For Kate Sanger and her colleagues in Positive and Active Behaviour Support Scotland (PABSS), reducing restraint with some of the country’s most at risk children in schools is the focal point of their existence.

Chemical restraint

But the charity believes restraint does not begin and end with children with special educational needs children being branded disruptive and bundled from classrooms into exclusion rooms. The charity says it receives up to two calls a week from parents being pressurised by schools into chemical restraint.

“He didn’t need medication. He just needed his sensory diet implementing properly".

Sanger says schools lean on parents to medicate children who are managing without drugs outside the classroom. 

Co-founder of the charity Sanger, from Pitlochry, in Perthshire, said: “The children have autism or attention deficit hyperactivity disorder (ADHD) and I think the schools find it difficult to cope because they don’t find the function of behaviour.

“So, therefore, the quick route is to suggest medication. That, in itself, brings a lot of problems".

Sanger, whose 26-year-old daughter Laura has the developmental condition Cornelia de Lange syndrome, said someschools will resort to threats to get their way. “The schools then almost (have) a coercive way of saying to the parents: ‘If the child, your son or daughter, isn’t on medication it could be that we can’t support them in school'.

“It’s a kind of form of blackmail. So if you don’t medicate, then they don’t get a position in school".

At the end of February a study on youngsters in New Zealand showed medication rates for psychotropic drugs like anti-depressants, anti-psychotics, anxiolytics, hypnotics, and stimulants rocketed between 2008 and 2016 by more than 65%.

The trend is international —  research shows the UK, the US, Denmark, the Netherlands, and Germany have all seen substantial increases in medication use with children.

PABSS is not anti-medication and recognises it has a legitimate role to play in treatment, said Sanger. She said her daughter’s Conrnelia De Lange syndrome saw her start to suffer extreme social anxiety, aggressive outbursts, and obsessive compulsive behaviours in adolescence that are treated with anti-anxiety medication. 

“When it’s needed and when it works and when it’s monitored along with good behaviour support plans — yes I totally agree with it”, said Sanger.

Implementing a sensory diet

One mother, who wanted to be identified only as Mary, told how she found herself in conflict with her nine-year-old son Isaac’s school over an ADHD diagnosis. The boy already had a diagnosis of autism, but the school wanted to press for an additional ADHD diagnosis.

The mother felt the academy school he was attending would use an additional diagnosis of ADHD as a way of getting extra funding for teaching the him or press her to put him on a stimulant.

Isaac was being restrained on a daily basis at the school, including in an illegal head restraint on one occasion, said the mother.

She said her son now attends a special school where he has a sensory diet that addresses the issues she feels the academy might have attempted to resolve with medication. The diet sees staff apply deep pressure by rolling a yoga ball along his body when he is becoming agitated or stressed. They also use a wobble cushion to help him concentrate at his desk and a weighted jacket, which is also designed to calm by creating a hug type sensation.

“He didn’t need medication. He just needed his sensory diet implementing properly", said the mother.

The mother feels drugs often represent a quick fix for teachers, who may lack the training to understand a child’s deeper medical needs.

She added: “I personally feel that the mainstreams do not have the knowledge, but they have a lot of power and I think having a lot of power without knowledge is dangerous. I really believe teachers aren’t doctors, but for some reason they are given the credit that they are.”

An increased need for medication?

Thomas Insel, the former director of the US National Institute of Mental Health (NIMH), has said the medication trend is symptomatic of more children “struggling with severe psychiatric problems” and “increased need”.

In a 2014 post on the NIMH website, Insel suggested the bigger problem may be under-treatment as at that time only 14.2% of children with mental health problems were using medication.

Special educational needs teacher Emma Parker said decisions on medication must be made in the child’s best interests - not those of parents or teachers. Parker, whose 13-year-old son James has ADHD and is medicated with the non-stimulant treatment Guanfacine, said long-term outcomes for children with developmental disorders and learning disabilities are very poor with around only 6% of adults with learning disabilities in jobs.

If they can’t learn or gain skills in school they are simply being set up to fail, Parker believes, saying “I very much believe that every person has their place in society, but we have to give them the skills and the tools to be able to find that space. And whether that is a social skill or a practical skill so they can find a job, we have to teach them that and we have to support them to find their niche".

But Parker, who is the National Education Union’s joint-district secretary for County Durham, also believes pressure on schools to achieve results and a reduction in support staff has contributed to the climb in medication rates. Wider cultural trends like both parents working has also had an impact, said Parker.

The teacher, who has two other sons Benjamin, 12, and Alexander, 10, in the process of being diagnosed for autism and ADHD, acknowledged that schools phone parents when they suspect a child has not had their medication.

Parker admits she had made these calls herself to parents.

“In some ways I think schools are trying to safeguard the child and give them the best that they can do by asking those questions", she said.

 

Caption: Kate Sanger with daughter Laura, who has the developmental condition Cornelia de Lange syndrome.