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Module 5: Severe Behavior

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Module 5: Severe Behavior

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    2. Module 5: Agenda Legal Requirements Defusing Behavior Crisis Management Critical Attributes Case Study

    3. Legal Requirements Definition of Restraint Restraint means the use of physical force or a mechanical device to restrict the free movement of all or a portion of the students body. TAC 89.1053(b)(2)

    4. Texas Behavior Support Initiative: Module 5 4 Definition of Restraint Restraint means the use of physical force or a mechanical device to significantly restrict the free movement of all or a portion of the students body. TEC 37.0021(b)(1) The word significantly was added to the definition of restraint. No further explanation was given. Read slide. The word significantly was added to the definition of restraint. No further explanation was given. Read slide.

    5. Legal Requirements Use of Restraint Restraint can only be used in an emergency with the following limitations: Limited to reasonable force necessary to address emergency Discontinued when emergency no longer exists Implemented to protect health/safety of student and others Shall NOT deprive student of basic human necessities TAC 89.1053(c)

    6. Legal Requirements Definition of Emergency Emergency means a situation in which a students behavior poses a threat of: imminent, serious physical harm to the student or others; or imminent, serious property destruction TAC 89.1053(b)(1)

    7. Legal Requirements Clarification Regarding Restraint Restraint does NOT include: Physical contact or appropriately prescribed adaptive equipment to promote normative body positioning and/or physical functioning Limited physical contact with a student to promote safety (e.g., holding a students hand), prevent a potentially harmful action (e.g., running into the street), teach a skill, or provide comfort TAC 89.1053(f)

    8. Legal Requirements Clarification Regarding Restraint (continued) Restraint does NOT include: Limited physical contact or appropriately prescribed adaptive equipment to prevent a student from engaging in ongoing, repetitive self-injurious behaviors Seat belts and other safety equipment used to secure students during transportation TAC 89.1053(f)

    9. Legal Requirements Training on Use of Restraint Who? By 4/1/03Core campus team (administrator and general/special education personnel likely to use restraint) After 4/1/03Personnel using restraint who have not received prior training What? Prevention/de-escalation techniques Alternatives to restraint Professionally accepted practices and standards regarding behavior management and use of restraint TAC 89.1053(d)

    10. Legal Requirements Documentation of Restraint

    11. Legal Requirements Notification/Documentation Requirements Name of student Name of staff member(s) administering restraint Date of restraint Time began/ended Location of restraint Description of activity student engaged in immediately preceding restraint Behavior that prompted restraint De-escalation efforts/alternatives attempted Parent contact/notification TAC 89.1053(d)

    12. Legal Requirements Data Collection Requirement Cumulative data regarding use of restraint reported through Public Education Information Management System (PEIMS) TAC 89.1053(d)

    13. Texas Behavior Support Initiative: Module 5 13 2003-04 PEIMS Requirement Documentation of restraint incidents required in the 2003-04 PEIMS data Written Summary of Restraint Use form revised to reflect PEIMS elements Beginning with the 2003-2004 school year cumulative data regarding the use of restraint must be reported through the Public Education Information Management System (PEIMS). The Written Summary of Restraint Use form provided in the TBSI materials has been updated to include all documentation elements required for PEIMS. The revised form is available through the Regional Education Service Center (ESC), Special Education Director or may be accessed on the Region IV ESC website at www.esc4.net/resources/catalog/?categoryId=6. The purpose of the form is three-fold: Documentation of the restraint event Notification to the parent of the restraint event Collection of PEIMS data elements for the 435 Report Beginning with the 2003-2004 school year cumulative data regarding the use of restraint must be reported through the Public Education Information Management System (PEIMS). The Written Summary of Restraint Use form provided in the TBSI materials has been updated to include all documentation elements required for PEIMS. The revised form is available through the Regional Education Service Center (ESC), Special Education Director or may be accessed on the Region IV ESC website at www.esc4.net/resources/catalog/?categoryId=6. The purpose of the form is three-fold: Documentation of the restraint event Notification to the parent of the restraint event Collection of PEIMS data elements for the 435 Report

    14. Defusing Behavior Pre-correcting problem behavior Utilizing effective correction procedures Managing off-task behavior Managing provocative or challenging behavior Responding to disrespectful behavior Managing agitation Establishing limits and defusing defiance Managing threats and intimidating behavior

    15. Pre-Correcting Problem Behavior Prevention or interruption of predictable problem behavior

    16. Pre-Correction Procedures Identify context and predictable behavior Specify expected behavior Modify context Conduct behavior rehearsal

    17. Utilizing Effective Correction Procedures The goal is to interrupt the chain of behavior and assist the student in engaging in the present activities

    18. Managing Off-Task Behavior Determine the motivation for the off-task behavior. Is it attention-getting or avoidance related?

    19. Managing Provocative or Challenging Behavior The students behavior may escalate or become defused, depending on how the teacher addresses the problem

    20. Responding to Disrespectful Behavior Delay responding Avoid escalating prompts Respond calmly Deliver appropriate negative consequence

    21. Managing Agitation Identify the signs of agitation Utilize techniques to defuse it

    22. Establishing Limits and Defusing Defiance Pre-teach procedures Present choices non-confrontationally Follow through

    23. Managing Threats and Intimidating Behavior Disengage and Get Assistance

    24. Texas Behavior Support Initiative: Module 5 24

    25. Texas Behavior Support Initiative: Module 5 25 Phase One: Calm On-task Follows rules and expectations Responsive to praise Initiates behavior Goal oriented Socially appropriate

