Memo sheds new light on Boulevard Heights student's death after school restraint

Sep. 13—A Fort Worth student with autism was physically restrained by about seven school staff members shortly before he died in March, according to a memo prepared by an external investigator.

It's unclear what roles each of the adults played in the restraint. Three experts say it's possible that several adults could safely be involved in a restraint with some acting as observers. But all agree it would be inappropriate for seven adults to participate in a restraint at once.

Xavier Hernandez, 21, died March 1 after being restrained at Boulevard Heights, a school for students with disabilities. The memo, dated July 16, offers more details about the events leading up to Hernandez's death than the district had previously disclosed.

The day after Hernandez's death, the Fort Worth school district hired a McKinney law firm to investigate the incident, including the district's policies and procedures related to physical restraints. The memo, which the Star-Telegram obtained through an open records request, is based on interviews with detectives from the Fort Worth Police Department who questioned witnesses after Hernandez's death.

Seven school staffers restrained student

On the morning of March 1, Hernandez tried to leave his classroom, raising concerns for his safety, according to the memo.

After a short period, Hernandez's behavior began to de-escalate, and the school staff members released him. Then, they noticed Hernandez was in medical distress and called 911. Paramedics arrived and provided emergency aid. A MedStar spokesman told the Star-Telegram that Hernandez was in critical condition when paramedics arrived. Hernandez was breathing and his heart was beating when paramedics took him to John Peter Smith Hospital, according to the memo.

The memo notes that school staff used restraint techniques that were approved under two separate training programs: Crisis Prevention Institute and Handle with Care. Witnesses consistently reported that school staffers restrained Hernandez for his own safety and released him "as soon as the emergency appeared to have subsided." Witnesses said school staffers didn't use excessive force or put undue pressure on Hernandez's torso or abdomen during the restraint, according to the memo.

"The evidence supported the conclusion that the Student's death was a tragic accident," according to the memo.

The memo doesn't name the school staff members involved in the restraint, citing a provision in the Texas Education Code prohibiting disclosure of documents evaluating the performance of teachers or school administrators.

Training focuses on de-escalation

The memo notes that everyone involved in the training had been through at least an online training program through Crisis Prevention Institute. The memo includes a recommendation that the district discontinue the use of Handle With Care and use only one training program across the district for de-escalation and restraint techniques. Shortly after the investigation, the district adopted Crisis Prevention Training districtwide.

When asked whether their training programs included techniques involving seven adults restraining a single student, representatives for both firms declined to comment. In an emailed statement, a spokesperson for Crisis Prevention Institute emphasized that the company's training program advises using physical restraint only after all other options have been exhausted.

"Our training focuses primarily on verbal de-escalation and providing teachers and education staff with the techniques and tools to reduce conflict and confrontation to avoid the use of restraint unless absolutely necessary," the spokesperson said.

Are seven people too many in a single restraint?

Charnequa Austin Kennedy, a former Crisis Prevention Institute trainer, said the company trains teachers to use a number of restraint techniques, depending on a number of factors like the size of the student being restrained and how many adults are available to assist. Kennedy, now the director of Tennessee State University's counseling center, previously worked as a trainer for the Williamson County school district in suburban Nashville and a nonprofit organization in South Carolina.

The training program covers verbal de-escalation techniques that are designed to head off potentially volatile situations before a restraint becomes necessary, Kennedy said. It's only appropriate for teachers to restrain a student if they've exhausted all those techniques and a student continues to escalate, becoming a danger to themselves or others, she said.

Generally, at least two adults are present during a restraint, and often three, Kennedy said. One adult acts as an observer, making sure the restraint is done properly and telling other team members when the restraint is no longer necessary, she said.

Kennedy said the institute's training doesn't include any restraint technique that would call for seven adults to restrain a single student at once. But it's possible that seven people could be involved in some capacity, she said. Some could act as observers, she said. If the restraint lasted long enough, other teachers could step in to relieve those who initiated the restraint, she said.

It's unclear from the memo if all seven teachers actively restrained Hernandez at once. But in a separate incident two months later, a bystander recorded video of about six Boulevard Heights teachers restraining a fourth-grader outside the school. In the video, the girl can be heard shrieking as teachers appear to pin her to the ground, a technique that Crisis Prevention Institute training discourages because it increases the risk of injury to the student. The bystander, Isabella Ellis, told the Star-Telegram one of the teachers appeared to be sitting on the girl, which is not an approved restraint technique.

