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THE SHORT LIFE
OF
ANGELLIKA “ANGIE” ARNDT
 
“BUBBLES
IN MY MILK”
(Click
here for picture gallery)
When the horrifying news came about Angie’s
death, one mother recalls her daughter’s reaction:
“Mom,
I know how she died,” her daughter said.
“How did Angie die?” her mom asked.
“She couldn’t breathe,” the child said.
How
did she know this? It happened to her, too.
Luckily she came out alive.
Information
and Resource Packet
Prepared by Isabelle
Zehnder
December 7, 2006©
www.caica.org
Disclaimer: The
contents of this resource and information packet were taken
from news articles, newsletter, videos, reports, court documents,
and statements.
Table of Contents
Introduction
Angie's Early Days
Outrageous Behavior for a child: Blowing
bubbles in her milk
Recognized guidelines for restraint: Were they
used in Angie's case?
Angie's final cries for help fall on deaf ears
News update: Facility and staff charged
An important first step
What next?
What others have to say
Questions
INTRODUCTION
“In order to
effect change, we must
first recognize the need for change”
The State of
Wisconsin has been hit with a tragedy that, in my opinion, needs to
be reviewed and discussed. Changes need to be made. New laws need to
be enacted. Why? Because a little girl lost her life at the age of 7
and if things don’t change, others will follow. This was a senseless
and needless death that occurred at the hands of those who were
supposed to be trained to help her. Not end her life.
Her name was
Angellika “Angie” Arndt and she was a beautiful little girl. Her
life was cut short because of inadequate staff training and the use
of good old common sense. Angie was placed into a dangerous
face-down prone restraint position and held down by a man nearly 5
times her body weight for nearly 50 minutes. The weight of his body
on her upper torso caused her death. The day before she died she was
reprimanded for blowing bubbles in her milk and laughing during
lunchtime. Her punishment was being held down in the same face-down
prone restraint position for 98 minutes.
After
reviewing all of the facts in Angie’s case, Randall Cullen, M.D.,
concluded Angie posed no real threat to herself or staff, the
guidelines for restraining a child. In fact, he stated the staff’s
actions escalated the situation and that, given the chance, Angie
would have likely calmed down on her own.
It is my hope
that you will read this resource and information packet in full to
understand the impact of what can happen, and does happen, to
children who are placed in dangerous face-down prone restraints in
treatment facilities. This is by far not an isolated
incident.
Restraint
deaths of innocent children appear to be on the rise. An increase of
children needing services, coupled with untrained staff and lax
restraint policies, have played a role in many of these deaths. It
is not always easy to find qualified, caring, and compassionate
people who are willing to work with children with special needs.
Placing children in the hands of unqualified, untrained staff is a
recipe for disaster, as we have all too often seen.
I believe it
is time for change. We, as a society, need to get involved, we need
to act, and we need to see to it that changes are made. Not just in
the state of Wisconsin, but in all states. Why wait until it is one
of our children, grandchildren, nieces, or nephews?
In the state
of Wisconsin, it is our hope that “Angie’s Law” will be enacted,
banning the use of deadly prone restraints on children. In the state
of Pennsylvania, it is our hope that “Joey’s Law” will be enacted,
again banning the use of deadly prone restraints on children.
States, like Texas, have paved the path. It’s time, in my opinion,
for other states follow their lead.
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ANGIE'S EARLY DAYS
"The
The Medical Examiner ruled Angie’s death was
caused by positional
asphyxia and that she died in the course of Ridout’s restraint."
* * *
Angie had a
rough start in life. Her biological parents relinquished custody of
her when she was a toddler. She did not escape without abuse. She
was bounced around the foster care system for several years until
she finally found “Mom and Dad”, foster parents Daniel and Donna
Pavlik. The Pavliks’ provided her with a stable, loving, normal,
and happy life, and intended to raise Angie until she turned 18.
They took her into their home and into their hearts.
Angie was a girl known for her beautiful smile. She loved dolls, camping,
going on walks, going to McDonald’s, listening to country music, and
birthday parties. She enjoyed imitating her sister Sasha and playing with
her
friends. Just like any other little 7-year old girl. The Pavlik’s have
hundreds
of pictures of Angie laughing and smiling, enjoying life to the fullest.
Her
mom said, “She was a happy little girl who lit up the room.” According to
her
obituary, Angie was, “A joy to be around and touched many lives.”
