The rate of infants dying suddenly and unexpectedly has dropped in recent years, but data show that racial disparities persist. Babies born to American Indian and Alaska Natives and African American families suffer much higher rates of sudden unexpected infant deaths (SUID) than other races and ethnicities, data from the Centers for Disease Control and Prevention (CDC) show. Between 2011 and 2014, 194.1 American Indian and Alaska Native infants and 170.2 African American infants per 100,000 live births died from SUID nationwide. Those rates are significantly higher compared with 83.8 for whites, 51.1 for Hispanics and 32.1 for Asian or Pacific Islander babies per 100,000 live births, during the same time period. SUID encompasses sudden infant death syndrome, commonly known as SIDS, as well accidental suffocation and strangulation in bed, and other unspecified causes of death in children up to a year old.
Lawmakers this session approved bills that put in place new initiatives to stem substance abuse and opioid overdoses, change the way restraints and seclusion are used in Connecticut schools and limit the use of shackles on juveniles in court. Those were just some of the legislature’s health and safety measures reported on by C-HIT during the year. The session, which ended last week, was largely dominated by budget and transportation issues. Under the bills approved:
• Any prescriber supplying more than a 72-hour supply of a controlled substance must first review the patient’s record in a statewide database. In addition, practitioners must review the patient’s record at least every 90 days if prescribing for prolonged treatment.
Legislative changes and increased training of school staff could help to reduce the incidence of children being restrained and secluded in schools, a panel of state officials said Friday at a forum hosted by U.S. Sen. Chris Murphy, D-Conn. The roundtable discussion was organized in response to a February report by the state Office of the Child Advocate (OCA) that raised “significant concern” about the frequency with which young children with autism and other disabilities are restrained or secluded in Connecticut schools. In each of the last three years, the state Department of Education has reported about 30,000 incidents of restraints or seclusion, with autistic students the most frequently subjected to the practices. More than 1,300 children have been injured while restrained or isolated. Research has shown that the techniques can be traumatizing to children, with no evidence that they have therapeutic value, the OCA report says.
A 4-year-old boy identified with a developmental delay was physically restrained by school staff after he “threw (puzzle) pieces on the floor and across the room” while playing with a puzzle on a classroom rug. An elementary school student was put into seclusion after “swinging her coat at staff.”
These are among hundreds of incidents — deemed “emergencies” by school personnel — that warranted restraining and isolating pre-school and elementary school students in Connecticut last year. A new report by the state Office of the Child Advocate (OCA) raises “significant concern” regarding the frequency with which young children with autism and other disabilities are restrained or secluded; lapses in documentation or actual compliance with state laws; and the prevalence of “unidentified and unmet educational needs for children subject to forceful or isolative measures.”
The OCA report, released Wednesday, reviewed records of restraints and seclusions for 70 students at seven public schools and special education programs around the state, including Hartford and Fairfield County. Those students, chosen randomly, were restrained 1, 065 times and placed in seclusion 703 times. In a number of cases, the report found, there was no documentation showing that the children had received requisite behavioral evaluations, or that educators had monitored and reviewed cases of repeated seclusions, as required.
The state Department of Children and Families will increase oversight and services to families with parental substance abuse, mental health and other problems who are identified at “highest risk” of a young child dying, the agency announced Monday. The move comes as Connecticut grapples with a high number of child deaths, outlined in a recent report by the state Office of the Child Advocate (OCA). In the report, OCA found that DCF’s response to “at-risk infants” was often insufficient, showing “gaps in risk assessment, treatment planning, case follow-up, and quality assurance.”
DCF said the new effort to target high-risk families came out of its own study of 124 fatalities that occurred between January 2005 and May 2014 of children ages three and under in families with some DCF involvement. The study findings are “prompting changes that will pinpoint families with the highest risks and increase oversight and services for these families,” the agency said in a statement. The study, which compared cases in which a child died to a control group, found that fatalities were less likely when DCF had conducted comprehensive assessments of parents’ needs.
Child deaths in families involved with the state Department of Children and Families are more likely in cases where agency workers have spent less time assessing and interacting with parents, a preliminary review by the agency indicates. In recent legislative testimony, a DCF official said that an ongoing review of 248 cases – half in which a child under the age of 4 had died, and half in which there was no fatality – had turned up a number of “risk factors,” including the young age of parents, addiction and mental health problems, and a lack of “quality” contact with DCF social workers. “We found that, in the comparison or control cases (where no fatalities occurred), we were assessing parents more, we were visiting parents more. The quality of home visits were more of (high) quality than those in which fatalities had occurred,” DCF research supervisor Janet Gonzalez told members of the Committee on Children. That finding “feeds one of our recommendations, in regards to enhancing the assessments that we do of families in the home,” she said.
Children with autism were the most frequently subjected to restraint or seclusion in Connecticut schools in the 2012-13 school year, according to a new state report that tallied more than 33,000 incidents of physical restraint or seclusion in public schools and private special education programs.
The report from the state Department of Education shows that autism was the primary disability among special education students subject to “emergency” restraint or seclusion, with 40.4 percent of all such incidents involving a child with autism. Autism also accounted for nearly half of all cases in which children were put in seclusion as part of their individualized education plans, or IEPs. The report shows a slight decline from the previous year in the overall number of students restrained or secluded, and a drop in reports of injuries – from 840 in 2011-12, to 378 last year. But the number of serious injuries rose from eight to 10, and more than 900 reported episodes of seclusion or restraint lasted more than an hour. “This is just so disheartening,” said Shannon Knall of Simsbury, policy chair of the Connecticut chapter of Autism Speaks, an advocacy group.
If Connecticut officials are going to continue to allow schools to use seclusion as a behavioral intervention, can’t they at least make sure that seclusion rooms have chairs? That was the understated, soft-spoken plea from a 19-year-old student named Laquandria, who told a gathering of state agency leaders, educators and parents Thursday that she had been secluded and restrained multiple times while attending public schools and special education programs in Connecticut. “The walls weren’t padded, there was nowhere to sit – I felt like an animal,” said Laquandria, whose last name was withheld because of her family’s involvement with the Department of Children and Families. She is now finishing her high school education at a Hamden residential program. “I feel like, you know,” she told the assembled state officials, “we should at least have somewhere to sit.”
Her comments punctuated a three-hour forum on the use of restraints and seclusion in state schools, convened by the Office of the Child Advocate and the Office of Protection and Advocacy for Persons with Disabilities.