A preliminary investigation by the California Department of Education has found that the school where a child with autism stopped breathing and later died violated several state regulations when they put the teen in a face-down restraint position for an extended period.
The Sacramento Bee reports that the boy, Max Benson, 13, became unresponsive while in the restraint hold on Nov. 28 and died a day later at UC Davis Medical Center.
The incident took place at Guiding Hands School in El Dorado Hills. Benson became unresponsive while being held in a ‘prone restraint’ for nearly an hour, according to a source familiar with the investigation.
In a letter sent to the school, state regulators found “sufficient evidence” that the facility had violated multiple state rules governing how and when physical restraints can be used on students.
Those violations included using an emergency intervention — the prone restraint — for “predictable behavior,” using an emergency intervention as a substitute for the student’s personally designed behavior intervention plan and using the restraint for longer than necessary.
The state also found in applying the restraint, school staff used “an amount of force which is not reasonable and necessary under the circumstances.”
Current evidence supports a finding that the staff’s actions were harmful to the health, welfare or safety of the student, the inspection stated.
Prone restraints are banned for use in schools in several states and are controversial.
The advocacy group Disability Rights California, in a recent report that includes fatal case studies, concluded that prone restraints are hazardous and potentially lethal.
According to the report, prone containment should never be used for people at risk for positional asphyxiation, including those with obesity and those in an agitated, excited state.
The state suspended the Guiding Hands School's certification as a result of Benson’s death, meaning it cannot accept new students. The school remains open, however.
Seth Goldstein, an attorney for the boy's family, says that contrary to initial reports, Benson was 5 feet 4 inches tall and weighed at most 230 pounds.
Benson was from Davis and had only been attending the school for a few months, Goldstein says.
Districts around the region contract with Guiding Hands to provide special education and related services to children with special needs, according to its website.
The number of students enrolled in special education programs for autistic students has skyrocketed over the last decade, according to data from the California Department of Education. There were about 8,300 autistic students in public special education programs in the Sacramento region during the 2017-18 school year. That’s roughly triple the number enrolled in special education programs in the 2008-09 school year.