictions, guidelines, training and monitoring requirements regarding the use of restraints and seclusion for children with disabilities.