Health

Actions

The handcuffed boy video: How to discipline children with ADHD

Posted
and last updated
 

The disturbing video of the 8-year-old Kentucky boy with attention deficit hyperactivity disorder, also know as ADHD, who was allegedly handcuffed at the biceps by a sheriff’s deputy at his elementary school, has led to a national debate about what is the best way to discipline and deal with children with disabilities.

The sheriff’s deputy, Kevin Sumner, who works as a school resource officer at the school, now faces a federal lawsuit for handcuffing the boy and a 9-year-old girl, who also has ADHD.

While Sumner’s attorney said he was doing what the law required, claiming the children were placing themselves and other people in danger of harm, experts who treat and work with children suffering from ADHD say using handcuffs is not an appropriate way to deal with children with special needs.

Dr. Claudia Gold, a pediatrician, infant mental health specialist and author, went even further, saying “absolutely never, under no circumstances” would you use handcuffs for a child who has ADHD and is out of control.

The top priority is making sure the child is safe and other people around the child are safe, said Gold. If a child is lashing out, that child needs to be physically removed and taken to a place where they can calm down, she said.

“If you cannot remove them from the situation any other way than carrying them, yes, you can do that, but that’s not the same as restraint. That’s just removing them,” said Gold, author of “Keeping Your Child in Mind: Overcoming Defiance, Tantrums, and Other Everyday Behavior Problems by Seeing the World through Your Child’s Eyes.”

Of utmost importance is the way adults communicate with a child who feels out of control, she said. “Is it punitive or is it gentle and supportive? Is it seeing the kid as being bad or seeing the kid as being helpless?” she said, adding that the way the adult responds can threaten the child even more.

“When kids are like that, the voice, the big people standing over them, the whole scene, this experience…is so threatening that it has to be completely rethought how you’re approaching the person,” said Gold, whose latest book, “The Silenced Child: How Labels, Medications and Quick-Fix Culture Keep Us From Listening,” is set to be released next year.

“The way you move your body, the way you are using your voice, all those things can affect the way the child either escalates further out of control or is able to calm down.”

Parents who have children with ADHD and who have seen them escalate into an out of control state will notice that if they just sit with them and speak to them softly, they’ll find their child’s heart rate will go down and their breathing will slow down, she said.

“The whole body will relax and only after that has happened, can you start to talk to them and think about things.”

The importance of a ‘plan’

Ann Abramowitz, chair of the advisory board for Children and Adults with Attention-Deficit/Hyperactivity Disorder, otherwise known as CHADD, said no question dealing with children who have ADHD and who may be more prone to outbursts can be very challenging, but having a plan in place for how any highly disruptive behavior will be dealt with is crucial.

“It’s not like these outbursts occur out of the blue because he has ADHD. He’s more prone to them because of his ADHD, but there’s a plan in terms of here’s a kid who is prone to this. Here’s what we do to prevent that from occurring and then when it does, here’s what we do. So there’s always a plan,” said Abramowitz, who is also professor in the department of psychology at Emory University.

That plan could include clear guidelines about what would happen if inappropriate behavior takes place, such as some loss of privilege, a brief time-out from the situation where the child wants to be and maybe a loss of points in a system where the child is also rewarded for good behavior.

Reminding them frequently about the expectations and reinforcing them for meeting those expectations is part of the approach, said George DuPaul, professor of school psychology at Lehigh University and a previous member of the CHADD advisory board.

“The bottom line is, and you’ve probably heard this phrase before, it’s kind of a cliche, but it’s ‘catch them being good’,” he said. “Pay much more attention to the times when they’re following the rules and they’re meeting expectations.”

DuPaul also works with schools to help students learn how to problem solve themselves. “You try to train them in ways to communicate what is frustrating them or bothering them so that they use words rather than physical acts to communicate their feelings.”

Restraining or holding back a child should definitely be a “last resort,” he said.

“We find that in situations even with highly aggressive kids who are put in the right situation where you have a positivity-based system as the backbone of the discipline method … that it’s relatively rare that you would even get into the circumstance that you would even have to think about restraining the kid.”

‘So much that can be done on the prevention side’

Many aspects of the classroom and school environment can also support really good behavior, said Abramowitz, the CHADD advisory board chair.

The way people talk to and about children with difficulties is key, so that there’s an understanding that professionals and other children are going to be helpful to children who find it hard to have self-control some of the time, she said.

“So we don’t laugh when they do it. We don’t egg them on when they do it if we’re kids. We act responsibly and we help these kids to act responsibly and we let them know when they’re acting responsibly so you have a supportive environment in the school and it permeates the whole school, not just that child’s classroom,” said Abramowitz.

“There’s so much that can be done on the prevention side so that it’s much less likely to occur in the first place.”

What the Kentucky case also illuminates, experts say, is the importance of training for teachers, administrators, school resource officers and anyone else who might be coming into contact with children with special needs.

We don’t know what kind of training the sheriff deputy in question had or whether he had training to deal with children with special needs.

Too often, schools don’t have the ability, manpower and funds to provide that training, the people I spoke with said.

“Especially with large classrooms and a lot of very significant requirements of teachers, teachers are in a tough position, and they may not have the training and experience to deal with kids who have trauma or who have disabilities especially if they have a lot of kids like that,” said Gold.

DuPaul of Lehigh University said the issue is not just teachers and administrators, but other people who come into contact with children every day in a school setting.

“And then you get out into the playground or the bus or some of these other environments that kids are in where the folks who are monitoring them clearly don’t have training,” he said. “That’s when a lot of these problems occur.”

Editor’s note: Kelly Wallace is CNN’s digital correspondent and editor-at-large covering family, career and life. Read her other columns, and follow her reports at CNN Parents and on Twitter.