Council for Exceptional Children’s Conference Louisville, Kentucky November 22, 2010 Toyah Robey

1. Current Issues Surrounding Seclusion and Restraint in Schools: Update on Federal and State Guidelines Council for Exceptional Children’s Conference Louisville, Kentucky November 22, 2010 Toyah Robey Sherri Clusky Kentucky Department of Education Toyah.Robey@education.ky.gov Sherri.Cluskey@education.ky.gov

2. Historical Context and Timeline: Federal • H.R.4247 - Keeping All Students Safe Act • Passed March 3, 2009 • Directs the Secretary of Education to establish minimum standards that: • prohibit school staff from using mechanical, chemical, physical restraint / escort that restricts breathing, or aversive behavioral intervention that compromises student health and safety • prohibit such school staff using physical restraint or seclusion, unless such measures are required to eliminate an imminent danger of physical injury to the student or others and certain precautions are taken • require states to ensure that a sufficient number of school personnel receive state-approved crisis intervention training and certification in first aid and certain safe and effective student management techniques; • prohibit physical restraint or seclusion from being written into a student’s individual education program as a planned intervention • require schools to establish procedures to notify parents in a timely manner if physical restraint or seclusion is imposed on their child. Requires that when the physical restraint or seclusion of a student is required to eliminate an imminent danger of physical injury to such student or others, school personnel continuously monitor such student face-to-face or, if their safety is significantly compromised by such monitoring, remain in direct visual contact with the student. Directs the Secretary of the Interior to ensure that schools operated or funded by the Department of the Interior comply with such minimum standards.

3. Historical Context and Timeline: Federal Committee on Education and Labor, House of Representatives requests Government Accountability office (GAO) to prepare report. • Selected Cases of Death and Abuse at Public and Private Schools and Treatment Centers- May 19, 2009 • no federal laws restricting the use of seclusion and restraints in public and private schools • Varies from state to state • 100’s of cases of abuse and death over past two decades • http://www.gao.gov/new.items/d09719t.pdf

4. Historical Context and Timeline: Federal U.S. Education Secretary Arne Duncan sends a letter to Chief State School Officers advising them to review their state polices on seclusion and restraint, July31, 2009: • Develop, review or revise State policies and guidelines to ensure that every student is safe and protected from being unnecessarily or inappropriately restrained or secluded • Publicize policies and guidelines so that administrators, teachers, and parents understand and consent to the limited circumstances under which these techniques may be used; • ensure that parents are notified when these interventions do occur (24 hours) • Provide resources needed to successfully implement the policies and hold school districts accountable for adhering to the guidelines. • Utilize ARRA dollars to implement school-wide positive behavior supports (PBS) • http://www.pbis.org/seclusion/restraint/arne_duncans_letter.aspx

5. Historical Context and Timeline: Kentucky • KDE does not currently have any statues or regulations pertaining to seclusion and restraint • KDE policy letter on the use of time-out in schools • KDE guidance on procedures and best practices for time-out rooms • Behavior Home Page http://www.state.ky.us/agencies/behave/homepage.html • Kentucky Center for Instructional Discipline (KCID) • Academic and Behavior Response to Intervention (ABRI)

6. Historical Context and Timeline: Kentucky KDE Restraint and Seclusion Advisory Committee • Met September 2009 • Membership- multi agency/local districts teachers and administrators • Made recommendations focused on • Seclusion definition and acceptable and unacceptable practices • Restraint and acceptable and unacceptable practices • Guidance districts to ensure successful implementation

7. Historical Context and Timeline: Kentucky On the forefront • In holding pattern… S.2860:Preventing Harmful and Restraint and Seclusion in Schools Act • Presentations/feedback • Behavior Institute, June 2010 • CEC , November, 2010 • Q&A Document • Policy Letters

