Restraint and Isolation Harms Students, Families, and School Staff

Restraint and Isolation Harms Students, Families, and School Staff

Research shows that students do not benefit educationally or therapeutically from restraint or isolation.4  Furthermore, all evidence associates the use of restraint and isolation with grave potential for physical and psychological harm of students. Survivors repeatedly report difficulty breathing while they were restrained, and children as young as five have died of complications including asphyxiation, cardiorespiratory arrest, and suffocation.5,6,7 Even when restraint is properly administered by an adult trained in an approved program, there are documented injuries of broken bones, bruising, damaged joints and ligaments, and loss of consciousness.8  Students in isolation may be harmed by hitting or kicking doors in attempts to leave the enclosed space, or by engaging in self-injurious behaviors such as repeatedly hitting their heads on walls.

As education leaders, we have a collective responsibility to ensure that all children are educated in learning environments that are safe, supportive, and responsive to their needs. We must keep this responsibility in mind when considering the practices of restraint and [isolation] in schools. The U.S. Department of Education remains concerned that children continue to be subjected to restraint and [isolation] practices even though these practices are harmful to children and despite the lack of evidence that these practices are effective strategies to respond to a child’s behavior or…reduce the occurrence of behaviors that interfere with learning.9 

Psychological and emotional harm associated with restraint and isolation include anxiety, fear, and symptoms of post-traumatic stress disorder (PTSD); these risks are higher for youth that have previously been exposed to abuse.10  Repeated instances of restraint and isolation can result in adverse childhood experiences (ACEs), which then contribute to complex post-traumatic stress disorder (C-PTSD). For students, this may manifest as avoidance of authority figures, difficulty paying attention in class, increased absences, or social withdrawal from friends and family.11  As a result of these outcomes, family members of students who have been restrained or isolated often report significant stress and resource strain in supporting their child’s continued engagement in school and mental/emotional recovery. For staff imposing the interventions, the effects are reflected in higher turnover, increased use of sick time, and lower job satisfaction;12 further, state data indicate staff are injured in 10% of incidents in which restraint or isolation are used.

Washington educators, students, and families who have shared their experience with OSPI and partner organizations have consistently described restraint and isolation use as detrimental to their physical and/or mental well-being, and have shared that its use erodes their feelings of belonging and/or safety in school settings. Therefore, to improve healthy conditions for teaching and learning for students and school staff alike, OSPI’s guidance centers the importance of reducing restraint and eliminating isolation from Washington schools.

4 U.S. Senate Health, Education, Labor, and Pensions Committee (2014). Dangerous use of seclusion and restraints in schools remains widespread and difficult to remedy: A review of ten cases.

5 U.S. Government Accountability Office (GAO; 2009). Seclusions and restraints: Selected cases of death and abuse at public and private schools and treatment centers. 

6 Council for Children with Behavioral Disorders (CCBD; 2020). CCBD’s position summary on the use of physical restraint procedures in educational settings. Behavioral Disorders, 46(1), 54-63. 

7 Nunno, M., McCabe, L., Izzo, C., Smith, E., Sellers, D., & Holden, M. (2022). A 26-year study of restraint fatalities among children and adolescents in the United States: A failure of organizational structures and processes. Child Youth Care Forum, 51, 661–680. 

8 Scheuermann, B., Peterson, R., Ryan, J., & Billingsley, G. (2016). Professional practice and ethical issues related to physical restraint and seclusion in schools. Journal of Disability Policy Studies, 27(2), 86-95. 

9 U.S. Department of Education (2025). Secretary Cardona letter on restraints and seclusion in schools. 

10 Mohr, W., Petti, T., & Mohr, B. (2003). Adverse effects associated with physical restraint. Canadian Journal of Psychiatry, 48(5), 330-337. 

11 U.S. Department of Education, Office for Civil Rights (OCR; 2016). Dear colleague letter: Restraint and seclusion of students with disabilities.

12 U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA; 2010). Promising alternatives to the use of seclusion and restraint.