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Quiet space, safe space, time-out rooms, seclusion rooms, screaming rooms...
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I first
presented a conference paper on the use of ‘time out rooms ‘in 2004, raising my
concern, that there appeared to be the use of rooms in UK schools and care services in response to managing behaviour. In the professional role I
was undertaking at that time I had become aware of seclusion being used within
school settings. In 2007 I presented a conference paper to a shocked professional
audience; the presentation included a short video clip of a child in an
American school who had been locked into a ‘time out room’. This video showed
Isabel Loffler
an eight year old girl with autism as she is videotaped for more than three
hours confined in the room, she has also wet herself. It was widely reported in
the media that she was put into the room for refusing to complete a reading
exercise, the video shows that she bangs her forehead with her fist and tries
to climb the walls. At several points in the film, Isabel drops to the floor
and stares at the teachers watching her through the window.
The use
of time out rooms within educational settings for children and young people has
been in the headlines once more in the UK following a recent report which was published by Estyn (Her
Majesty's Inspectorate for Education and Training in Wales) that highlights continuing concerns with regard to safeguarding
issues at Pembrokeshire Council, these concerns arose from the report published
in August last year which discussed the inappropriate use of so called ‘time
out rooms’. The rooms were in schools and pupil referral units.
In June
2011 another case which centered on the use of so called ‘time out rooms’ hit
the headlines when the Court of
Protection ruled that an 18-year-old man with autism and severe learning
disabilities who was regularly placed in a padded seclusion room more than six
times a day was unlawfully deprived of his liberty . In April 2012 Lord Justice
Ryder took the unusual step of lifting certain reporting restrictions applied to
cases before the court of protection by naming some of the parties involved in
this case. The young man was at a residential school which was reported by the
media to charge fees of up to 250,000 GBP per annum, the school was run by
SCOPE, a national charity which has campaigned for the rights of people with
disability over many years.
On
reading the sensational reports about the use of time out rooms in the media
most people, especially parents, have the immediate reaction of knowing that
the practice of locking a child in a room is at the very least immoral. However
when a parent is faced with a professional who is having difficulty in
responding appropriately to the behaviour of their child that presents a
challenge, it may be that they have agreed to their son or daughter being
placed in “time out” as they feel powerless to do otherwise. It may be also
possible that they do not fully appreciate what the professionals mean when
they suggest ‘time out’ ‘ quiet time’ or ‘chill out time’. It can be presented in
a such a sanitized way which gives parents confidence that the professionals
know what they are doing. It is also true that for many parents there is a feeling
that if they do not agree to a strategy offered to then that perhaps their son
or daughter may be excluded from school.
It is
important to understand what time out actually is. It is a term used to
describe a very specific behavioural technique; you may be familiar with Super
Nannies version of this? To explain it simply time-out is
“time spent away from reinforcement, usually
for a specified period of time”.
Time-out can be implemented
using two primary approaches, non-exclusion and exclusion.
In non-exclusionary
time-out the individual is not physically removed from the setting but they do
not receive positive reinforcement from other people for a period of time or at
least until they desist from exhibiting the behaviour of concern to other
people (which may be challenging). Positive reinforcement is something which
the person finds to be pleasant; even being ‘told off’ may be a pleasant
experience for some children.
In exclusionary time out the individual is at least partially
removed from the (educational) environment. Time out
does not have to take place in a certain room with special equipment and the child
isn’t usually left alone. For time out to be effective as a behaviour change
strategy the individual must have a level of understanding which enables them
to make the link between their behaviour and the response of time out. There should also be some way that the
young person can reflect on their behaviour and communicate this to someone (in their own way, this may be with symbols or signing) so that they are able to
return to the activity/ environment they have left as soon as possible. As a
strategy time out has limited use especially with children and young people who
have autism or intellectual disability as they often lack the ability to make
the connection between time out and any behaviour they may have been exhibiting.
