Autistic Boy's Mother May Sue State Over Cage

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Autistic Boy's Mother May Sue State Over Cage

Adoptive mom injured after CPS banned cage used to control boy, 12

[by in the Spokesman-Review.com.]

http://www.spokesmanreview.com/news-story.asp?date=060101 & ID=s971877 & cat=sec

tion.spokane <-- address ends here

A Suncrest woman who suffered brain damage trying to control her

autistic son is filing a $5 million claim of negligence against Washington

state.

Rhoda Hoisington's claim, to be filed today in Olympia, says the

state Department of Social and Health Services contributed to her injuries

by requiring that a metal cage used to control 12-year-old Bud be

dismantled.

The cage, termed a " safe room " in the claim, was 6 feet tall, less

than 5 feet wide, and constructed out of the steel mesh that separates the

front and back seats in police cars.

Child Protective Services cited Rhoda Hoisington for child abuse last

year for using the cage. The agency ordered it disassembled and banned her

from physically restraining Bud.

The child abuse finding also prompted the DSHS to cut Hoisington's

caregiver contract for Bud and the couple's other disabled, adopted children

by $1,120 a month, down to $1,480.

The finding was later changed to inconclusive, but the money was not

restored.

The lack of a cage and loss of funding, according to the claim, left

Rhoda and her husband, Rick Hoisington, without tools to control Bud, an

adopted alcohol- and crack-exposed baby with severe autism and Tourette's

syndrome.

The consequences were dramatic, according to the claim. Rhoda

Hoisington, 51, suffered a series of injuries last winter grappling with Bud

during his autistic fits.

Since then, Hoisington -- a veteran foster parent who has adopted

four other severely disabled children -- has had her spine fused and has

lost sight in her right eye, short-term memory and some verbal skills.

The Hoisingtons' attorney, Burns of Spokane, said the metal box

was an unconventional but effective device to control Bud.

DSHS staff, according to Burns, knew of the safe room in 1998 but

didn't report it to Child Protective Services. Nearly two dozen other

people -- including Bud's teacher and doctor -- also knew of the device, but

didn't call in a complaint.

" There's certainly episodes where he was acting out, but they were

able to manage him, " Burns said. " Then they (DSHS) took the safe room down

in July, and by December Rhoda was injured. What does that tell you? "

Santschi, regional administrator for the DSHS's Division of

Developmental Disabilities, stands by the state's actions.

" We can't ever justify locking a child in a cage, " Santschi said

Thursday.

State policy prohibits the use of such devices outside of schools and

institutions, and has strict criteria governing their use inside facilities.

Other parents, Santschi said, are able to control their troubled

children without resorting to a cage.

" This child is not the worst of what I've seen, " she said. " We need

to look at each child individually, and manage them without locking them up

or holding them down. "

Santschi declined to comment specifically on the claim.

Bud, according to Hoisington and other caregivers, voluntarily went

into the cage as he felt rages coming on. He was also locked in the cage at

times, and occasionally spent the night inside, they said.

The cage, according to his teacher and parents, helped Bud learn to

read and attend school regularly. His attendance plunged after it was

dismantled.

The claim faults Santschi's staff for failing to allow an alternative

" crisis management " plan after the cage was dismantled.

Through Spokane attorney Ken Isserlis, Rhoda Hoisington and her

husband have requested permission to construct another " safe room, " or to

allow the couple to physically restrain Bud.

The DSHS has hired a Gonzaga University professor to meet with Rhoda

Hoisington and draft a new crisis plan.

Although Isserlis is happy to see a response, he has been critical of

the DSHS's treatment of the Hoisingtons.

" It's deplorable, " he said. " There's not a lot of families who would

shelter him and adopt him. We have an extraordinary kid with extraordinary

needs, and we have an extraordinary family who took him in and adopted him. "

The Hoisingtons' claim, filed with the state Risk Management Office, is

likely a precursor to a lawsuit. State attorneys have 60 days to respond

before a lawsuit can be filed.

• can be reached at or by e-mail at

jonathanm@....

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His World Is a Plexiglas Room

'Mommy, home,' autistic man whispers, begging to be freed from his cell

[by Margaret Philp in the Globe and Mail.]

http://ad.ca.doubleclick.net/adi/www.theglobeandmail.com/health;kw=;sz=468x6

0;ord=20010602121823?

Hasit Khagram presses his palms against the plastic window that

divides his artificial world of bolted-down furniture and sterile yellow

walls from ordinary life.