The Pavlik’s
wanted the best for Angie. They knew, given what she had been
through during her first five years of life, that Angie would need
help. They enrolled her into the Marriage and Family Health Services (MFHS) “Mikan”
program where she thrived. In an August 2006 MFHS Newsletter, they
said,
“She was a small little girl with big friendly eyes who was a very
workable
child … Angie was a good child who had bad things happen to her.”
They
stated that during Angie’s eight-week stay at their program, she was
never
restrained, nor was she ever emotionally or physically traumatized.
The Pavlik’s
were making good progress with Angie. But it came to an abrupt halt
when a social worker suggested last spring that Angie re-enter day
treatment in order to get caught up with school and to give her the
best shot at first grade. Unfortunately, the Mikan program was full and Angie
was not old enough for MFHS’ Ladysmith program. She was instead
admitted to the Rice Lake Day Treatment Clinic in Rice Lake,
Wisconsin, late last spring. This was not a residential treatment
facility where children stayed overnight. She went during the day,
Monday through Friday.
During her
stay at Rice Lake her mom and dad saw changes in Angie, and the
changes were not for the better. They made an appointment to talk to
the Rice Lake director, but the June 6th appointment date
came too late. Angie was already gone by then.
Angie’s life
was taken at the hands of the very people who were hired to care for
and help her, not recklessly and needlessly end her life.
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contents
OUTRAGEOUS
BEHAVIOR FOR A CHILD:
BLOWING BUBBLES IN HER MILK
On May 24, the
day before her death, Angie arrived at Rice Lake around 11:30 a.m.
She was sitting having lunch with the other children when she got
the giggles and blew bubbles in her milk. She was reprimanded and
told to stop laughing and to stop blowing bubbles. When she laughed
again, she was taken to “time out” where she was told to sit still
on a hard chair. This is a seven-year old child with attention
deficit disorder, so sitting still in a chair was a very difficult
thing to do. This was done as a “cool down” period.
During this
“cool down,” Angie crossed her legs and rested her head on her
knees. Because she did not do exactly what she was told to do she
was taken to the “cool down” room, a closet-sized room with nothing
but a chair, a mat on the middle of a cement floor, and blank walls.
“I don’t want to go,” she cried.
But she was
forced to go. She was told once again to sit in a chair and not
move. She covered her ears and began to cry. She was tired and
curled up on the chair. She fell asleep, was woken up, and told to
sit appropriately and complete the cool-down. She was asleep, how
much cooler did she need to be?
Head up, feet
down, don’t move, and be quiet.
Again she fell
asleep and again they woke her up. She became agitated and began to
swing her legs. As this continued and staff surrounded her, she
became more agitated and was restrained in her chair.
She was told
if she struggled it would be considered “unsafe behavior”. She knew
that meant she would be taken down and put into a face-down prone
restraint. She was told by staff not to cry and to control her
emotions. But she was not able to control her emotions and she
couldn’t stop crying. During the course of the chair restraint she
fell out of her chair. Knowing what would come next, she pleaded
with them, saying she would complete the “cool down.” But it was too
late.
It appears
that in the minds of the staff, and after a staff discussion, this
called for an all-out face-down floor restraint. She was taken down
by two adults. One grabbed her ankles while the other grabbed her
shoulders and held her down for 98 minutes. During this time
she struggled, cried, screamed for help. But no one responded to her
pleas for help.
It was
reported that during some of the prone restraints she vomited, lost
control of her bodily functions, complained of headaches, complained
of eye pain, and fell asleep – or possibly passed out.
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"Risks of
Restraints" Brochure: "Especially dangerous
positions" include face-down floor restraints. The problem is,
one staff person's "emergency" may be another's lack of
training."
RECOGNIZED GUIDELINES FOR RESTRAINTS:
WERE THEY USED IN ANGIE'S CASE?
The accepted
guidelines for the use of physical restraints are responding to a
child’s behavior that is so serious and violent that they are a
threat to the safety of themselves or others. The question is: Were
these guidelines used in Angie’s case?
Most of
Angie’s 30 days at Rice Lake were spent in either cool-down
(time-out) or on the floor in face-down prone restraints. Some
restraints lasted as long as 98 minutes.
The recognized
guidelines for prone restraints are one minute for every year of age.
Angie was 7.