Restraint should be last option considered, professor says

Julie Thompson, the special education division chair at Texas A&M University'sCollege of Education & Human Development, said it's typical for schools to have teams of teachers or other school staff who are designated to help when a teacher has to restrain a student. When Thompson worked as a teacher for students with autism in North Carolina, her emergency response team included four people. Thompson said it would be excessive for seven teachers to be actively involved in restraining a single student at once.

Thompson underwent Crisis Prevention Institute training twice while she was a classroom teacher, although her certification has since lapsed. The techniques she learned in the training sessions involved one or two adults actively restraining a student, she said. The one-person and two-person techniques she learned both took place from a standing position, she said. If the student made a dive for the floor, trainers taught teachers to let go. As long as the student remained on the floor and wasn't at risk of harming themselves or others, teachers were taught not to engage, she said.

Teachers, parents and anyone else who deals with children need to understand the dangers of taking students to the ground during a restraint, Thompson said. Prone and supine restraints — those in which the person being restrained is lying either face-down or face-up on the ground — can obstruct the person's airways. She noted that George Floyd died while being restrained on the ground.

It's critical that teachers who work with students with behavioral disabilities do everything they can to avoid restraining students, Thompson said. Typically, those students show warning signs before their behavior begins to escalate, she said. When she worked as a classroom teacher, she had a student who would curl his top lip and bare his teeth when he was having a bad day, she said. When she saw that, she knew the steps she could take to head off problem behavior before it began.

"Always, restraint should be the very last thing you consider doing," Thompson said.

Glenna Billingsley, a professor of special education at the Texas State University College of Education, agreed that it might not be unreasonable for seven adults to be in the room during a restraint. For example, it would be appropriate for a school nurse to be in the room to watch for signs of medical distress, she said. An administrator might also be on hand to watch the restraint for the sake of transparency, she said. But it wouldn't be appropriate for that many adults to have hands on the student at once, she said.

"I hope seven people were not on top of him," Billingsley said.

The fact that teachers were trained using two separate training programs could be problematic, Billingsley said. Most training programs teach, at least in broadest terms, the same principles, she said. But if one program allows a particular technique that another doesn't, it could create confusing among teachers during the restraint, she said.

Billingsley said she thinks physical restraints are overused in schools. Most states have laws dictating that restraints may only be used in cases where students present a danger to themselves or others, but even in those cases, Billingsley said teachers sometimes use restraints as punishment. Texas' education code allows schools to restrain students in cases where they present an immediate danger to themselves or others, or when there's an immediate threat of property damage. Billingsley said she thinks the property damage provision should be removed from state law. The implications of physical restraint are so grave that it should only be used to protect students, teachers or other school staff from physical harm, she said.

Although she called it "a horrible practice," Billingsley said she doesn't think the state can ban physical restraint outright. If it did, school administrators might argue that they could no longer take students with serious behavioral disabilities because they posed too great a safety risk, she said. That would mean those students would ultimately end up in an even more restrictive setting, like a state hospital, she said.

Student's aunt calls for greater transparency

The Tarrant County Medical Examiner's Office ruled last month that Hernandez died of the combined effects of physical restraint and chlorpromazine, an antipsychotic medication Hernandez had been prescribed.

A clinical pharmacy expert told the Star-Telegram that when someone who has taken chlorpromazine is physically restrained, the two could have a dangerous compounding effect on blood flow and oxygenation.

The Dallas-based advocacy group Disability Rights Texas is investigating Hernandez's death. An attorney with the organization said the investigation is ongoing.

Ebonie Baltimore, Hernandez's aunt, said her nephew's death has been difficult for his family to bear. His family feels his absence especially acutely around weekends and holidays, when they'd often make visits to the group home where he lived, she said. Labor Day weekend was a painful reminder of what her family has lost, she said.

Baltimore said she's frustrated by the district's lack of transparency about her nephew's death. She wants to know whether the school staffers who restrained Hernandez on the day he died have faced any disciplinary action. The narrative in the memo and the cause of death clearly show that Hernandez died as a result of the restraint, she said.

"So how is it that it was just a tragic accident?" she said.

___

(c)2021 the Fort Worth Star-Telegram

Visit the Fort Worth Star-Telegram at www.star-telegram.com

Distributed by Tribune Content Agency, LLC.