difference/disorder

Today on the website of the Atlantic, Emily Richmond has a brief piece that illustrates many of our pathologies about children and disability.

I'm not an unbiased commentator on the particular school district on issue: I am a (proud) product of the Middletown public school system. My eldest niece went to Farm Hill school, where this controversy originated, and my youngest niece attends now. I also have worked at the school district as a substitute teacher, in years past. Most significantly, I worked for a program that was of particular relevance to these issues.

I worked in a special program within the district's elementary school system. It was a program for kids with certain kinds of developmental, social, or cognitive disabilities. Most of the students suffered from some form of severe emotional disturbance; some were autistic and had difficulty making it through their day without attempting to harm themselves or others. The program was housed within a regular elementary school, and some of the students were significantly "mainstreamed" into the general school population, in keeping with the Americans with Disability Act case law. Many students, however, could not attend the regular classes due to the severity of their problems, and the program itself was separate. Support staff were specially trained to physically restrain students when they were a physical danger to themselves or to others. (The state's euphemism for this was "therapeutic hold.") There was also a room that, I suppose, could be referred to as a "scream room": a small space with padded walls, where students could take out their frustrations without the chance of harming themselves. The lock on the door required you to hold down a button, and there was a window in the door, meaning that a member of the staff had to continually stand at the door watching the child. Not that anyone in the program would have just put a child in there and walked away, but it was a good idea to make sure.

I only worked in the program for a little over a year, as I was filling in for a support staff member out on medical leave. I found it very difficult work, both emotionally and physically, and to this day I admire the permanent teachers and staff who worked with these children and attempted to teach them amid all the difficulty. (I should hasten to say that many of the children improved markedly and moved on to regular classrooms.) As most neighboring school districts had no similar program, children were often sent into ours from other towns. For many of these children, the program represented the end of the line; those who proved too difficult even for the special program might well move on to the state mental health system. The educators in the system were doing their best in a very difficult situation, and the compassion, energy, and dedication they showed after decades of doing this work humbled me.

One night, while working for the program, I went out to drinks with a few friends. There was a woman there who I had only met a few times before. I began to talk (in general terms, so as to preserve the privacy of the children involved) about a particularly difficult day from the past week. One of the children had had a major event, throwing chairs, going after his peers, striking members of the staff. As was typical, the heightened tension and emotions of the moment caused some of the other children to escalate and need intervention as well. I talked about it and admitted that the program was become emotionally punishing in a way I wasn't quite equipped to handle.

After talking about it for awhile, the woman I didn't know very well broke her silence and said, "you need to honor that." I told her I didn't know what she meant. She said that, in acting out the way he had, the child was expressing who he was. Our attempts to control his behavior was in fact an unwarranted restriction on a person with a disability. She even analogized our removing him from his peers with preventing a paralyzed person from entering a public building. 

I told her that I didn't see things that way. I pointed out that, had we not intervened physically, he would have hurt himself, the staff, his peers, or all three. I said that I hated when students went into the padded room, as all the staff did, but that there didn't appear to be any other choice that kept the rest of the population of the school safe. I asked her, point blank, what else we should have done, what "honoring" a dangerous and self-destructive behavior could have meant.

She only said again "you need to honor that," and as I could tell she was becoming upset, I changed the subject.

That was an extreme case, but I have come to realize that this idea is pervasive: that any behavior that can be plausibly attributed to a medical or psychological condition is a behavior that must exist free from the appearance of judgment or reproach, particularly in children. Well: it happens that I didn't and don't blame these children, at all. Many of them had lived incredibly difficult lives. I didn't and don't doubt that there are serious medical and psychological issues at hand here. The point was not punishment. The point was that there were no alternatives to removing these children from a position where they could hurt themselves or others. That notion, that physical separation might be the product of pure, grim necessity, is totally absent from Richmond's piece.

In my short time there, I saw students throw desks at their peers with every intention of doing severe bodily harm; I saw a student hit himself in the face repeatedly with a heavy medallion; I saw a girl tear the stuffing out of the wall in the padded room and attempt to swallow it; I saw students struggle with police and EMTs who were attempting to load them into ambulances; I saw kids who were totally out of their own control. I have nothing but sympathy for them and respect for the parents and teachers who work with them day in and day out. My question for those who oppose physical separation is, what else would you do?

We've come to a place in our society where optics are the only prevalent concern in discussions of disability and mental health. What matters is how things look, the aesthetics of our behaviors and language, rather than what is being accomplished. Look at Richmond's piece: these interventions appear archaic, they "silence" troubled schoolchildren, they make them frightened. I'm very sorry for that, I am. I'm very sorry that children have to go through any of this. If I have to choose between silencing a child and letting that child break her own nose, I know which I'm going to choose. I'm sorry if that puts me on the wrong side of an empty, self-satisfied ethic of positivity, of "honoring" conditions that only hurt people's lives. These behaviors are not just different, and they are not the legitimate expression of individuality.

The details matter. How children are treated when they're removed from their peers, how long they are so removed, the level of training the person doing the removal has, the conditions in the separate space... all of these are legitimate subjects of inquiry. Whether physical separation is being undertaken responsibly, and not done merely to avoid working with a difficult child, has to be adjudicated by impartial agencies. But as to the fundamental question, of what critics of physical separation would do with a student who can't be talked out of dangerous behavior? I haven't got a clue.