Seclusion & Restraint: Prevention, Practices, Policy, & Politics

1. Seclusion & Restraint: Prevention, Practices, Policy, & Politics Tim Lewis, Ph.D. University of Missouri OSEP Center on Positive Behavioral Interventions and Supports pbis.org

2. This Afternoon • Big Ideas – prompts to learn more • Issues with the use of Seclusion & Restraint • Recommendations • Alternatives • Prevention • Understanding function of behavior • Instructional strategies & Environmental supports

3. The Key Behavior is functionally related to the Teaching Environment

4. Big Ideas • Build Positive Behavior Support Plans that teach pro-social “replacement” behaviors • Create environments to support the use of pro-social behaviors • School-wide • Classroom • Individual student

5. Starting Point…. • Educators cannot “make” students learn or behave • Educators can create environments to increase the likelihood students learn and behave • Environments that increase the likelihood are guided by a core curriculum and implemented with consistency and fidelity

6. Seclusion & Restraint

7. Restraint To restrain involves ‘‘preventing from doing, exhibiting, or expressing something,’’ and restraining means ‘‘limiting, restricting or keeping under control’’ (Webster, 2009)

8. Restraint • ShouldNotbe viewed as a behavior reductive technique • Response to crisis when imminent danger or harm is present • Only with trained personnel • Document, Document, Document • Use information to prevent from happening again

9. Seclusion “Seclusion is the involuntary confinement of a student alone in a room or area from which the student is physically prevented from leaving” (CCBD, 2009) NOT: • Appropriate use of “Time Out” • Brief removal from access to reinforcement • “Cool down” or “Safe spot”

10. Seclusion • Limited to no research demonstrating behavior reductive potential • Associated with side effects including: • Aggression • Escape/Avoidance • Withdrawal

11. Danger with Both • Negative Reinforcement --- Contingent removal of an aversive stimulus upon the occurrence of the target behavior that is associated with an increase in future occurrences of that behavior • In Plain English = danger of being overused, misused, and abused because educators are “reinforced” for removing students displaying significant problem behavior

12. Further Danger • Negative student outcomes • Potential for physical harm (adults and students) • Legal, social, & moral sanctions • Use does not teach

14. Good News • 70% of state policies recommend pro-active and positive behavior support strategies • Professional organizations (e.g., CCBD, NAMI, OSEP center on PBIS) also recommend pro-active and positive behavior support strategies

15. Even Better News • Missouri has invested in building a state-wide regional network of support to districts/schools in positive behavior support pbismissouri.org

16. For More Information • CCBD’s Position summary on the use of physical restraint procedures in school settings. • CCBD’s Position summary on the use of seclusion in school settings. • MSBA / DESE Model Policy • Michigan Department of Education Supporting student behavior: Standards for the emergency use of seclusion and restraint.

17. 7 Minutes • Review the self assessment pp. 21-24 of handout • With your neighbor, discuss strengths/concerns • Identify sessions during the institute than can assist in addressing concerns

18. So What do We do Instead Evidence/Research-Based Practices

19. Research-Based Practices • Academic • “Effective instruction” • Antecedent / setting modifications • Peer tutoring • Direct Instruction • Self-management targeting academic related skills • Opportunities to Respond

20. Research-Based Practices • Behavior • Environmental modifications and supports • Contingent positive performance based feedback • Self Management • Social Skill Instruction (with maintenance and generalization strategies)

21. Research-Based Practices • Related Supports* • Comprehensive case management / wrap around • Family supports/ parent training *limited empirical support

22. Systems Systems Putting Research-Based Practices In Place Systems Prevention, Early Intervention and Individualized Student Supports through Positive Behavior Support

23. Remember…. • Educators cannot “make” students learn or behave • Educators can create environments to increase the likelihood students learn and behave • Environments that increase the likelihood are guided by a core curriculum and implemented with consistency and fidelity

24. The Challenge • The “core curriculum” is often “punishment” to try and reduce problem behavior in school • However, “punishing” problem behaviors (without a proactive support system) is associated with increases in (a) aggression, (b) vandalism, (c) truancy, and (d) dropping out.

25. Good News… Research reviews indicate that the most effective responses to school violence are: • Social Skills Training • Academic Restructuring • Behavioral Interventions = instructional strategies - “teaching”

26. School-wide Positive Behavior Support SW-PBS is a broad range of systemic and individualized strategies for achieving important social and learning outcomes while preventing problem behavior OSEP Center on PBIS

27. Essential Features at the School Level • Teams of educators within the school (administrator) • Data-based decision making • Instructional Focus • Teach & Practice • Acknowledge student mastery of social skills • Positive Feedback

28. Social Competence & Academic Achievement Positive Behavior Support OUTCOMES Supporting Decision Making Supporting Staff Behavior DATA SYSTEMS PRACTICES Supporting Student Behavior

29. Academic Systems Behavioral Systems • Intensive, Individual Interventions • Individual Students • Assessment-based • High Intensity • Intensive, Individual Interventions • Individual Students • Assessment-based • Intense, durable procedures • Targeted Group Interventions • Some students (at-risk) • High efficiency • Rapid response • Targeted Group Interventions • Some students (at-risk) • High efficiency • Rapid response • Universal Interventions • All students • Preventive, proactive • Universal Interventions • All settings, all students • Preventive, proactive Designing School-Wide Systems for Student Success 1-5% 1-5% 5-10% 5-10% 80-90% 80-90%

