Seclusion and Restraint: A Scoping Review of the Peer-Reviewed Published Literature Since the GAO Congressional Hearing of 2009 Through the End of the 2020 COVID-19 Pandemic

JAASEP SPRING/SUMMER 2025 Part 3 of 11
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For decades, the use of seclusion and restraint practices on children have been topics of concerned discussion, legal proceedings and safety. Primarily, this is because children and staff alike have been repeatedly injured by unsafe and untrained (many well-meaning) individuals. Others have lost their lives because of situations that could have been easily avoided. Seclusion and restraint have specific definitions (see below) and the need for specific language addressing the concerns raised by parents, educators, staff and other special education experts is long overdue. Seclusion and restraint practices have been recognized as aversive practices, and when used by someone with malintent, they can constitute abuse. In response to complaints, investigations, and litigation by concerned parents and advocates, many disciplines (e.g., psychiatry, military) have enacted policy or placed strict restrictions on the practice. However, it is not true within many educational contexts. This is particularly salient in this era as it relates to discussions surrounding proper methodology for supporting children with varied diagnoses in classrooms across school campuses. That stated, it is commonly understood across educational contexts, regardless of location, seclusion and restraint practices are a last resort (even when used properly); to be reserved for situations of imminent danger.

Abstract

Aversive procedures such as seclusion and restraint are generally viewed as emergency only procedures in school settings. However, they are still used too often to respond to student behaviors in schools. The purpose of this scoping review was to determine which types of documents have been published in peer-reviewed journals, the degree of progress that has been made toward the reduction in the inappropriate use of seclusion and restraints, and how these practices have impacted students with emotional and behavioral disorders (EBD) and/or emotional disturbance (ED). Our summary includes the type of article, antecedent and preventative variables, parent and student perspectives, policies, preventative measures, and legal cases in the literature across 32 peer-reviewed articles from 2009 to 2022. Key findings reveal an increase in the use of seclusion and restraint procedures, despite growing awareness and attention within the education sector. Additionally, the ongoing lack of staff training in emergency procedures suggest that the small number of staff employing these measures may be causing greater harm than previously reported in prior years. Further, we found individuals with disabilities (in particular students ED) and students of color or with linguistic diversity were much more likely to be secluded or restrained in school than their peers. Finally, the varied documents present within the peer-reviewed literature suggest an ongoing interest in advocating for students and their families who have experienced seclusion and/or restraints in school settings. Recommendations for research, practice, and policy are discussed.

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