From the start
things did not go well for Angie at Rice Lake. On her first day she
was restrained in the dangerous, face-down prone position for 97
minutes because she was hitting her hand on her chin, didn’t
stop when she was told, fidgeted on the cool-down chair, and kicked
her shoe off her foot.
In Angie’s case, the incidents that precipitated prone restraints
revolved mostly around the cool-down chair and included: sitting
inappropriately, falling asleep, fidgeting, refusing to remain
seated, crossing her feet and folding her arms, throwing herself
back in the chair, pulling her knees up and putting her feet on the
chair, pulling her shirt over her head, and kicking her shoe off her
foot.
A question was
asked. When does pulling your shirt over your head, crossing your
feet, or falling asleep meet the criteria for restraining a child?
The Rice Lake director indicated Angie was placed in these holds to
“ensure everyone’s safety.”
According to a
review of the Rice Lake Day Treatment Program submitted July 17,
2006, by Randall Cullen, M.D., he states there was no real physical
threat to staff or to Angie. The unrealistic demands for total body
control, sitting perfectly still in a prescribed manner seems to
invite oppositional behaviors. He further stated these expectations
are not appropriate for pre-teens with impulse control problems,
attention problems, and often devastating histories of extreme
control or abuse. The review indicated Angie most likely would have
calmed herself, given a chance. Many of these escalations could have
possibly been avoided if expectations were more age-appropriate.
The incidents
that precipitated cool-downs were being disruptive, off-task, not
sitting appropriately, throwing an object, not being able to follow
directions, drawing on her pants, not participating in group,
standing up without permission, having her hood on, gargling milk,
talking to peers during lunch, kicking the table, using baby talk,
and putting her arms inside her shirt.
Expectations
for cool-downs: sit still, quiet, upright, with feet on the floor.
Angie had attention deficit disorder making this very difficult for
her to accomplish.
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ANGIE'S FINAL CRIES FOR HELP FALL ON DEAF EARS
Jodi Pelishek, Family Advocate for Wisconsin
Family Ties, helps place a banner to honor Angie and promote
community awareness of children’s mental health issues less than
a block away from where Angie died. She and Rick Pelishek,
Office Director of NW Wisconsin Disability Rights Commission,
are working to insure that Angie is not forgotten and that in
the future laws are changed and families supported on their
journey of parenting challenging children.
You can reach Jo (715) 790-1317,
jopel.wft@chibardun.net.
You can reach Rick at (715) 736-1232,
rickp@drwi.org. “Let
Them Bloom”, a father’s perspective by Rick
Pelishek.
On Angie’s
last day at the Rice Lake Day Treatment Center, she was reprimanded
for misbehaving in the kitchen. Her punishment?
Angie was
taken to the “cool down” room and placed in a face-down prone
restraint. Again two staff participated in the restraint. One held
her ankles while the other held her upper body. Bradley Ridout was
summoned to assist another employee in the restraint. At the time,
Angie was laying in a prone position, face-down on a thinly-carpeted
cement floor. The other employee restrained Angie’s legs while
Ridout covered her upper torso with his body, initially supporting
his weight with his elbows. But as time went on his body weight of
about 250 pounds shifted on her small upper torso, suffocating her.
During the
course of this restraint she cried, screamed, thrashed, begged for
help, said she couldn’t breathe, complained of a headache, and said
her eyes hurt. Rather than stop to listen to her complaints, Ridout
grabbed her head and held her down. He continued holding her down
for about 30 minutes, putting pressure on her small upper body.
No one seemed
to listened to her, no one seemed to believed her. Instead,
regardless of the fact that she vomited, urinated and defecated on
herself, and was crying out for help, they continued to hold her
down. Finally, she became quiet and still. Finally she gave up. When
they released her, Ridout rolled her small listless body over and
noticed her face was blue.
Why had no one
noticed this before it was too late? Why had no one responded to her
pleas for help?
She had
stopped breathing. They tried to revive her, called 911, but it was
too late. The medical examiner ruled Angie’s death was caused by
positional asphyxia and that she died in the course of Ridout’s
restraint.
His body weight upon her back significantly impaired and ultimately
precluded her ability to breathe.
Ridout now
claims he was just doing what he was taught to do.
Ridout’s
attorney said the charges against Ridout allege he was much bigger
than Angie and that he should have known better than to put her in a
choke hold, despite his training.
