Guidelines for Minimizing the Use of Seclusion and Restraint

TULSA PUBLIC SCHOOLS

SPECIAL EDUCATION & STUDENT SERVICES

AUGUST 2011

Guidelines for Minimizing theUse of Seclusion and Restraint

Conditions on the use of physical restraint and/or seclusion

May not be used for the purpose of managing behavior

May be used only in an emergency and when there is animminent risk of harm or danger.

Imminent risk of harm or danger: The immediate and impendingthreat of a person causing serious bodily injury to self or others.

Serious bodily injury involves:

A substantial risk of death;

Extreme physical pain;

Protracted and obvious disfigurement; or

Protracted lost or impairment of the function of a bodily member,organ or mental faculty.

May be used only as a last resort

Conditions on the use of physical restraint and/or seclusion

Should never be used if the student has a knownmedical/physical condition that would make theintervention dangerous for the student

May be used only by staff members trained inMandt, First Aid and CPR

Seclusion

Involuntary confinement of a student alone in a roomor area that the student is physically prevented fromleaving.

The student doesn’t choose to be there.

No one else is allowed to be in the room with thestudent.

The student is forced to remain in the assignedroom/area and is not allowed to leave.

Conditions on the use of seclusion forstudents with disabilities

Seclusion must end when the student is not longer athreat of harm or danger to self or others.

Periods of seclusion may be extended past the pointof imminent threat of harm only if waiting for lawenforcement to arrive.

Never attempt to transport a student to a seclusionroom unless the student can safely be moved

While in seclusion the student must be continuouslymonitored visually and aurally.

Conditions on the use of seclusionfor students with disabilities

The student will be:

Permitted to use the restroom upon request

Provided water to drink upon request

Staff will take immediate action at signs of medicaldistress.

Seclusion rooms must be inspected at least annuallyfor adherence to safety requirements.

Physical Restraint

Any method of one or more persons limiting orrestricting another person’s freedom of movement,physical activity, or normal access to his/her body.It is a means for managing that person’s movement,reconstituting behavioral management andestablishing and maintaining safety for the student,other students and staff.

Physical restraint does NOT include:

Physical escort (temporary touching or holding ofthe hand, wrist, arm, shoulder or back for thepurposes of escorting a student who is acting out towalk to a safe location)

Rifton chair (when used for the purpose for whichthey are designed)

Conditions Governing Use of Physical Restraint

May be used only in emergency situations and

When the behavior of a student presents animminent risk of harm to the student or others

When the student’s actions show the immediate andimpending ability to cause serious bodily injury

Only as a last resort after less restrictive methods ofde-escalating the risk of injury have failed

Conditions Governing Use of Physical Restraint

The restraint ends when the risk of danger or harmhas passed

The level of restraint should not exceed what isnecessary to protect persons from imminent bodilyinjury

Only persons who are certified as trained in all of thefollowing may be involved in the physical restraint ofa student:

First aid

CPR

Mandt

Conditions Governing the Use of Physical Restraint

Mechanical restraints include the use of any deviceas a restraint to restrict a student’s freedom ofmovement for the purpose of discipline or behaviormanagement or as a consequence for misbehavior.

Mechanical restraints are prohibited.

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• Mechanical and chemicalrestraints

• Prone physical restraint

• Maneuvers that placepressure or weight on thechest, sternum, lungs,diaphragm, neck, throat orback.

To report or to not report…

Child Safety Restraint Systems (CSRS) are NOT considered

physical restraints under the Guidelines.

Examples of CSRS include:

Adaptive devices or mechanical supports used to achieveproper body position, balance, or alignment to allow greaterfreedom of mobility than would be possible without the use ofsuch devices or mechanical supports;

Vehicle safety restraints when used as intended during thetransport of a student in a moving vehicle;

Restraints for medical immobilization; or

Orthopedically prescribed devices that permit a student toparticipate in activities without risk of harm.

To report or to not report…

Pepper spray directed at an individual with adisability is a chemical restraint that is completelyprohibited.

Additional Instructions for Completing thePhysical Restraint Documentation Form(OSDE Form 12) and SeclusionDocumentation Form (OSDE Form 13)

OSDE Form 12 and OSDE Form 13

Completely fill out the student demographic informationat the top of them form. Do not leave any sections blank.

Location-school name and site number

Describe the location utilized for the seclusion:

List the specific hallway, classroom number, cafeteria,dean’s office, library, timeout room, etc. Describe theroom or setting (i.e. approximate size, number of doorsand windows, furniture).

School personnel involved in incident:

List each staff member involved by name and title.This includes the witnesses and/or observers.

Describe the student’s activity and behavior immediatelypreceding the behavior that prompted the use of physicalrestraint or seclusion:

This section will serve the purpose of identifying and effectively dealing with the behavior in thefuture. Staff will use this information to identify possible root causes or origins of the conflict.Describe the event or set of events, which precedes a behavior.

In other words, consider the “who”, “what”, “when” and “where” of the situation.

Questions to Consider:

What did the student do or say?

What was school personnel doing and/or saying?

What was happening in the environment around the student?

