Topic 13

TOPIC 13


Issues Regarding Seclusion and Restraint





Federal Policies



• Federal legislative information is made available to the public as a primary source on the Library of Congress’ Thomas site. http://thomas.loc.gov



• House Resolution 4247: Preventing Harmful Restraint and Seclusion in Schools Act was passed by the U.S. House of Representatives on March 3, 2010.



• On March 4, 2010 Senate Bill 2860 was read twice and referred to the Senate Committee on Health, Education, Labor, and Pensions.



• Specific information about the Preventing Harmful Restraint and Seclusion Act now being reviewed by the Senate can be found on the Thomas Site at: http://thomas.loc.gov/cgi-bin/bdquery/D?d111:1:./temp/~bdAkkm:@@@L&summ2=m&
/bss/d111query.html




Support and Opposition



• Over 100 organizations have gone on record as being in support of HR4247 and SB2680. These organizations include Council for Children with Behavior Disorders, and the Council for Exceptional Children. The list of supporters with links to each of their sites can be found at: http://edlabor.house.gov/blog/2010/01/supporters-of-the-preventing-h.shtml



o CCBD has released position papers regarding the use of seclusion and restraint: http://www.ccbd.net/advocacy/positionpapers.cfm?categoryID=D399524C-C09F-1D6F-F9ABEED1B7D76FDD#





• There is also opposition to some aspects of the bill



o The American Association of School Administrators: http://www.aasa.org

o The AASA sent a letter to Congress opposing content in HR4247. The letter can be accessed from: http://www.aasa.org/uploadedFiles/Policy_and_Advocacy/files/Ed%20Labr%20Cmte%20Letter%20020210.pdf





State Regulations



• On July 31, 2009, Secretary Arne Duncan sent a letter to the states and territories urging them to develop, review and/or revise their state policies and guidelines.



• Read Arne Duncan’s letter to states and territories: http://www2.ed.gov/policy/elsec/guid/secletter/090731.html



• The Office of Elementary and Secondary Education compiled information concerning the status of each state's efforts with regard to limiting the use of seclusion and restraint in schools. Several states have developed guidelines for documenting and reporting, while some states have developed actual regulations and statutes regarding the use of seclusion and restraint in schools. A summary document of this information is available for download and a state-by-state summary table can be viewed at: http://www2.ed.gov/policy/seclusion/seclusion-state-summary.html



• Code of Maryland Regulations (COMAR) provides a detailed policy for school personnel in an online annotated state regulation site. Code:13A.08.04.03 is entitled Student Behavior Interventions Authority and reads as follows:

o School personnel are encouraged to use an array of positive behavior interventions, strategies, and supports to increase or decrease targeted student behaviors.



o School personnel shall only use exclusion, restraint, or seclusion:



 After less restrictive or alternative approaches have been considered, and:

o Attempted

o Determined to be inappropriate;

 In a humane, safe, and effective manner;

 Without intent to harm or create undue discomfort; and

 Consistent with known medical or psychological limitations and the student's behavioral intervention plan.



• Missouri’s Department of Elementary and Secondary Education is currently working on a Model policy. The Missouri General Assembly has declared, “By July 1, 2011, the local board of education of each school district shall adopt a written policy that comprehensively addresses the use of restrictive behavioral interventions as a form of discipline or behavior management technique. The policy shall be consistent with professionally accepted practices and standards of student discipline, behavior management, health and safety, including the safe schools act.” Read more on this Missouri State Statute at: http://www.moga.mo.gov/statutes/c100-199/1600000263.htm





• Oregon’s State Board of Education adopted new provisions on the use of physical restraint and seclusion in Oregon public schools in 2006. Several policy and procedural changes where required as of September 1, 2007. These included:

o Each school district establishing written policies and procedures on the use of physical restraint and seclusion.

o Each district identifying the training program(s) or system(s) of physical restraints and seclusion to train appropriate staff.

The Oregon Department of Education provided schools with a technical assistance document. This document can be accessed through: www.ode.state.or.us/pubs/sped/tarestraintseclusion.doc



• Wisconsin Department of Public Instruction developed and posted directives in 2005. http://dpi.wi.gov/sped/sbseclusion.html. Wisconsin adapted Maryland’s (COMAR) regulations.