8. The Use of Restraint in Schools

9. Types of Restraint Mechanical • use of objects or device to restrict student’s movements in order to manage out-of-control behavior • Examples: tape, ropes, weighted blankets, belts, straps, handcuffs Proper Use • Used only for orthopedic purposes in order to participate in the school setting • With written order by physician, OT or PT • Should be included in IEP

10. Types of Restraint Chemical • Use of medication to control behavior or restrict movement (e.g. ADHD, ODD) Proper Use • Administer all medications as prescribed by physician • Schools may not require a student to be on medication in order to attend school • Schools should provide on-going data regarding behavior or side effects of medication during titration

11. Types of Restraint Physical • Physical restraint is a procedure with which a person(s) uses his or her body to effectively and immediately control or immobilize another” (Physical Restraint, 2001) • An emergency procedure to prevent injury to student or others in a crisis situation • Physical restraint is sometimes referred to as ambulatory restraint, manual restraint, physical intervention, or therapeutic holding

12. Physical Restraint • Used as last resort option • Used only when student poses a danger to seriously hurting themselves or others • Conduct assessment of situation and student’s history • NOT appropriate • Only to protect property • When student is non-compliant, confrontational, or verbally aggressive without substantial risk of immediate injury to self or others • Used as a consequence for inappropriate behavior Restraint and Seclusion in Schools: 21 Questions and Answers, CASE

13. Physical Restraint • Staff training on effective classroom behavior management strategies and conflict de-escalation techniques • Training/certification for staff responsible for employing physical restraint • Employ proactive intervention planning (positive behavior supports) • Understand the function/purpose of challenging behavior (Functional Behavior Assessments) • Multiple methods for collection/monitoring of student behavior with on-going team analysis • Develop a continuum of reinforcements and consequences • Use a team approach for problem-solving

14. Physical Restraint • District/School procedures/protocol when to employ physical restraint • Staff training and review throughout school year • Maintain record of staff trained • Employ “safety plans” for students whose history of aggression or self-injurious behavior would cause safety concerns • Maintain incident reports of all restraints • Select key individuals to receive training/certification • Establish Review Team • Staff debriefing/Incidence Report within 24 hours of incident • Student actions/outcomes/student interview • Student actions/outcomes/student interview • Staff actions/outcomes/staff interview • Next steps, plan modifications • Contact parents

15. Physical Restraint • Avoid prone restraints (student is face down on stomach) and supine restraints (student is face up on back) • Avoid any restraints or places pressure/weight on chest, lungs, sternum, diaphragm, back, neck, or throat. • The student should be able to speak and breath at all times • Never to be used as a punishment, force compliance, or an educational support • Manage student behavior

16. Physical Restraint Emergency Situation • Student poses a clear, present, and imminent physical danger to self or others • Employed by trained staff (2 staff) • Use of established protocol- less restrictive measures have been employed and exhausted (where not effective) • Restraint should last only as long as necessary to resolve risk of injury to self or others • Degree of force should be commiserate with child’s size and age • Degree of force may not exceed what is necessary to protect the child or others from harm • 2nd or 3rd Trained staff person should be observing and documenting all actions of staff and student- for incident report • Contact building administrator as soon as possible

17. Physical Restraint • Parent Contact • Contact parents as soon as possible (within 24 hours both verbally and through written communication) • Provide copy of all documentation • Employ multiple tools as proactive measures to prevent or avoid physical restraint of students • School-wide safety planning • Effective classroom management strategies • Threat assessments • Individual Safety plans/check and connect • Wrap around services and consultation with community agencies, special education cooperatives, and KDE

18. The Use of Seclusion in Schools

19. Seclusion • When a student is placed in a room or location where they are alone (isolation) or prevented from leaving • Should be considered as a last resort option • Students who are out of control • Posing threat to themselves or others • Not to be used as a punishment/consequence • Only to protect property • When student is non-compliant, confrontational, or verbally aggressive without substantial risk of immediate injury to self or others • Used as a consequence for inappropriate behavior