According to
the Affidavit of Chief Investigator John Knappmiller, of the
Wisconsin Department of Justice, there were numerous acts and
omissions by employees of Rice Lake Day Treatment that had
compromised Angie’s safety. Unskilled staff performed almost daily
physical restraint of Angie, following an ambiguously written
restraint policy. He stated, “The ‘emergency’ restraint policy
became the justification for the almost daily physical restraint of
Angie.” The staff member responsible for training of all
staff in proper restraint techniques had, himself, never actually
received any appropriate training. The methods he taught were
self-devised and substandard, including the use of the
face-down-on-the-floor-hold used on Angie on the day of her death.
 Angie
was portrayed to some media as an aggressive child. MFHS, the
program she attended prior to attending Rice Lake Treatment, stated,
“We at MFHS feel an obligation to mention Angie in a more accurate
light. She was not the aggressive, out of control child that was
presented to the media. We hope that her loss can bring about change
… the majority of children we serve have had enough trauma in their
lives.”
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NEWS
UPDATE:
FACILITY AND STAFF CHARGED, NEW INFORMATION RELEASED
Officer
Dewayne Reiten of the Rice Lake Police Dept. reported he observed
Angie at the Lakeview Medical Center in Rice Lake before she was
transferred to the Children’s Hospital. According to a December 6
news article, Reiten reported he observed a bruised area on the
right side of Angie’s face, both of her knees had abrasions on them,
and there was an abrasion to the left side of her face. Northwest
Guidance and Counseling Clinic Inc. pleaded no contest to one felony
count of negligent abuse. Staffer Bradley Ridout pleaded no contest
to misdemeanor negligent patient abuse.
Northwest
faces a maximum punishment of $100,000 fine. Ridout faces up to nine
months in jail and a $10,000 fine. Sentencing for the center and
Ridout are set for December 27. Ridout was freed on a $1,000
signature bond, according to court documents.
After 28
minutes of being in the face-down, prone restraint position, Ridout
was called to assist another employee already restraining Angie. She
was crying, thrashing, complaining of a headache and eye pain, and
rather than listen to her pleas for help they continued to restrain
her. News articles today revealed Ridout held her head for about 30
minutes longer, she quieted down, and he continued to hold her down
another 10 minutes. When he released her staff noticed she was not
moving. He shook her but she did not respond. He then rolled her
small, listless body over and noticed her face was blue. He began
CPR but it was too late.
Though some
news reports have indicated Angie died the following day at the
hospital, the Hennepin County, Minnesota, Medical Examiner concluded
her death was caused by positional asphyxia and that she died in the
course of being restrained. The weight of the staff member upon her
back significantly impaired her ability to breathe.
After today’s
court appearance, Ridout read a statement expressing "deep sadness":
"I regret that
any of my actions to help protect this girl may have actually caused
her harm," he said. "I understand the demand for personal
responsibility. I hope that my decision not to contest the charge is
the first step in allowing everyone involved with this tragedy to
begin to heal and to move forward."
Now that
Northwest has been convicted of a felony, will they be allowed to
operate their other 12 facilities? According to a
Chronotype news article,
the answer to that question is, surprisingly, yes, under certain
conditions. The no contest pleas were part of a plea agreement
entered into by the corporation, Ridout, Assistant Attorney General
William Hanrahan and Barron County District Attorney Angela
Holmstrom.
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contents
IMPORTANT
FIRST STEPS
It was
determined that faulty training, improper restraint, numerous acts
and omissions by employees of the facility, failing to follow a
treatment plan for Angie, using improperly taught and administered
restraint, among other things, contributed to Angie’s death.
Just days
after Angie’s death, Denison Tucker, president of the clinic’s board
of directors, said they’ve done an internal review and determined
their staff, which is trained and licensed, followed proper
procedures for the hold.
Angie’s death
was ruled a homicide by the medical examiner. Last June, Barron
County District Attorney Angela Holmstrom said the medical
definition of homicide is death caused by another person. She also
said they did not know if they would be able to prove criminal
homicide in this case, as there has to be an intentional act or
criminal reckless conduct, which results in a death.
Now, they
know. The organization, the Northwest Counseling and Guidance Clinic
(Northwest), is being charged with a felony and faces a fine up to
$100,000.