    26. Texas Behavior Support Initiative: Module 5 26 Signs of Escalating Behavior Questioning and arguing Non-compliance and defiance Verbal abuse Disruption Bothering others Destruction of property Whining and crying Limit testing Threats and intimidation Avoidance and escape Off task behavior

    27. Texas Behavior Support Initiative: Module 5 27 Phase Two: Triggers/Antecedents School-Based Conflicts Denial of something needed Something negative is inflicted Changes in routine Provocations Pressure Interruptions Ineffective problem- solving Academic errors Corrections

    28. Texas Behavior Support Initiative: Module 5 28 Phase Two: Triggers/Antecedents Non-School-Based Family disruption Health problems Abuse Nutrition Sleep Substance abuse Gang involvement

    29. Texas Behavior Support Initiative: Module 5 29 Phase Three: Agitation Increase in Behavior Eyes dart Language non-conversational Busy hands In and out of group Off-task/On-task Decrease in Behavior Stares into space Language subdued Hands contained Withdraws from group Off-task, Frozen

    30. Texas Behavior Support Initiative: Module 5 30 Managing the Agitation Phase Teacher support Space Choices Preferred activities Teacher proximity Independent activities Movement activities Involvement of the student Relaxation activities

    31. Texas Behavior Support Initiative: Module 5 31 Phase Four: Acceleration Questioning & arguing Non-compliance & defiance Off-task Provoking students Compliance with accompanying inappropriate behaviors Criterion problems Whining & crying Avoidance & escape Threats & intimidation Verbal abuse

    32. Texas Behavior Support Initiative: Module 5 32 Managing the Acceleration Phase Limit verbal instructions and commands Allow student to express emotion Provide more space Assess the need for assistance Maintain a calm demeanor Mentally review the emergency plan Limit number of persons interacting with student

    33. Texas Behavior Support Initiative: Module 5 33 Phase Five: Peak Serious destruction of property Assault Self-abuse Severe tantrums Hyperventilation Screaming, running, violence

    34. Texas Behavior Support Initiative: Module 5 34 Managing the Peak Phase Assess safety needs of self and all students Implement a behavior support plan Institute emergency plan Assess need for restraint Request assistance Coordinate response with other staff Use room clears

    35. Texas Behavior Support Initiative: Module 5 35 Phase Six: De-escalation Confusion Reconciliation Withdrawal Denial Blaming others Sleeping Responsive to directions Responsive to manipulative or mechanical tasks Avoidance of discussion (unless there is occasion to blame others)

    36. Texas Behavior Support Initiative: Module 5 36 Managing the De-escalation Phase Monitor for health and safety of all involved Monitor student for re-escalation of behavior Allow time and space Provide opportunity for non-judgmental discussion Provide easy/concrete tasks Determine appropriate time to de-brief with student and staff

    37. Texas Behavior Support Initiative: Module 5 37 Phase Seven: Recovery Return to Phase One: Calm

    38. Texas Behavior Support Initiative: Module 5 38 Things to Avoid Getting in the students face Discrediting student Nagging or preaching Arguing Engaging in power struggles Tugging or grabbing the student Cornering the student Shouting or raising voice

    39. Texas Behavior Support Initiative: Module 5 39 TIPS Move slowly and deliberately Keep reasonable distance Minimize body language Speak privately Speak calmly Speak respectfully Use simple language Acknowledge cooperation Withdraw if problems escalate

    40. Crisis Management Systems response Safe strategies

    41. Systems Response Planning Action Follow-up

    42. Safe Strategies for Managing Behavioral Crisis Before During After

    43. Texas Behavior Support Initiative: Module 5 43 Interventions During the Behavioral Emergency Removal of the other students Removal of the student who is in crisis Defusing verbal aggression and intimidation Display non-involvement behavior

    44. Texas Behavior Support Initiative: Module 5 44 Interventions After the Behavior Emergency

    45. Follow-Up Gathering information Delivering consequences Providing support to victim as needed Restoring environment as needed Conducting a debriefing session

    46. Debriefing Session What did you do? Where, when, and why did the problem behavior occur? What could you do differently next time? What do you need to do next? What is the action plan How do we check on how you are doing?

    47. Utilizing Additional Strategies for Chronic Offenders Additional Assessment Functional Behavioral Assessment Mental Health or Other Health Assessment Assessment of Risk Factors Specific Behavior Support Plan Follow-up

    48. Texas Behavior Support Initiative: Module 5 48 Critical Attributes Development Program Review Additional Considerations

    49. Texas Behavior Support Initiative: Module 5 49 Activity: Crisis Management

    50. Texas Behavior Support Initiative: Module 5 50 Activity: Crisis Management

    51. Texas Behavior Support Initiative: Module 5 51 Activity: ABC Definitions

    52. Texas Behavior Support Initiative: Module 5 52 Activity: ABC Interventions* *Not to all be used at same time

    53. Texas Behavior Support Initiative: Module 5 53 Activity: Systemic Interventions

    54. Texas Behavior Support Initiative: Module 5 54 Activity: Additional Considerations Additional Assessments Consider additional evaluation for written language and/or emotional concerns Additional Interventions Referral to community programs for medical and supportive services LRE Issues Appropriate interventions will avoid the need for a more restrictive environment PBS Issues Positive interventions will reduce the frequency of behavior emergencies and need for restraint

    55. Big Ideas! Defuse behavior by interrupting the crisis behavior early in the behavior chain Understand the phase of escalation in student behavior to better respond to the behavior Prepare a schoolwide or system response to crisis behavior

    56. Big Ideas! Plan for behavioral emergencies Train staff in the use of professionally accepted methods of physical restraint Prevent or reduce the use of physical restraint by using positive interventions

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