ME: Classroom crises - How does a teacher respond?

From the Portland Press Herald:

October 11, 2010

A group of city educators gets training to defuse situations when students become angry or upset.

By Kelley Bouchard kbouchard@mainetoday.com
Staff Writer

PORTLAND - Peter McCormack moves around the room as if the information he's about to share can't wait to get out.

In front of him are 17 Portland teachers, education technicians, social workers and others who have signed up for a three-day training course in how to use Therapeutic Crisis Intervention techniques in school.

Some of them will stay for a fourth day to learn how to do physical restraints or holds, a controversial practice allowed in Maine schools when students are in danger of hurting themselves or others and all other efforts to calm them have failed.

"You are the best tool in any crisis situation," McCormack tells the teachers. "There are so many things you can do before resorting to physical intervention. Restraint truly is the intervention of last resort."

McCormack invited The Portland Press Herald to cover a recent training session in the hope of shedding light on a practice that is being scrutinized here in Maine and across the nation. Pressure is on to reduce the use of restraints, and many Maine schools are responding with increased training in alternative intervention methods and positive student supports.

In general, the methods call for building personal relationships with students, setting clear expectations for behavior, recognizing when and why students may be struggling or acting out, and responding with logic and compassion rather than anger and contempt.

"When a child is upset, it didn't happen out of nowhere, folks," McCormack says during the first day of training. "There's always a cause. It may not be right in front of you, but it's there. You have to know your child. And depending on your response, you're either going to throw gasoline on the situation or you're going to throw water on the situation."

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Superintendent Jim Morse has charged McCormack and East End Principal Marcia Gendron, also newly appointed from her former job as principal of Reiche Community School, with greatly reducing the number of restraints at East End.

"More often than not, the use of restraint only escalates a situation," Morse said. "Our goal is to keep kids in school and keep them learning. We want teachers to have the skill sets in their toolbox to de-escalate disruptive situations and help youngsters refocus."

Morse said he wants to reduce the overall number of physical restraints in Portland schools, which last year included seven at Longfellow Elementary School, four at Riverton Community School, three at Lyseth Elementary School and two at Moore Middle School. Nine other Portland public schools reported no restraints.

Moreover, Morse said, he wants all Portland schools to have a more positive and personal approach to behavior and discipline. With that in mind, he's moving to adopt a federally endorsed system known as Positive Behavioral Interventions and Supports across Maine's largest school district.

For the full article, please follow the link: http://www.pressherald.com/news/its-teachers-time-to-learn-handling-a-classroom-crisis_2010-10-11.html

Maine - Restraint & Seclusion Regulations Explained

PHYSICAL RESTRAINTS IN SCHOOLS - By Gerry Huber, Advocate
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Maine Department of Education regulations allow for the use of “therapeutic restraint” in situations when necessary to prevent injury or harm to the student or others. Many districts view the use of restraints as an indication that the school has failed to develop and implement an appropriate educational plan for the child in question. Advocates believe that parents should similarly consider use of physical intervention with their child as a “red flag” suggesting something is lacking in the educational program their child is receiving.

Children who are eligible for special education must have an Individualized Education Plan (IEP). That plan should address problematic behaviors in a comprehensive behavior intervention plan. If the school does not have the appropriate expertise available to develop the plan themselves, the plan should be developed with the input of outside professionals who are knowledgeable in the field. The plan should emphasize positive supports aimed at reducing or eliminating problem behaviors. The behavior plan should be detailed in the overall IEP and should be implemented by all staff consistently.

Every school district must have a written policy on restraint use. The policy must adhere to state regulations that require that incidents be documented thoroughly and that parents be notified with each use of restraint “as soon thereafter as practical.”

Districts are required to ensure that individuals who implement or who supervise the implementation of therapeutic restraint have completed an appropriate training program. Appropriate training is defined as a program in the “identification and de-escalation of potentially harmful behaviors and the safe use of passive physical therapeutic restraints.” Examples of such training programs include NAPPI, Mandt, and Therapeutic Crisis Intervention Training. There are others as well. Local districts can choose which program they wish to implement to meet the training requirement.

Some states have banned the practice of prone, or face down, restraints due to death and serious injuries that have occurred. Prone restraints are not currently banned in Maine, although many of the training programs cited above rule out the use of prone restraints in their curriculum. Parents should keep informed about all restraint practices employed with their children. Any parent would be well within their rights to insist that some practices, such as prone restraint, be deemed inappropriate for use with their child.

If a child has been restrained in a school setting, we suggest that the parents discuss the issue with school officials. Parents should insist on the development and implementation of a plan for appropriate and positive interventions that will reduce negative behaviors and that will teach appropriate replacement behaviors. A parent should be looking for the elimination of physical restraints altogether, through use of the positive supports.

