For an autistic child experiencing a sensory overload, a therapeutic blanket could be used to calm the youngster.
But the recent death of a nine-year-old Quebec boy, who suffocated after being rolled in the blanket, has raised questions about the standards around its use.
A coroner's report released last week showed that young Gabriel Poirier was acting up in class when his teacher placed the boy, who weighed 53 pounds, on his stomach and wrapped a 39-pound blanket tightly around him at least four times. Gabriel's head was covered and only the tips of his toes stuck out. When the teacher went to check on him 20 minutes later, the child's face was blue. He died in hospital the next day.
Therapeutic blankets, often stuffed with buckwheat or other seeds, have been used to relax autistic children. But there are no guidelines on the use of the blankets, or any scientific evidence about their benefits.
Quebec coroner Catherine Rudel-Tessier said yesterday that although Gabriel's death on April 18 was tragic, the blanket should not necessarily be banned altogether. Instead, rules should be put in place governing the practice of this form of treatment. "Doctors or therapists must approve the use of the blanket before it is used," she said, stressing that a child or adult wrapped in the blanket should not be left unsupervised and their face should not be covered.
Gabriel was left alone in a corner of the classroom at his special-needs school in St.-Jean-sur-Richelieu, south of Montreal. When the teacher saw he wasn't moving, he called the nurse and 911. But Gabriel was already in a coma.
In her report, the coroner said the therapeutic blanket should be used as therapy, not as a form of punishment.
Lynn Andrews, a spokeswoman for the Autism Society of Canada, said her association has been pushing for guidelines and hopes the coroner's report will urge regulators to act.
"We've been pushing for this. We need more guidelines on all therapies for autism, not just this one," Ms. Andrews said.
In the meantime, Jennifer Sexton, a board member at the British Columbia Society of Occupational Therapists and a pediatric occupational therapist, said that a therapeutic blanket is a piece of equipment and should be used only by a professional or a person trained in sensory integration.
"We have to have a good understanding of any child's body systems before we just use pieces of equipment," she said.
Claudia von Zweck, executive director of the Canadian Association of Occupational Therapists, added that while the association hasn't developed guidelines on the therapeutic blanket, the group informs members of the latest research and standards so that they can implement them in their own practices.
However, Jean-Pierre Ménard, lawyer for Gabriel's parents, said he wants regulations on how restraints should be used in schools. "It was the first time to my knowledge that we have a death in the school system following the use of restraints. But with no regulation, the question is not could we have another one, but when will we have another one," he said.