.Nameplate February 2013 Issue
Feature                                                       Pages 34-37

 

The Option of Seclusion

and Restraint    

While most schools exceed state standards for their use, staff training can greatly diminish the need for intensive interventions

 Sasha Pudelski
    Noelle Ellerson (center) and Sasha Pudelski (right)
      work on federal policy matters, including the use
        of seclusion and restraint in schools, for AASA.
BY SASHA PUDELSKI

Eight years ago, Carleen Doucet was making her regular visits to schools in the Lafayette Parish district of Louisiana, where she works as the system’s crisis intervention specialist, when she noticed a disturbing trend: More students with severe emotional disabilities were enrolled in the district than ever before. Few teachers and other school personnel were capable of effectively managing the students’ aggressive behavior without resorting to interventions such as seclusion and restraint.

Having worked with students with emotional and behavioral disabilities for more than two decades, Doucet was familiar with techniques such as seclusion and restraint that can be used when a student is having a severe outburst. However, she believed more school personnel in the 26,000-student school district could benefit from practical training in light of the sharp increases in the student population.

After receiving permission to attend a well-recognized crisis intervention program, Doucet returned to the district ready to train teachers and other school-based staff on how to use nonviolent crisis intervention techniques with their students.

Pro-Active Practices
Today, the Lafayette Parish schools have trained about 2,000 individuals — including parents, bus drivers, custodians and educators — on how to use positive behavioral supports, as well as nonviolent crisis intervention, to reduce the need to use seclusion and restraint with an out-of-control student. In the last two years alone, Doucet and two colleagues have trained approximately 1,000 school personnel on the proper use of seclusion and restraint, as well as other de-escalation strategies. As a result, the school district has experienced a 60 percent reduction in the use of physical restraint and a 45 percent reduction in workers’ compensation cases due to assaults on school personnel.

The decision by school administration and school safety personnel to comprehensively review the use of seclusion and restraint in Lafayette Parish has become the norm. While state legislation in Louisiana pushed districts to address their policies and practices, the majority of districts, such as Lafayette, have taken it upon themselves to craft policies that meet the specific needs of the students they serve and the wishes of both parents and school personnel. Lafayette Parish, in fact, did not make any changes to district policy as a result of the state seclusion and restraint law enacted in 2011.

When Doucet reviewed the state legislation, she discovered her school district “was way ahead of the game.”
A 2012 review of state policies on seclusion and restraint found the majority of AASA members have local policies and procedures that exceed the requirements set by state boards and legislatures. Eighty percent of respondents said all school personnel trained to use seclusion and restraint also received training in nonviolent crisis intervention techniques, although only 18 states mandate some school personnel be trained in conflict de-escalation and prevention. Seventy percent of respondents indicated the majority of school personnel are trained in seclusion and restraint or nonviolent crisis interventions annually, even though only five states require periodic re-training of staff on seclusion and restraint interventions. Eight percent of survey respondents said school personnel are trained in these techniques and interventions more than once a year.

 READ MORE:

Restraint in Schools: Benefits Beyond Safety
Common Feelings
Little variation exists among how school districts attempt to reduce the use of seclusion and restraint. Findings from a survey of several hundred AASA members in May 2012 suggested the use of seclusion and restraint interventions by school personnel is fairly uniform. For example, 97 percent of survey respondents said their school personnel end the use of seclusion and restraint as soon as the emergency ends; 97 percent said their districts do not use mechanical restraints on students under any circumstances; and 94 percent said their school personnel monitor students “at all times” when they are in seclusion.

Widespread agreement exists among behavioral experts and school administrators on the use of School-wide Positive Behavioral Interventions and Supports, or SWPBIS. They consider this the most effective way to ensure seclusion and restraint are used at a bare minimum and only when alternative approaches to de-escalate student risk behavior have been tried.

However, this system can be expensive to implement. The Technical Assistance Center on Positive Behavioral Interventions and Supports estimated that a midsize district interested in adopting the first stage of SWPBIS at 15 schools should expect to spend between $5,000 and $10,000 per school over a two-year period. This takes into consideration implementation costs, direct transition costs like substitute teachers, expenses associated with building a new or modified data system, as well as staff turnover, extra training or hiring of a district coordinator.

Although SWPBIS is a recognized prevention model endorsed by the U.S. Department of Education, for improving school climate, student behavior and the use of seclusion and restraint, school districts have limited funds with which to support professional development and training. The Safe and Drug-Free Schools Program, the single federal funding stream available to school districts to implement such measures, was discontinued in 2009.

Forty-three percent of superintendents surveyed by AASA indicated the elimination of this funding has made it “considerably more difficult” to offer training or programs such as positive behavioral support systems and nonviolent crisis interventions.