30. Universal School-Wide Features • Clearly define expected behaviors (Rules) • All Settings • Classrooms • Procedures for teaching & practicing expected behaviors • Procedures for encouraging expected behaviors • Procedures for discouraging problem behaviors • Procedures for data-based decision making • Family Awareness and Involvement

31. Benton Elementary School

32. RAH – at Adams City High School(Respect – Achievement – Honor)

33. Academic Systems Behavioral Systems • Intensive, Individual Interventions • Individual Students • Assessment-based • High Intensity • Intensive, Individual Interventions • Individual Students • Assessment-based • Intense, durable procedures • Targeted Group Interventions • Some students (at-risk) • High efficiency • Rapid response • Targeted Group Interventions • Some students (at-risk) • High efficiency • Rapid response • Universal Interventions • All students • Preventive, proactive • Universal Interventions • All settings, all students • Preventive, proactive Designing School-Wide Systems for Student Success 1-5% 1-5% 5-10% 5-10% 80-90% 80-90%

34. Tier II (small group) • Efficient and effective way to identify at-risk students • Screen • Data decision rules • Informal assessment process to match intervention to student need & function of problem behavior • Small group Social Skill Instruction • Self-management • Academic Support • Part of a continuum – must link to universal school-wide PBS system

35. Academic Systems Behavioral Systems • Intensive, Individual Interventions • Individual Students • Assessment-based • High Intensity • Intensive, Individual Interventions • Individual Students • Assessment-based • Intense, durable procedures • Targeted Group Interventions • Some students (at-risk) • High efficiency • Rapid response • Targeted Group Interventions • Some students (at-risk) • High efficiency • Rapid response • Universal Interventions • All students • Preventive, proactive • Universal Interventions • All settings, all students • Preventive, proactive Designing School-Wide Systems for Student Success 1-5% 1-5% 5-10% 5-10% 80-90% 80-90%

36. Tier III (individualized support) • When small group not sufficient • When problem intense and chronic • Driven by Functional Behavioral Assessment • Connections to Mental Health and Community Agencies • Part of a continuum – must link to universal school-wide PBS system

37. Why Invest in SW-PBS? • Change in school discipline system creates an environment that promotes, teaches, and acknowledges appropriate behavior • Reduction in problem behavior resulting in less staff time dealing with problems, more student time in the classroom • Improved academic performance • Improved social behavior performance • Improved school safety, mental health connections, and individual interventions

38. Centennial School

39. Centennial School Police Contacts

40. The Connect Point Across the Continuum Classroom Management & Instruction

41. Basic Steps • Focus on what you want students to do “instead” (replacement behaviors) • Look for patterns of behavior that suggest “functional relationships” • Teach replacement behavior and provide multiple opportunities to practice • Deliver high rates of positivefeedback/same similar outcome as problem behavior when students display replacement behavior

42. Setting up the Classroom Environment Establishing expectations: • What do I want my classroom to look like? • How do I want children to treat me as a person? • How do I want children to treat one another? • What kind of information or values do I want to communicate to students about being an adult, an educator, a woman or a man in today's society? • How do I want children to remember me when the last day of school ends and I am no longer part of their daily lives? • How can I change my instruction to help pupils develop the skills I am trying to teach? Bottom line = ask if students have pre-requisite and requisite skills to succeed based on each of the answers – if not, teach and practice

43. Classroom Essentials* • Classroom expectations & rules defined and taught • Procedures & routines defined and taught • Continuum of strategies to acknowledge appropriate behavior in place and used with high frequency (4:1) • Continuum of strategies to respond to inappropriate behavior in place and used per established school-wide procedure • Students are actively supervised • Students are given multiple opportunities to respond (OTR) • Activity sequence promotes optimal instruction time and student engaged time • Instruction is differentiated based on student need

44. “Learning Errors” How are you going to prevent it from happening again? • Minors addressed quickly and quietly/privately • School wide procedures for majors are followed • Upon “return,” debrief and plan to prevent • What does student need? • What can we do to help?

45. “Appropriate” Responses to Learning Errors • If student removed from learning environment, create opportunities to teach/practice replacement behaviors • Natural consequences (is it “punishment” from the student’s perspective) • Changes within and across environments to promote appropriate behavior

46. A Classroom Example…

47. Study Basics • Subject: • Seven years old • Identified with EBD and ADHD • Setting • General education 2nd grade classroom with 19 other students • One licensed teacher and one student teacher • Concern • Student exhibits high rates of off-task • Student shouts out answers and questions and comments at high rates and often inappropriate

48. “Function of Behavior” • Descriptive (interviews and teacher reported ABC/ Scatterplot data) • Function identified as Attention • Significant antecedents: multiple step direction and group settings • Very High rates of both problem behaviors reported/ inconsistency in accuracy of data collection

49. “Environment Assessment” Significant variables: • clarity of expectations & directions • consistency of expectations • accessibility of class schedules • lack of enforced procedures (especially regarding to hand raising and verbalizations or entire class)