FL MORRIS / FMORRIS@STARBULLETIN.COM Loveland Academy student Andrew Daguio dangled on a swing recently in the school's sensory integration therapy room, pushed by dad, Andy, who arrived to pick him up at the end of the day. The Makiki school for special-needs students is in danger of losing students due to its techniques.

A technique that resembles restraint
leads the state to suspend referrals
to a center for autistic students

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By Crystal Kua
ckua@starbulletin.com

A child is rolled in or sandwiched between a mat or blanket and given deep pressure massages to quell a behavioral outburst.

Officials at a Makiki private school for special-needs children consider this an occupational therapy technique used to calm their agitated autistic students -- an approach likened to swaddling a jumpy infant.

But the state Health Department calls what's going on at Loveland Academy physical restraint and has suspended referring any more students covered by the Felix consent decree to the school, which could mean the demise of the academy.

"Right now, referrals are on hold," said Christina Donkervoet, chief of the Child and Adolescent Mental Health Division.

In a March 1 letter to Loveland, Donkervoet also said "appropriate transitions" from Loveland will be made for all the children remaining in the program. A total of 29 children are at Loveland, according to the Health Department.

FL MORRIS / FMORRIS@STARBULLETIN.COM In the controversial therapy used for calming hyperactive students, Loveland Academy pupil Andrew Daguio was covered Monday by the deep-pressure stimulation pad, demonstrated by therapist Leslie Tamashiro. The Makiki private school has 29 special-needs students.

"CAMHD's obligation is to ensure the safety and well-being of its clients," Donkervoet wrote Loveland Academy owner Patricia Dukes. "Because of the serious nature of the concerns that have been identified and the lack of submittal of required corrective actions, CAMHD is requiring the suspension of referrals to your program effective immediately."

Dukes and others at the school deny that staff has been physically restraining students. They say the Department of Health's directive shows a lack of understanding of what is known as "sensory integration therapy," which Loveland uses as a calming technique.

"They refuse to hear the information about what sensory integration is, and ... so they have decided that this is a restraint," said Leslie Tamashiro, Loveland's occupational therapist, who trains the Loveland staff in the use of sensory integration therapy activities.

Sensory integration therapy is also controversial across the country -- some people believe it works, while others do not.

Whether it is rolling a child up in a mat or having a child handle different textures like sand or shaving cream, sensory integration therapy is described as an attempt to meet the sensory needs of children with autism or other disorders who are either over- or undersensitive to touch, movement, sights or sounds.

FL MORRIS / FMORRIS@STARBULLETIN.COM Arthur Foxman spent time with his dad, Daniel, on Monday at Loveland Academy. The school's techniques with autistic students have raised questions from the Health Department.

Donkervoet refers to what Loveland does as "mat-rolling."

"They roll a child in a mat, which they identify as an occupational therapy intervention," Donkervoet said. "It restricts the child's movements."

If the "mat-rolling" is part of a child's occupational therapy, then it must be specified in the child's educational plan, and a licensed occupational therapist should be conducting the treatment, which is not always the case, Donkervoet said.

Her division requested that Loveland take "corrective measures," Donkervoet said. "They were not willing to do that, and we had to take this action."

Donkervoet said transitions would be made in the best interest of the child and in accordance with a student's individual educational plan, the vehicle that sets out taxpayer-paid services for a child, including placement at Loveland.

Referrals could resume if the Health Department's concerns are addressed, Donkervoet said.

She said there are a limited number of programs for autistic children in Hawaii, but she believes that children's needs can still be met if the suspension of referrals to Loveland continues.

Parents and other supporters of the school said special-needs children have made progress while at Loveland. These supporters are also suspicious of the state's motives.

"They're making unilateral decisions on shutting down programs before contracts are over and not sharing that information with parents," said parent advocate Naomi Grossman. "We're concerned that it damages the development and the capacity-building of services for autistic children."

The Felix consent decree -- named for a special-needs student whose parents sued the state for violating federal special-education law -- mandates improvements in the delivery of mental health and educational services for special-needs children in the public school system.

The state faces a March 31 deadline to come into compliance with federal law and the consent decree.

Loveland Academy, which began in 1999 to provide services in connection with the decree, was the subject of testimony alleging overbilling practices during hearings last year by the Joint Senate-House Investigative Committee examining state spending in the consent decree compliance effort. The school denied the allegations. Loveland also faced off with state Auditor Marion Higa over student records the auditor had subpoenaed.

Dukes and her staff said the school caught the state's ire this time around following an incident last fall involving a student being rolled and squished in a mat -- his arms to his side and head sticking out of the mat -- to calm him down while in the care of a Health Department-contracted behavioral specialist.

Dukes called the department to complain about the behavioral specialist, who caused the boy to become agitated, but the school soon learned that there would be a complaint against them.

"This is a technique we use all the time," Dukes said of this sensory integration therapy activity.

Tamashiro added, "I usually do like a fold motion with the mat, like a sandwich. It's like a game; the kids jump to get into the mat."

Tamashiro then gives a hug or applies pressure incrementally to the child who is in between the blanket or mat.

"They don't get to integrate all those senses like a typically developing infant does, and until they are able to do that, they are at war with the world because they never know what's coming," Tamashiro said.

The therapy allows the children "to become much more alert, and they are able to learn," she said.

Donkervoet said that her office has received two parental complaints.

But parent Lena Gregory, whose 6-year-old daughter is placed at Loveland, has nothing but praise for what the school has done for her daughter. "My daughter has made significant gains since she's been there."

Gregory also said she has no problem with the sensory integration therapy and sees it as necessary.

Gregory said she was not aware that the Health Department has stopped referring, and was told that her daughter needed to be transitioned from Loveland to their neighborhood school at Kamaile Elementary for unrelated reasons.