20. Types of Time-out • Inclusionary- student remains in classroom setting • Exclusionary- student moves away from classroom setting but still has access to other staff/students (principals office, detention, hallway) • Seclusionary- student moves to setting where the student is alone with no access to reinforcement

21. Seclusion Time-out Rooms • Safe and humane • Inspect for potential hazards • Free of electrical outlets, equipment or breakable glass • ensure proper ventilation, lighting, and temperature • No locks • Presence of trained staff- be able to see and hear student at all times • Be of reasonable size for student movement • Access to restroom and water Cool-down room/safe seats • Same rules apply • Student has ability to enter and exit at free-will

22. Seclusion • Sensory Rooms • No sustained evidence or research to support positive, education impact or benefits • Conflicts with best practice • Removes or impedes access to general curriculum • Without understanding function of behavior, may reinforce negative behaviors • No research supporting use

23. Seclusion • Staff training on effective classroom behavior management strategies and conflict de-escalation techniques • Certification for staff responsible for employing seclusion • Employ proactive intervention planning (positive behavior supports) • Understand the function/purpose of challenging behavior (Functional Behavior Assessments) • Multiple methods for collection/monitoring of student behavior with on-going team analysis • Develop a continuum of reinforcements and consequences • Use a team approach for problem-solving

24. Seclusion Emergency Situation • Student poses a clear, present, and imminent physical danger to self or others • Employed by trained staff (2 staff) • Use of established protocol- less restrictive measures have been employed and exhausted (where not effective) • The seclusion should last only as long as necessary to resolve risk of danger/harm • Student is permitted to use restroom • Student is permitted to drink water • Any medical signs of distress must be reported and acted upon

25. Restraint and Seclusion • District/School procedures/protocol when to employ seclusion • Staff training and review throughout school year • Maintain record of staff trained • Employ “safety plans” for students whose history of aggression or self-injurious behavior would cause safety concerns • Maintain incident reports of all restraints • Select key individuals to receive training/certification • Establish Review Team • Staff debriefing/Incidence Report within 24 hours of incident • Student actions/outcomes/student interview • Staff actions/outcomes/staff interview • Next steps, plan modifications • Contact parents

26. Resources • Autism: Sensory Rooms, Maybe Not?, June 04, http://autism.change.org/blog/view/sensory_rooms_maybe_not • Debunking the Myths of Restraint and Seclusion,http://aprais.tash.org • Evaluating the Educational Experiences of Students with Profound and Multiple Disabilities in Inclusive and Segregated Classroom Settings: An Austrailian Perspective, Athur-Kelly, Pascoe, & Smyth-King, 2004 • Handle With Care Letter to Congress, February 2, 2010 • National Disability Rights Press Release on Follow-up Report on Restraint and Seclusion in Public Schools, February 2, 2010 • National Education Association Policy Letter, November 10, 2009 • Policy Letter Concerning the Use of Time-Out, Kentucky Department of Education, 2000 with review in 2006 • Restraint and Seclusion in California Schools: A Failing Grade, Protection and Advocacy, June 2007 • Restraint and Seclusion in Schools: 21 Questions and Answers, Council of Administrators of Special Education, 2009 • Socio-communicative Perspectives on Research and Evidence-based Practices in the Education of Students with Profound and Multiple Disabilities, Athur-Kelly, Bochner, Center, & Mok, April 2007 • The Use of Physical Restraint Procedures in School Settings, CCBD Position Paper, Council for Children with Behavior Disorders July, 2009 • Unsafe in the Schoolhouse: Abuse of Children with Disabilities, Jessica Butler, Council of Parent Attorneys and Advocates, Inc, (COPAA), May 2009 • The Use of Seclusion in School Settings, CCBD Position Paper, Council for Children with Behavior Disorders July, 2009 • The Use of Seclusion and Restraint in Public Schools: The Legal Issues, Congressional Research Service, April 14, 2009