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behavior, safety & medication
The operative claimPhysical restraint and seclusion in schools are disproportionately used on students with disabilities, carry documented risks of physical and psychological harm, and lack evidence that they improve behavior or serve any therapeutic or educational purpose; the science supports their use only as emergency last resorts to prevent imminent serious harm, not as behavior-management tools.
Contested at the margins: consensus that restraint/seclusion harms and has no behavioral benefit, with debate only over the unavoidable-emergency threshold.
Federal civil-rights data show students with disabilities are restrained ~7x and secluded ~4x more than peers (Gage et al., 2020). Reviews of restraint/seclusion document trauma, PTSD (incidence 25-47% in psychiatric settings), distress, and dehumanization (Chieze et al., 2019; Cusack et al., 2018), and a critical school-focused overview finds injuries, deaths, inadequate training, and no evidence of behavior change (Ryan et al., 2026). A single-school EBD study reports low injury concentrated in few students (French et al., 2017), illustrating setting variation.
Gage, N. A., Katsiyannis, A., Rose, C., & Adams, S. E (2020). National Trends and School-Level Predictors of Restraint and Seclusion for Students with Disabilities. Exceptionality.
Observational
Students with disabilities were seven times more likely to be restrained and four times more likely to be secluded than peers, and students in special-education schools were almost guaranteed to be restrained or secluded.
Bearing on this claim: OCR data: students with disabilities restrained ~7x, secluded ~4x more than peers.
doi.org/10.1080/09362835.2020.1727327Chieze, M., Hurst, S., Kaiser, S., & Sentissi, O (2019). Effects of Seclusion and Restraint in Adult Psychiatry: A Systematic Review. Frontiers in Psychiatry.
Systematic review
Seclusion and restraint had deleterious physical and psychological consequences (PTSD incidence 25-47%); effectiveness and adverse effects appear similar, leading the authors to recommend use only as a last resort.
Bearing on this claim: Systematic review: deleterious effects; PTSD 25-47%; recommend last-resort use only.
doi.org/10.3389/fpsyt.2019.00491Cusack, P., Cusack, F. P., McAndrew, S., et al (2018). An integrative review exploring the physical and psychological harm inherent in using restraint in mental health inpatient settings. International Journal of Mental Health Nursing.
Review
Physical restraint was associated with trauma/retraumatization, distress, fear, feelings of being ignored, and dehumanization — documenting psychological as well as physical harm.
Bearing on this claim: Integrative review: restraint -> trauma, distress, dehumanization (psychological + physical harm).
doi.org/10.1111/inm.12432Ryan, J. B., Peterson, R. L., Tetreault, G., & van der Hagen, E (2026). A Critical Overview of the Use of Restraints in Educational Settings. Behavioral Disorders.
Review
Reviews the safety problems, inappropriate and disproportionate use, inadequate staff training, and documented injuries and deaths associated with restraint in schools, and notes the lack of evidence that it changes behavior.
Bearing on this claim: School-focused overview: injuries/deaths, poor training, no evidence behavior improves.
doi.org/10.1177/01987429261421267Counter-authority (1). Studies an adversary may cite — surfaced deliberately so the grade is honest about its limits.
French, D. D., Strunk, L. L., & Robinson, M. F (2017). Restraint and Seclusion: Frequency, Duration, and Rate of Injury for Students with Emotional and Behavioral Disorders. School Mental Health.
Observational
In a specialized EBD school, restraint/seclusion frequency was concentrated in a small number of (often younger) students, and durations and student injury were quite low — suggesting some specialized settings may necessitate higher use with low injury.
Bearing on this claim: Single EBD school: low injury, concentrated in few students — specialized-setting variation.
doi.org/10.1007/s12310-017-9240-54 supporting · 1 counter verified sources
Harm evidence is largely from psychiatric/inpatient settings and observational school data; experimental benefit evidence cannot ethically be generated; and injury rates vary by setting, training, and population even as disproportionate use is consistent.
Last reviewed June 28, 2026