What were the expectations?

Have you seen the student reliably perform those expectation in past? (describe)

Who else was in the room?

What were others in the room doing?

What were peers doing and/or saying?

What were other adults doing and/or saying?

When did the behavior occur? (i.e. time of day, class period, activity)



NOTE: The purpose of any behavior is to communicate something. Focus on what the student wastrying to communicate.

Describe efforts of school personnel to de-escalate the situation, andalternatives to physical restraint that were utilized prior to the use ofphysical restraint or seclusion.

Explain the problem solving methods utilized. Describe the verbal and non-verbal strategies

staff used in their efforts to de-escalate the situation.

Examples:

 Use Diversion Or Distraction

 Channel Feelings Into Activity

 Engage In Side-dialogue or Cross-dialogue With Others

 Use Reflective Listening - Paraphrasing

 Using Accurate Words

Gaining Cooperation

 Calm tone of voice

 Reminded student of consequences

 Use “I” messages

 Kept communication simple

 Efforts to redirect the student

 Avoid the student’s personal space

 Gradual and graded system of alternatives

Provide a description of the physical restraint utilized:

Explain and thoroughly describe the specific techniquesutilized (Mandt System).

Examples:

One-Person, Standing Side Body Hug Restraint

One-Person, One-Arm Restraint

Two-Person, One-Arm Restraint and Side Body Hug

One-Person Kneeling, Child Standing

Other (explain)

Note: Include a description of the intensity and durationof the restraint.

Describe the actions of the student and school personnel thatoccurred during the physical restraint or seclusion:

Describe how the observer/witness continually checked for signs ofphysical distress.

Describe the behaviors the student manifested that indicated he/sheremained an imminent risk of danger.

Describe the de-escalation techniques used while the student was inthe restraint.

Indicate how often the restraint was loosened to check for de-escalation and possible release of restraint.

List all efforts used to keep the student safe.

Note: The witness/ observer is a person responsible for looking ateveryone involved in a physical restraint and making suggestions toprotect all persons from possible danger or harm. Once the risk ofimminent danger has passed, the restraint must end. All physicalinteraction should be terminated as soon as the need for protectionis over.

Describe observed student and school employee behaviors thatfollowed the physical restraint or seclusion:

The Mandt System dictates that staff keeps a vigilant eye on the studentduring and following the restraint because the student is in a veryvulnerable state.

Monitor, observe and document any signs of distress such as flushed orashen face, rapid or shallow breathing, confusion or disorientation,headaches. Refer to the MANDT System manual for a complete list ofsigns of distress.

Note: This documentation should include information about how longthe student was monitored following the restraint.

Describe de-escalation techniques and interventions utilizedfollowing the physical restraint or seclusion:

Describe any supportive measures taken to ensure continued de-escalation.

Examples:

Avoid surprises; keep the person informed as to what is going to happen.

Act in a caring, professional manner.

Move slowly and smoothly.

Structured cooling off with removal of or from the upsetting stimulus andstress.

Offer appropriate options but avoid "either/or" choices.

Communicate understanding.

Use diversion and/or distraction.

Channel feelings in a positive direction or into a creative activity, such asmusic, exercise, games, art, etc.

Describe any injuries to the student or schoolemployee:

Check the student and staff for injuries and signs ofpossible distress. The school nurse or healthassistant should examine the individuals as soon aspossible after the incident has ended, when suchexamination is deemed necessary.

NOTE: Do not leave this blank even if there were noinjuries.

Describe future alternatives to physicalrestraint that will be utilized:

Prior to the debriefing meeting, school professionals shouldhave reviewed the information about this incident and allprevious incidents in order to identify patterns in thestudent’s behavior. Discuss these patterns during thedebriefing meeting, in order to identify future alternatives touse of physical restraint.

It is important to get parental input and support.

One of the functions of behavior is to cope with demands andto respond to them in ways that meet the needs of the peoplemaking the requests, etc., and in ways that meet theindividual’s own needs as well.

Finding of debriefing meeting:

These reports are vital in maintaining effectivesupports for people as they enable the team tocommunicate, to modify ongoing support plans orintervention strategies, and to develop preventivemeasures of potential crisis.

Parent Participation in the Debriefing Meeting

The debriefing meeting must occur within two school days after eachincident.

Follow the standard procedures outlined in the Policies and Proceduresin Oklahoma, 2007 (Amended May 2010) to ensure parentparticipation.

Document efforts to gain parent participation on the Record of ParentContact (OSDE Form 2).

If the parent is unable to attend, a meeting may be held via telephoneconference or a home visit.

Documentation

Retain a copy of the documentation in the student’sconfidential file and provide the parents a copy.

A copy of each Physical Restraint Documentation (OSDEForm12) and Seclusion Documentation (OSDE Form 13)must be sent to Compliance Monitoring Coordinator,Cheryl Henry in Special Education and Student Services.These forms are necessary for data tracking purposes.

FURTHER QUESTIONS

Cheryl Henry

henrych@tulsaschools.org

918-746-6545

Linda Geier

geierli@tulsaschools.org

918-746-6307