If the school’s current team doesn’t have the expertise to address a challenging situation, a parent has the right to and should ask the school to bring in an outside consultant who is skilled at developing creative and effective behavior intervention plans.

The Disability Rights Center shares the concerns of many Maine families regarding the extent to which restraints are used in school settings. We believe the current regulations are in many ways overly broad and do not sufficiently protect the health and safety of Maine students. DRC is exploring policy interventions to address these issues, and would welcome the input and ideas of families whose children have been restrained in school settings.

If your child is experiencing physical restraints in school and you need assistance in working with the school district to eliminate the use of those restraints, feel free to contact us at 1-800-452-1948 or at advocate@drcme.org. If your child experienced physical restraints in the past and you want to share your experiences and ideas on how restraints in school settings can be eliminated, please email us at advocate@drcme.org or write to us at DRC, P.O. Box 2007, Augusta, ME 04338.

If you want to review the State’s school related restraint regulations, they can be found on the web at:

http://www.maine.gov/sos/cec/rules/05/chaps05.htm (Chapter 33).


Gerry Huber is an advocate at DRC who provides educational advocacy.

Maine - Chapter 33

http://www.maine.gov/sos/cec/rules/05/chaps05.htm

05-071 DEPARTMENT OF EDUCATION

Chapter 33: REGULATIONS GOVERNING TIMEOUT ROOMS, THERAPEUTIC RESTRAINTS AND AVERSIVES IN PUBLIC SCHOOLS AND APPROVED PRIVATE SCHOOLS

Section 1. In General
1.1 Policy and Purpose
These regulations establish standards for the use of separate, isolated timeout rooms and the use of therapeutic restraint when the behavior of a student presents a risk of injury or harm to the student or others, significant property damage, or seriously disrupts the educational process and other less intrusive interventions have failed. Nothing in these rules would require an SAU or approved private school to construct or use a timeout room or implement a program of therapeutic restraint. Schools that are licensed as residential child care facilities or mental health treatment centers and governed by other state standards shall comply with the higher standard. Nothing within these rules limit the protections of individual students under applicable special education standards.

1.2 Local Policy Required
Each School Administrative Unit and each approved private school shall develop local policies and procedures relating to the use of timeout rooms and therapeutic restraint prior to initiating such interventions in their schools. School Administrative Units and approved private schools which have local policies and / or permit the use of timeout rooms and / or therapeutic restraint shall revise existing policies or develop policies consistent with these rules within 90 calendar days of the effective date of these rules. These policies and procedures shall be developed with input, as needed, from representatives of related disciplines such as special education, psychology, school psychology, social work and / or counseling. SAUs and approved private schools shall establish a process to review, at least annually, the use of timeout rooms and therapeutic restraint and to make recommendations as necessary to the governing body for changes in local policy.

1.3 Documentation
Each use of a timeout room and / or therapeutic restraint shall be documented. The documentation shall include at a minimum, the date and time of initiation, the time of termination, the student, the location, the antecedent events prior to the behavioral episode, the behavior that resulted in the use of timeout and / or therapeutic restraint, the type of intervention, and the staff person(s) involved in the use of timeout and / or therapeutic restraint. This documentation shall be written as soon as practical after the incident and provided to the program administrator or designee within 2 school days of the incident. The program administrator or designee shall inform the parents or guardians of the use of timeout or therapeutic restraint as soon thereafter as practical.

Section 2. Definitions

2.1 Timeout
Removal to a timeout room is a therapeutic intervention to bring the behavior of a student presenting a risk of injury or harm to self or others or significant property damage under control. The purpose of the use of timeout rooms is to reduce the frequency and intensity of harmful behaviors, to permit the student to regain his or her composure and to assist the student to return to the learning environment. Timeout includes requiring a student to leave the classroom, playground, or other educational setting and go to a designated timeout room for a period of time specified in these rules and local policy. For purposes of these rules, timeout is limited to a designated timeout room. The term does not include disciplinary actions imposed by a school administrator or teacher / staff imposed behavior interventions. Examples of disciplinary actions imposed by a school administrator include, but are not limited to, detention and "in school suspension." Examples of teacher / staff imposed behavior interventions include, but are not limited to, requesting a student to sit in a "quiet chair" within the classroom, directing a student to put his / her head on their desk, sending a student to the principal's office, etc. These exclusions may not be used to circumvent the intent of these rules.

2.2 Timeout Room
A time out room is a designated space, separate from a student’s classroom, which is used to isolate a student from his or her peers and school activities. All timeout rooms will meet the standards specified in these rules.