Ridout, the
staff responsible for her death is being charged with misdemeanor
negligent abuse of a patient causing bodily harm and faces a fine of
up to $10,000 and/or a maximum of 9 months in jail.
Holmstrom,
said “The charges are appropriate for the levels of culpability each
of the defendants share in the death of Angellika Arndt.”
A November 30,
phone call by CAICA to Holmstrom yielded few answers – Ms. Holmstrom
cannot discuss the case while it is pending, she said in a
voice-mail message to CAICA. But her assistant told CAICA that the
DA evaluates the information she receives in each individual case
and then sets the charge according to what is appropriate.
Some believe
this is but a slap on the hand. Reports revealed the facility did
not follow proper guidelines and laws when restraining Angie and
that there was no evidence showing she was a danger to herself or
others, which is the legal guideline for performing prone restraints
on a child in the state of Wisconsin.
Minnesota and
Wisconsin have somewhat differing laws about restraint, but neither
state forbids its use altogether.
Wisconsin’s
Mental Health Act requires that clients in public and private
treatment centers not be restrained “except for emergency
situations” or when the restraint is part of a treatment program.
In Minnesota,
the use of restraint in inpatient programs is strictly regulated,
with each program required to be certified in its use. “Most
programs have worked really hard to create an environment where
holds are very rare,” said Mary Regan, executive director of the
Minnesota Council of Child-Caring Agencies, an association of
children’s treatment providers.
But day
treatment programs are not covered by the law. And schools in both
states may use restraints in emergencies.
I personally
agree with Rick Pelishek, the Rice Lake-based regional director of
Disability Rights Wisconsin, when he said, “This was not an accident
or mishap … I think it is an important first step in holding the
organization accountable for their actions, and correcting the
problems that have existed for years.” Disability Rights Wisconsin
is a nonprofit watchdog group that earlier recommended the Rice Lake
center be closed.
Again, some
say this is but a slap on the hand for the clinic and questioned why
Ridout received a misdemeanor when the Medical Examiner ruled that
Angie died as a result of the weight he placed on her body while he
improperly restrained her.
Some questions
that have been raised: How much is Angie’s life worth? $110,000? How
much of a message is this going to send? Is this the most the
District Attorney can do? Aren’t there other remedies of law that
would send a stronger message? What would happen if a parent held a
child down for over an hour and a half for making bubbles in her
milk? Would that be considered normal discipline?
Or if the
child was held down again the following day for over an hour because
she misbehaved in the kitchen? What if the child complained of a
headache and eye pain, struggled, vomited, lost control of her
bodily functions, and later died? Would the parent face serious
legal consequences?
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WHAT
NEXT?
According to
an August 1, 2006, Capital Time article, the State instructed
Northwest to move the 11 children remaining at Rice Lake and that
none of their other 12 centers would be affected.
CAICA contacted DHFS director Otis Woods in August to question why
the other 12 facilities would not be affected. Woods assured CAICA
that all 12 centers would be investigated.
According to a
November 30, Chronotype article, Woods wrote a letter to Rice
Lake Clinic board president Dennyson Tucker informing him that a
state-imposed plan of corrections must be followed at its 12 other
sites. “We continue to be concerned with the number of control
holds within the NWGCC system,” Woods wrote.
The article
further states that in a letter to the state dated Nov. 10, Tucker
wrote, “The public scrutiny, although understandable, would place
the program under an onerous set of public expectations for
perfection.” He does not plan to reopen in Rice Lake.
Facilities
working with children, including Northwest, cannot hire staff who
have been convicted of felony child abuse charges. Since that is the
case, the question is why should it be any different if the
organization responsible for the facility has been charged with a
felony? The staff at the remaining 12 facilities presumably received
the same training as staff did at Rice Lake. It would be one thing
if they had stopped their use of restraints on children, but
according to Otis Woods, that is not the case.
What about
other children still in their care? I doubt Angie was the only child
who endured pain and trauma that, had she lived, might have caused
her severe mental and emotional trauma, much more than what she came
to Rice Lake with in the first place.
Advocates
recognize the deficiencies in a system that should be there to help
children with special needs. There is a rise in children diagnosed
with autism, ADHD, Asperger Syndrome, to name a few. With this rise
there needs to be a system in place to help families in desperate
need of help. I believe Angie’s story could help effect change.