On a
personal note I am also concerned that anyone might have an honest belief that
a young child or child who has an intellectual or cognitive disability might
reasonably be expected to gain control over their behaviour while effectively
being isolated from other people and important social contacts. For a child to
learn and understand how to manage their emotions and any behaviour which might
be seen as ‘challenging’ by other people they are likely to need support
guidance and explanation. If a child is isolated from others whenever they
exhibit a behaviour which is perceived as ‘challenging’ by others it’s unlikely
they will be able to reflect on why they have been left alone, or experience
any guidance relating to their behaviour, its actually more likely this is a
frightening experience and for any child, for a child with a disability it
would possibly be more frightening.
When we
consider this carefully it is easy to understand though why some people may
almost drift into using a practice when you are faced with a child whose behaviour appears to be out
of control and risky, you notice that when the child is allowed to spend time
alone they calm quickly. A potential solution may appear to be a room which the
child can use in order to ‘self sooth’, at first being accompanied by staff
when in the room. Over time this practice becomes embedded, and it becomes the
normal response to the child’s behaviour. Arguably it is easier to mange the child and the behaviour by putting them in a room rather than
try to figure out what is making them behave this way which would be a more
proactive and positive response.It might also be that it feels less risky than
managing the behaviour in a more direct manner. In order to free up a member of staff from guarding a door a
catch is put on the exterior of the door to the room. The child is now placed
in the room alone with the catch down; in most circumstances if this is a
planned response it is likely to be unlawful. It is probable that this would
constitute unlawful imprisonment and it might also be considered a breach of
that child’s human rights.
Questions to ask…
Does the child access the room or
space voluntarily?
Is the child accompanied by a support worker/ teacher or other person in
the room?
Can the child leave the room independently? Do
they know how to get out of the room or area?
Is the ‘time out’ part of an assessed and
agreed behaviour support plan that includes short term and long term goals?
Can the’ time out’ strategy
be easily implemented in a number
of environments?
If the answer is yes to most of the above it is likely that you
are using a time out strategy.
Do support staff or teachers or others take the child to the room
or space?
Is the child left in the room or space alone?
Is the child is unable to leave the
room independently or not understand how to leave the room when they choose to?
Do people watch/monitor the child from outside the room without entering
the room?
Is the practice dependent on a room or
space which is available at the place the child is being educated or cared for?
If the answer is yes to the above
questions the practice is more
likely to be seclusion, and may be illegal except in specific circumstances
described in legislation such as The Mental Health Act (1983)
It is
important to understand what is actually meant when professionals suggest
options such as ‘time out’, quiet space or safe space. The questions above may
act as a quick guide. If a child
is put into any room or area from which their free exit is prevented this is a
breach of their human rights, it may constitute unlawful imprisonment and in any
event it is unacceptable practice. There is limited evidence that time out
strategies, implemented as part of an overall behaviour response strategy will have any
positive impact on children or their behaviour in the long term, especially
when such strategies are applied without any positive behaviour support plan.
Indeed it is likely that any such isolation may cause distress and even
traumatise the child.
In
November 2004 a 13 year old child, called Jonathan King hanged himself while in
a time out room at his school in Georgia USA. While this is an extreme and
incredibly sad example of what can happen when time out is implemented it is
too simplistic to argue that such an event could never occur in the UK. The two
examples cited in the opening of this article are evidence that the practice is occurring in
schools in the UK. It is difficult to say how widespread the practice is but it
is probable that the two cases discussed at the outset of this piece are not
isolated examples.
Wales
Audit Office (2012)
Special Inspection – Implementation of
Safeguarding
Arrangements- Pembrokeshire County
Council. Cardiff Estyn . Care
and Social Services Inspectorate Wales (2011) Joint investigation into the
handling and management of allegations of professional abuse and the
arrangements for safeguarding and protecting children in education services in
Pembrokeshire County Council. Crown Copyright. Wales
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