We have a student that is head butting his desk while seated. What is the best approach to restrain the student in this situation?
He will also head butt the staff when they attempt to restrain him.
You do not mention the age of the level of functioning of this student. For this answer we assume you have already tried less intrusive strategies to interrupt the behavior.
These are some of your options:
- For an older child or adolescent, you can use a standard PRT initiated from behind and over the seat back. You may also want to add another adult to help keep his body from pressing forward toward the table top with an arm; keeping his back pressed backward and into the seat back. If you cannot prevent his body from pressing forward and his head is coming in contact with the table top, allow him to lean forward (while remaining in a PRT) and use the cushion and some manual stabilization to protect his head and the head of the PRT person from impact forces. This is the identical strategy that you should use if the student was being held in the “Neutral Position” on the floor. As an additional precaution, you may want to get a cushion to place between the front of his head and the desk and a second cushion, if necessary to place between the back of his head and the person performing the hold. You can get a “stadium cushion” from one of the sporting good stores. They are made out of vinyl and are perfect for this purpose.
- For a younger child, you can use a “Modified PRT for Smaller Children” initiated from behind and over the seat back. The arm in front will be able to keep him pressed backward and into the seat back. If you cannot prevent his body from pressing forward and his head is coming in contact with the table top, allow him to lean forward (while remaining in a Modified PRT) and use the cushion and some manual stabilization at the student’s temples to protect his head and the head of the PRT person from any impact forces.
Finally, knowing that this is a persistent problem, your best choice may be to routinely keep his desk in the back of the class and backed up against a wall. You can use two adults on either side to perform, what I call, a “Two Person Escort Position in reverse” to keep him pinned into the seat back. This configuration is exactly like HWC’s “Two Person Supine” hold, except that the students back is erect in his seat rather than face-up on the floor. Both staff can protect their own heads using the same hand position on either side of his head as you would during our Supine hold.