2.3 Therapeutic restraint
Therapeutic restraint is the use of a therapeutic physical intervention with a student by an appropriately trained staff person to prevent injury or harm to the student or others. Title 20-A, §4009 permits staff to use a reasonable degree of force to intervene and control emergency situations. Nothing in these regulations applies to any conduct by a school official that would otherwise be covered by the legal protections of 20-A MRSA §4009.


Section 3. Time Out Room
3.1 Limitations on the use of timeout room
Timeout rooms shall be used consistent with local policy to reduce dangerous behaviors and only after less intrusive interventions have failed. Timeout rooms may be used for either an emergency intervention or as part of an intervention plan. Local policy will determine when a pattern of the use of timeout rooms requires referral to the appropriate intervention team and / or the development of an individualized intervention plan. Parents or guardians shall be involved in the development of any individualized intervention plans. Timeout rooms shall not be used for punitive purposes, staff convenience or to control minor misbehavior.

3.2 Time limitations on the use of timeout rooms
Use of timeout rooms shall be limited in duration to that time necessary to allow the student to compose him/herself and return to the classroom. The use of timeout shall be consistent with local policy and the student’s individualized intervention plan but may not exceed one hour. If a student is still presenting dangerous behaviors after this period the use of timeout may be continued with written authorization of the program administrator or designee.

3.3 Adult supervision
Students in a timeout room shall be directly observed at all times by a staff person.

3.4 Physical Characteristics
Timeout rooms will be a minimum of 60 square feet with adequate light, heat, and ventilation and of normal room height. The door to the timeout room may not be locked, latched or secured in any way that would prevent the student from exiting the room. An unbreakable observation window shall be located in a wall or door to permit continuous observation of the student and any staff member in the timeout room.

Section 4. Therapeutic restraint

4.1 Permitted uses of therapeutic restraint
Appropriately trained staff may physically intervene with a student to prevent injury or harm to the student or others. Therapeutic restraint may be used for either an emergency intervention or as part of an intervention plan. The intervention shall occur only after less intrusive efforts to control the behavior have been attempted. The intervention shall involve the least amount of physical contact necessary, shall be implemented consistent with the standards of a training program as specified in §4.5 and consistent with local policy. The use of therapeutic restraint shall require the presence of at least two adults at all times. Title 20-A, §4009 permits a single individual to use a reasonable degree of force in emergency situations to control or remove the student.

4.2 Time limits on the use of therapeutic restraint
Use of therapeutic restraint shall be limited in duration consistent with local policy and the student’s individualized intervention plan but may not exceed one hour. If a student is still presenting dangerous behaviors after this time period, the use of therapeutic restraint may be continued with written authorization of the program administrator or designee.

4.3 Exclusions
Protective equipment or devices that are part of a treatment plan prescribed by a physician or psychologist for treatment of a chronic condition are not prohibited by these regulations.

4.4 Mechanical or Chemical Restraints Prohibited
The term "therapeutic restraint" does not include mechanical or chemical restraints used to control or modify a student's behavior. Chemical restraints include but are not limited to medication, noxious sprays or gases. Prescribed medication administered by a health care provider consistent with a student's health care plan are permitted. Mechanical restraints are prohibited.

4.5 Training
Except as provided by Title 20-A, §4009, individuals who implement or supervise the implementation of therapeutic restraint shall have successfully completed an appropriate training program in the identification and de-escalation of potentially harmful behaviors and the safe use of passive physical therapeutic restraints. This training includes, but is not limited to, Non-Abusive Psychological and Physical Intervention (NAPPI), Mandt, Crisis Prevention Institute, Therapeutic Crisis Intervention Training, and other training as determined appropriate by local policy.

Section 5. Aversives

5.1 Use of Aversive Therapy or Treatment Prohibited
A school administrative unit or an approved private school may not use aversive therapy or treatment in order to modify or change a student's behavior. Aversive therapy or treatment includes the application of unusual, noxious or potential hazardous substances, stimuli or procedures to a student. Such substances, stimuli and procedures include but are not limited to: water spray, hitting, pinching, slapping, noxious fumes, extreme physical exercise, costumes or signs.

STATUTORY AUTHORITY: 20-A MRSA §4502(5)(M)

EFFECTIVE DATE:
July 29, 2001 - added as sub-section 17(D) to Chapter 125, "Basic Approval Standards: Public Schools and School Units".

EFFECTIVE DATE:
April 27, 2002 - filing 2002-104 accepted March 28, 2002: sub-section 125.17(D) removed from Chapter 125 and established as new Chapter 33, "Regulations Governing Timeout Rooms, Therapeutic Restraints and Aversives in Public Schools and Approved Private Schools"