Train the Trainers
There are many programs — programs with the abbreviations of MANDT, CPI and PCMA being the most popular — that school districts purchase to train school personnel in nonviolent crisis intervention techniques as well as how to appropriately use seclusion and restraint. The length of training, the frequency of the sessions and the costs associated with materials vary substantially.

Each of these programs enables a train-the-trainer approach. This allows school districts to send a team to a multiday institute, where team members receive the most intensive training and then return to the district to act as instructors for other school personnel.

Sheila Donahue, who works as a behavior specialist in the Syracuse, N.Y., City School District, attended a training conducted by CPI in 2007. During that school year, Syracuse appointed Donahue to implement a program to train a handful of the 4,000 educators in the district on proper use of nonviolent crisis intervention techniques with students.

At first, Syracuse focused solely on training staff who were working with students in an alternative program for youngsters with severe emotional and behavioral disabilities. But the district subsequently expanded the program to schools where workers’ compensation claims related to the handling of student behavior were the steepest. By targeting nonviolent crisis intervention training to the 3 to 4 percent of school personnel engaged with students most likely to injure staff, the district saved approximately $480,000 in workers’ compensation costs over a two-year period ending in 2009. The savings do not reflect associated costs, such as the hiring of classroom substitutes.

As a result of the targeted training, the Syracuse City Schools found teacher retention also improved, and Donahue attributes the cost savings to the district’s investment in nonviolent crisis intervention training — rather than the use of School-wide Positive Behavioral Interventions and Supports and other behavior-related supports the district offered.

While SWPBIS is a proven method for reducing problem behavior — within any student population, a small range of students will have disabilities that may cause them to be unusually volatile and reactive. As public schools educate more students with emotional and behavioral disabilities in inclusive settings, the need to physically intervene through the use of restraint or seclusion only grows, even when appropriate interventions are in place.

In a report last March, AASA documented a few examples of why school personnel felt physical restraint was a rare but necessary component of educating students with severe emotional and behavioral disorders in an inclusive environment. For example, a medium-size school district in Georgia told about a student named “Dave” that illustrated how seclusion and restraint techniques enabled him to remain in the public school system, rather than be forced into a private, segregated school facility. Although the district had implemented SWPBIS for four years and had personnel from general education and special education trained in de-escalation strategies and appropriate restraint, the use of physical restraint was still necessary for this student.

Unreasonable Legislation
Unfortunately, legislation introduced in the last Congress by Sen. Tom Harkin, D-Iowa, would prohibit the use of seclusion entirely and limit the use of physical restraint in a way that would undermine school safety. AASA firmly believes that passage of this legislation would significantly increase personnel and administrative costs without ensuring a safer school environment for students and school personnel.

More significantly, AASA believes the legislation would lead to a greater number of students with severe emotional and behavioral disabilities being educated exclusively in segregated, nonpublic settings because school districts would refuse to educate them if they could not guarantee the safety of other students and staff.

AASA opposes the federal legislation because it lacks a reasonable option for intervening when a student’s behavior is dangerous and unmanageable; forbids school personnel from secluding a student for any reason, even if this technique has proven effective in the past; and contains burdensome meeting, record-keeping and reporting requirements. Harkin’s bill also prohibits schools and parents from incorporating any planning for the use of seclusion and restraint into a student’s individualized education program, even when past behavior has indicated a need to use these interventions.

Disability-rights organizations promote the need for federal seclusion and restraint restrictions, but AASA questions why federal policy is necessary when 41 states have legislation, regulations or administrative guidance on the use of seclusion and restraint.

“The goal of state and local policy must be to end the inappropriate use of seclusion and restraint, not to eliminate the appropriate use of these necessary interventions,” said Bruce Hunter, AASA’s associate executive director of advocacy, policy and communications. “This legislation does not do that.”

While a well-designed crisis management system in conjunction with SWPBIS does much to ameliorate the need for intensive interventions, many special education administrators and teachers will admit they don’t want to rule out the option to use these measures in emergency situations. James Stevens, director of special education in the East Wenatchee, Wash., school district, summarized the situation this way: “When a public education staff member opts for student seclusion or restraint, it is at the end of many pro-active attempts of de-escalation. I know this, because in addition to being a certified school psychologist and special education director, I am a fair, reasonable, calm and compassionate person who would rather not spend my days restraining a child. Nonetheless, I have restrained students in the past and bear the literal scars of student violence.”

If superintendents and their fellow administrators are pro-active in developing effective local seclusion and restraint policies and invest in training their staff members in techniques that reduce the need to use intensive interventions, AASA can continue to advocate for local and state handling of seclusion and restraint. However, if school districts are reactive in developing these policies and reluctant to do anything more than what is required by state guidance or regulations, it will be difficult to fight against the groundswell of support for costly, administratively burdensome, ill-designed federal policy.

Sasha Pudelski is AASA government affairs manager. E-mail: spudelski@aasa.org

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