Website Resources



• National Disability Rights Network advocates for the enactment and vigorous enforcement of laws protecting civil and human rights of people with disabilities. They have release the report, “School is Not Supposed to Hurt” in 2009. http://www.ndrn.org/



• Beach Center on Disability proposes a multi-tier approach to eliminating school seclusion and restraint except in emergency situations of imminent risk to the health or safety of the student or other persons. http://www.beachcenter.org/pbs/seclusion_and_restraint.aspx?JScript=1



• Disability Scoop is an on-line national news organization serving the developmental disability community. To read news articles about seclusion and restraint issues go to: http://www.disabilityscoop.com/restraint-seclusion/



• Families Together is a parent training and information center serving Kansas families who include a child with disabilities. This section of the Families Together website provides resources and links for families. http://www.familiestogetherinc.org/SECLUSIONRESTRAINT.html



• Kansas Department of Education offers guidelines for the use of seclusion and restraint. The state is also developing and providing training on data collection systems for documenting and reporting seclusion. More information and resource documents can be found at: http://www.ksde.org/Default.aspx?tabid=3119



• Missouri Families Against Seclusion and Restraint is a grass roots organization in Missouri. http://nomoseclusion.blogspot.com



Additional Tools and Resources



• The following link is an on-line video presentation produced by the National Association of State Directors of Special Education.

o Title: Seclusion and Restraint: The Impact of Federal and State Policy on the Classroom

o Presenter(s): Dr. Joe Ryan, Amanda Lowe, & Bill East

o Length: 1 hour 33 Minutes

o You must use Internet Explorer in order to view

http://video.pattanpgh.net/mediasite/viewer/?peid=5dc81fc6-4223-4b47-aaf7-1c0d0d08d497



• Bazelon Center for Mental Health Law provides several resources related to mental health policy for children. While Protection and Advocacy (P&A) information is available, specific resources are available around the topic of seclusion and restraint. http://www.bazelon.org/issues/children



• Ryan, et. al. (2007) provides information regarding commonly reported reasons among school staff for using seclusion and restraint.



Reasons Stated for Using Seclusion Staff Reports

Leaving Assigned Area 32.6%

Non-compliance 31.9%

Disrupting Class 11.2%

Property Misuse 10.1%

Disrespect 4.5%

Physical Aggression 2.8%

Harassment 2.4%

Threats 2.0%



Reasons Stated for Using Restraint Staff Reports

Non-compliance 48.4%

Leaving Assigned Area 19.4%

Disrespect 7.3%

Property Misuse 7.3%

Disrupting Class 6.5%

Physical Aggression 3.2%

Threats 3.2%

Horseplay 3.2%

Harassment 0.8%







• Training Programs: The following is a resource list of training programs that include a) a prevention focus, b) a behavior support emphasis, c) de-escalation strategies, and d) crisis response techniques.



Crisis Prevention Institute (CPI), Nonviolent Crisis Intervention Training Program: www.crisisprevention.com



• Philosophy: Providing a balanced behavior management system while maintaining care, welfare, safety and security for both the student and staff.

• Methodology: Provides a holistic system for defusing escalating behavior and safely managing physically aggressive behavior. CPI methods focus on effective communication and an understanding of human physiology during aggressive moments.



“Since 1980, more than 5 million human service professionals around the world have participated in the Nonviolent Crisis Intervention training program to learn its proven strategies for safely resolving situations when confronted by anxious, hostile or violent behavior, while still protecting the therapeutic relationships with those in their care.

CPI is committed to continuing its research, support, and delivery of the highest quality behavior management training and resources, and to serving as a positive change agent for helping professionals and the individuals in their care.” From the CPI website at www.crisisprevention.com .





Handle With Care (HWC): www.handlewithcare.com



• Philosophy: Handle With Care was designed for agencies caring for people who have the potential of being aggressive, violent, suicidal, and out of control.

• Methodology: HWC’s training program consists of verbal de-escalation (including theoretical models and role play) and non-violent physical interventions.



“The individual components of Handle With Care technology are integrated with each other, creating a system that is beautifully simple, coherent and adaptable to the classroom environment. Teachers who complete the training will have the practical tools to manage students effectively to avoid a crisis. When a crisis does occur, we teach you how to work as a team in “real time real speed” interventions. It is a program that your faculty will believe in because it is rooted in practicality, the ethical treatment of students and common sense.” From the Handle With Care website at www.handlewithcare.com .





The Mandt System: www.mandtsystem.com



• Philosophy: The Mandt system is based on the principle that all people have the right to be treated with dignity and respect. All individuals have the right to a personal identity, the right to normalization, and the right to the least restrictive and most appropriate environment.

• Methodology: The Mandt System teaches the use of a graded system of alternatives, which use the least amount of external management necessary in all situations.