" Give Mommy a hug and a kiss, Hasit, " his mother, Suniti Shah, chimes

in the singsong lilt of an adult's conversation with a small child, her

hands flush against his on the other side of the divider.

As his mother leans her cheek to the window, Hasit nuzzles her face

from his side of the barrier that confines him to a laboratory-rat existence

without human touch or fresh air.

She is allowed to visit him for no more than an hour each week, the

door silently propped open at the end of the hour by the staff person who

supervises her visits. For six months, the closest she has come to wrapping

her arms around her mentally impaired son are these pretend embraces through

Plexiglas.

She speaks to him through small holes drilled into the plastic window,

pressing her ear against them to catch his muffled replies. " Mommy, home, "

he whimpers into the holes on a recent visit. " Mommy, home. " Short and

stocky, Hasit is a 31-year-old man with the mind of a three-year-old child.

Diagnosed with autism as a stuttering and antisocial teenager, he has

regressed in adulthood to soiling his underwear, urinating on the floor,

pounding his face with his own clenched fist, pulling out his fingernails,

spitting on the window.

For all the havoc he wreaks, Hasit is being fought over in a nasty

tug-of-war with a modern twist on a decades-old debate about the

institutionalization of people with severe mental disabilities.

On one side is his overwrought mother, whose single-minded resolve to

bring her son home has antagonized almost every doctor, therapist and

bureaucrat who has worked on Hasit's case.

On the other is Ontario's Public Guardian and Trustee, who took the

unusual step of persuading a judge to strip Mrs. Shah of guardianship last

summer.

The battle has left Hasit in seclusion at a small-scale institution

called Bethesda Home, in a coldly stark apartment more in keeping with a

bygone era when mental institutions dotted the province than with the

present, when most autistic people live at home.

The doctors and therapists at the home regard Hasit as a stick of

dynamite so explosive -- so prone to hitting, biting, gouging at eyes --

that not even his mother is safe within arm's reach.

" I think the whole question is, in this day and age, should this be

happening to somebody, especially when there are other treatments? " said

Spindel, a sociologist at Humber College who works with disabled

people that the deinstitutionalization movement has passed by.

Hasit was first ushered through the whitewashed corridors of Bethesda

in restraints last December after months in seclusion at Hamilton

Psychiatric Hospital, where he was sedated and lived without a toilet or

shower.

The red-brick building, tucked behind a pastoral expanse of lawn and

trees outside the town of Vineland in Ontario's grape-growing country, was a

relief after the horror of soiled bedsheets and physical restraints at the

psychiatric institution.

But in the six months since his arrival at Bethesda, Hasit has lived

behind glass like an exotic animal in a zoo, under a regime of solitary

confinement and drugs to dull his aggression, a regime that baffles some

doctors who subscribe to a less austere philosophy of treating people with

severe autism.

In a letter to the public guardian last week, Sherrie Bieman-Copland,

a psychologist at Brock University who has worked with Hasit for several

years, contends that Bethesda officials are blaming the family unfairly for

the behaviour problems that have persisted under their roof.

She questions the institution's move to limit visits from his parents

and two younger brothers to an hour a week, rules she describes as

" counterproductive in that they fail to acknowledge that Hasit's family are

an integral part of his long-term environment. "

In six months at Bethesda, not once has he stepped outdoors. Sheets of

plastic film on the windows obscure his view of the birds and trees. His

every move is tracked by a remote-control camera monitored around the clock

by staff who sit in a room on the other side of the plastic window and speak

to Hasit through an intercom.

A television is mounted in the wall close to the ceiling of the main

room in Hasit's apartment. Underneath it is a hard-backed wooden chair

bolted to the floor. That is the room's only piece of furniture, except for

a chalkboard screwed to one wall bearing simple addition and subtraction

problems.

In Hasit's bedroom, a lone bed sits in the corner. The dining room is

empty apart from a table and chair anchored to the middle of the floor.

When his food is delivered at mealtimes -- sometimes chicken and fish,

even though his Hindu family observes a strict vegetarian diet -- staff

instruct him to sit down while they hurriedly place his tray in the

dining-room doorway and scurry back to the safety of the room on the other

side of the glass. When he soils his underwear, fresh clothes are placed in

a pile just inside a door to the apartment nowhere near where he is

standing.

" What is it that is clinically indicated as a treatment program for

this young man that would warrant him being so limited in his contact with

human beings who care about him and who he knows? " demands ,

executive director at the Ontario Association for Community Living, an

ardent advocate of disabled people remaining outside institutions.

