Tuesday, December 1, 2009

MD: School seclusion rooms come out of the dark

By Marge Neal
News-Post Staff

Originally published November 27, 2009

A planned addition to Oakdale Elementary School will include classrooms, restrooms, a faculty room -- and a seclusion room.

Seclusion rooms are used to isolate a child -- most often a special-education student -- who poses a physical threat to himself or others, or is disrupting the educational process, Pam Pencola told the Frederick County Board of Education this week.

After looking over the Oakdale plans, board members recently asked school officials to explain the use of seclusion rooms, which are seldom acknowledged or discussed in public.

"A very small percentage" of students need this kind of intervention on a regular basis, said Pencola, the school system's director of special education and psychological services.

She described the use of a seclusion room as a "very serious step" and said staff members employ many other strategies before isolating a student.

The school system already has seclusion rooms at Carroll Manor, Lewistown and Middletown elementary schools, Oakdale Middle, Gov. Thomas Johnson High and Rock Creek School. One is being built at Middletown Primary School.

At Rock Creek, the room is used for students with severe cognitive impairments who may also have behavior disorders, according to the report to board members.

At the other schools, the seclusion room is used for students in the Challenges or Pyramid programs. Challenges serves students ages 3 to 21 who have autism or severe communicative disorders, Pencola said. Pyramid is a K-12 program for students with significant emotional and behavioral needs.

At Lewistown Elementary, which houses the county's only elementary Pyramid program, parental consent is required to use the seclusion room as a behavior modification tool, principal Amy Schwiegerath said.

"A parent must sign the permission slip or be a part of the team decision-making process for the seclusion room to be used," she said.

The principal is notified every time the room is used, Schwiegerath said. A log is kept of all uses, and an incident report is filled out each time seclusion or restraint is used. Parents are to be notified within 24 hours of these techniques being used on their children. Lewistown also holds a staff debriefing after each use.

The seclusion room at Lewistown is about six feet square with a ceiling about eight feet high. The walls are covered with carpet from floor to ceiling. The floor is tiled with linoleum. In the ceiling is a light fixture, as well as a camera that allows constant observation of the student. The light switch is outside the room. The room is free of electrical outlets or anything else that could harm a student.

A calming place

Frederick County Public Schools use seclusion rooms in accordance with the Code of Maryland Regulations, which provides the legal definition and authority for their use. The FCPS policy on the rooms mirrors the state's parameters.

At Lewistown, students in the Pyramid program benefit from a team approach that includes general educators, special educators, administrators and clinical social workers, Schwiegerath said.

"The kids who come here come through the county's (individualized education plan) process," she said. "It's a highly structured program."

Thirty-three students are in Pyramid. Lewistown has another 160 students in its general education program.

Karen Williams, a licensed clinical social worker at Lewistown, said the seclusion room is used once or twice a day for "true seclusion events." The room might also be used at the request of a child.

"Our students know how to self-advocate," she said. "A student will ask for five or 10 minutes in the room to calm themselves down.

"A student might ask to have five minutes in the room with the door open and the lights out."

When a child with psychiatric or behavioral disorders is out of control, the cause is often sensory overload, Williams said. Putting a child in the room takes away the stimulation that has the child worked up and allows him or her to decompress.

The school system uses the Crisis Prevention Institute's techniques for de-escalation, Williams said.

The institute is an international training organization that specializes in the safe management of disruptive and assaultive behavior, according to its website.

Williams is a CPI-certified trainer and provides training to her colleagues.

"We must be annually trained and annually refreshed," she said. "And that's according to COMAR and FCPS."

Parents, when they first come to visit the Lewistown Pyramid program, are hesitant about the restraint and seclusion techniques, Schwiegerath said.

"But it is a last resort and is safety-oriented. We use this room for the safety of the child and the safety of others around him."

"The concept of seclusion and restraint always makes people nervous -- and it should," Williams said. "It's a very serious intervention, and should only be used to match the level of seriousness of the behavior being disciplined.

"We employ this tool in a professional, appropriate and positive manner. It's a necessary thing at times."

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