“The Mandt System is a systematic training program designed to help you de-escalate yourself and other people (e.g., co-workers, spouse, children, friends, clients, patients, residents, students, etc.) when you or they have difficulty managing their own behavior. We believe that until you and the other person are de-escalated, no training (i.e., behavior program, etc.) or work will take place. The Mandt System blends well with a Behavior Support approach.” From the Mandt System website at www.mandtsytem.com.





References & Readings



• COMAR: 13A.08.04. Student Behavior Interventions Authority. Students. State Board of Education, Annotated Code of Maryland Regulations. Available from: http://www.dsd.state.md.us/comar/SearchAll.aspx



• National Disability Rights Network. (2010). School is not supposed to hurt: Update on progress in 2009 to Prevent and Reduce Restraint and Seclusion in Schools. Available through download from the National Disability Rights Network at: http://www.ndrn.org



• Office of Student Learning and Partnerships. (2007). Technical assistance: Use of physical restraint and seclusion. Oregon Department of Education. Salem, Oregon. Available from: http://www.ode.state.or.us/pubs



• Peterson, R.L., Ryan, J., Otten, K., Couvillon, M. (2010). Reducing restraint and seclusion in schools: An update and analysis. Presentation at the Midwest Symposium for Leadership in Behavior Disorders. February 27, 2010: Kansas City, Missouri.



• Ryan, J.B., Peterson, R., Rozalski, M. (2007). State policies concerning the use of seclusion timeout in schools. Education and Treatment of Children. 30 (3) 215-239.



• Ryan, J.B., Peterson, R. (2004). Physical restraint in school. Behavioral Disorders 29 (2) 154-168.



• Ryan, J.B., Robbins, K., Peterson, R., Rozalski, M. (2009). Review of state policies concerning the use of physical restraint procedures in schools. Education and Treatment of Children. 32 (3) 487-504.



• Ryan, J.B., Peterson, R.L., Tetreault, G. & Van der Hagen, E. (2007). Reducing Seclusion Timeout and Restraint Procedures with At-Risk Youth. Journal of At-Risk Issues. 13(1), 7-12.



• Sailor, W., Doolittle, J., Bradley, R., & Danielson, L. (2008). Response to intervention and positive behavior support. In M. Roberts (Series Ed.) & W. Sailor, G. Dunlap, G. Sugai, & R. Horner (Vol. Eds.), Issues in clinical child psychology. Handbook of positive behavior support (pp. 729-754). New York: Springer.



• Wisconsin Department of Public Instruction. (2009). WDPI directives for the appropriate use of seclusion and physical restraint in special education programs. Madison, Wisconsin.





Glossary of Terms



• Ambulatory Restraint - manual restraint, therapeutic holding involves one or more people using their bodies to restrict another individual’s body movement



• Chemical Restraint - uses medication to control behavior or restrict individual’s freedom of movement



• Exclusion - the removal of a student to a supervised area for a limited period of time during which the student has an opportunity to regain self-control and is not receiving instruction or educational services



• Mechanical restraint - the use of any device or material attached or adjacent to the student's body that restricts freedom of movement or normal access to any portion of the student's body and that the student cannot easily remove. (Tape, tie downs, hand cuffs) "Mechanical restraint" does not include a protective or stabilizing device.



• Physical restraint - the use of physical force, without the use of any device or material, that restricts the free movement of all or a portion of a student's body.



• Protective or stabilizing device - any device or material attached or adjacent to the student's body that restricts freedom of movement or normal access to any portion of the student's body for the purpose of enhancing functional skills, preventing self-injurious behavior, or ensuring safe positioning of a person.

Protective or stabilizing devices include:



a) Adaptive equipment prescribed by a health professional, if used for the purpose for which the device is intended by the manufacturer;



b) Seat belts; or



c) Other safety equipment to secure students during transportation in accordance with the public agency or nonpublic school transportation plan.



• Restraint - any method of restricting an individual’s freedom of movement, physical activity, or normal access to his or her body



• Seclusion - the involuntary confinement of a student alone in a room or area from which the student is physically prevented from leaving.



• Time out - removing a student for a short time to provide the student with an opportunity to regain self-control, in a setting from which the student is not physically prevented from leaving. Types of Time-out include:

o Inclusion - takes place in the classroom; access to instruction

o Exclusion - takes place outside the classroom; no access to instruction

o Seclusion - takes place in a special room or location and the student is prevented from leaving and has no access to instruction