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WHAT OTHERS HAVE HAD TO SAY
Donna Wrenn,
executive director of the National Association for the Mentally Ill:
"No matter what a child's behavior is, I can't imagine holding them
down to the point of suffocating them … it's a horrible tragedy.
It's unbelievable. Someone needs to be held accountable."
Rick
Pelishek, Regional director of Disability Rights Wisconsin:
"This was not an accident or mishap … I think it is an important
first step in holding the organization accountable for their
actions, and correcting the problems that have existed for years.”
Mary Beth
Kelley, former special education teacher: "She should have never
been on her stomach, she should have been upright … there's been
enough research out there, enough deaths, that I'm surprised anyone
would still use that as a practice.”
Anne
Gearity, clinical social worker, Washburn Child Guidance Center,
Minneapolis: “The fact that Angellika was held in the face-down
position, and for periods of between one and two hours each time, is
totally unacceptable … whatever happened, they lost control.”
Crisis
Prevention Institute, a prominent provider of training: "We
always try to say in our training that any time we put our hands on
someone, we're introducing risk … there is no safe physical
restraint."
Daniel and
Donna Pavlik, Angie’s Mom and Dad: “Angie was never a danger to
herself or others, we never restrained her … we made huge gains on
her behavior … her difficult times could be minutes or an hour out
of a whole day. Not ever was a complete day a difficult day.''
Barbara J.
Harrison, licensed social worker and registered nurse:
"Sometimes the staff in these programs are not very experienced, and
I think they can fuel the fire … in this program they were clearly
into control."
Bradley
Ridout, Rice Lake mental health professional-group facilitator:
Bradley A. Ridout said he doesn’t feel he did anything wrong and
that he was simply doing what he was trained to do by the facility.
He says he feels terrible about what happened.
Bradley Ridout’s attorney: Ridout’s attorney said the charges
against Ridout allege he was much bigger than the girl and should
have known better than to put the girl in a choke hold, despite his
training.
Angela
Holmstrom, District Attorney: “The charges are appropriate for
the levels of culpability each of the defendants share in the death
of Angellika Arndt.”
Dennison
Tucker, Rice Lake president of the clinic’s board of directors:
Tucker believes his staff followed proper procedures for the hold, a
hold he says is used only if a child is in danger of harming him or
herself or another person. He stands behind his staff and believes
they did nothing to contribute to Angie’s death.
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contents
QUESTIONS WE MUST ASK
It is hard to
imagine what went through the minds of employees, all claiming to be
professionals, when they physically restrained Angie in some manner
nearly every day over a month’s time. She was a small 7-year old
56-pound little girl. She was placed in dangerous, face-down prone
restraints nine times over the course of 30 days, some restraints
lasting 97 and 98 minutes. These types of restraints are known to
have taken the lives of many children.
I would hope
that anyone working with children in a treatment setting will take
time to ask these questions, and seek answers for themselves so in
the future they use common sense when taking the life of children
into their hands.
I also
challenge you to imagine what it is like for a small child placed
into a prone, face-down restraint with the weight of an adult 2, 3,
sometimes 4 or more times their body weight.
It is
estimated Ridout weighed about 250 pounds, nearly five times Angie’s
weight of 56 pounds. Imagine a 1,115-pound person sitting on the
upper torso of a 250-pound person.
Questions to
ask ourselves:
-
Why did
Rice Lake Treatment staff fail to consult Angie’s prior records?
-
Why was
the employee in charge of teaching restraints not trained
properly?
-
Why were
Ridout and other staff not taught it was inappropriate to place
a child in a dangerous face-down prone restraint for over 90
minutes for wiggling in her chair?
-
Why was
the staff not taught to use common sense?
-
Why was
Angie placed in nearly daily restraints when in other settings
she never needed to be restrained?
-
Why did
Ridout and other employees choose to ignore Angie’s cries for
help, ignoring her complaints of headache and eye pain?
-
Why did
the fact Angie vomited and lost control of her bodily functions
not send out red flags that something was dreadfully wrong?
-
Why did no
one notice, until it was too late, that she was turning blue?
-
Why, when
she stopped thrashing and crying out, did Ridout continue to
hold her down? Where was the other staff?
-
As
professionals caring for children in a residential setting, were
the staff aware of the many deaths of children who are placed in
face-down prone restraints?
If not, they should be made aware.
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contents
FOOTNOTES
AND HELPFUL LINKS
FOOTNOTES:
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