To this, Bethesda executive director Davies replies that there

are junctures in the lives of people with severe mental disabilities such as

Hasit's where restrictive treatment in an institution, though it may be

frowned on, is crucial for the sake of safety.

He insists staff at Bethesda are deeply compassionate, that Hasit's

seclusion and bleak surroundings are an unfortunate but deliberate exception

to the rule made necessary by a violently aggressive autistic man who is

" one of the most difficult people to support in Ontario. " It often costs an

institution as much as $200,000 a year to provide care for people with

profound disabilities such as Hasit's, not including the thousands of

dollars often poured into renovations.

When Hasit's mother visits, as she does every Wednesday morning for

her stipulated hour, she can touch his fingers through a five-centimetre

slit cut into the partition. But the rough edges scratch his hand, so she

resists reaching for it for fear he will cut himself.

" What do you want to do, Hasit? " Mrs. Shah shouts through the window

at Hasit, a vacant look in his eyes, his grey sweatpants pulled up just

below his armpits. " Do you want to do math? Let's do math. " Hasit turns to

the chalkboard, grasps a stub of chalk in his fingers, and starts correctly

adding 632 with 195. Without warning, he turns to face his mother and drops

his sweatpants down to his ankles. He has defecated in his underwear, and

looks at her with questioning eyes as if asking, " What do I do now? " He

suffers a prolapsed rectum -- from years in an institution, his mother

insists -- and is oblivious to the sensation of his bowel moving.

" Don't put them back on, " Mrs. Shah pleads, as he pulls his dirty

underwear back up around his waist. " Hasit, don't do it. " Until last summer,

Hasit lived for seven years in a house with a back-yard swimming pool on a

leafy Welland street about a 10-minute drive from his parents' home in

neighbouring Fonthill. Mrs. Shah and her husband, Welland family physician

Vinod Shah, bought the house for Hasit when he was sprung from a psychiatric

hospital after his mother's first round with the courts back in 1993.

With $116,000 in funding from the province -- not out of line for

families caring for severely disabled people at home -- Mrs. Shah hired

round-the-clock caregivers who would prepare Hasit's meals, dole out the

medication doctors prescribed to tame his rages, and clean up after him.

But trouble was simmering across the back fence. Complaints by

neighbours brought an investigation that uncovered serious allegations about

Hasit's care, including unqualified staff -- some with criminal records for

assault -- who never lasted long in the job, safety hazards in the house

such as exposed wires, medications altered at Mrs. Shah's whim, and Hasit

being locked away, alone, for long stretches of time.

Mrs. Shah flatly denies fiddling with Hasit's medication without a

doctor's permission and accuses some of her underpaid staff -- some snapped

photographs of Hasit in fouled underwear later used as exhibits in court --

of sabotaging her in the investigation.

It could be that Mrs. Shah, passionate and outspoken, is her own worst

enemy.

For years, no matter where Hasit was living, she carried on a pitched

battle both with the professionals tending to him and the government funding

his care. There are stacks of court documents from all the legal wrangling

to fill a room. She has amassed an army of advocates for the disabled behind

her cause. And Mrs. Shah is a fixture in the local newspapers.

" To some extent the son is being punished because of the actions of

the mother, and it's a horror because he's the one who suffers in all of

this, " Dr. Spindel, the Humber College sociologist, said. " It seems the

government and the service system is locked into a control issue with her,

and this young man is being sacrificed every day because of that. It's very

grim. " In his ruling that awarded guardianship to the public trustee,

Justice Lofchik said he did so " with some reluctance because I

believe that Mrs. Shah is endeavouring to do what is best for Hasit. "

" However, I fear at times reason is clouded by emotion and bias, causing her

to be at odds with the professionals who have the expertise to institute

proper care. " Mrs. Shah, after years of requesting more funding to pay

richer wages to entice a higher calibre of staff and being turned down every

time, is bitter that the province has invested hundreds of thousands of

dollars to renovate and staff space in a bleak, soulless institution where

she maintains her son is miserable and his condition fast deteriorating.

" I want to smile and laugh again, if only they would treat him like a

human being, " Mrs. Shah said. " I don't care where the government spends

their money, as long they look after my son in a human way. That's all I'm

asking for. " " All I'm looking for is happiness for him. Nothing else. I

don't want anything else in this world. "

* * *

Reader’s Posts

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