Module 5: Severe Behavior Texas Behavior Support Initiative: Module 5 1

Module 5: Agenda Legal Requirements Defusing Behavior Crisis Management Critical Attributes Case Study Texas Behavior Support Initiative: Module 5 2

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 student’s body. TAC 89.1053(b)(2) 3 Texas Behavior Support Initiative: Module 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) Texas Behavior Support Initiative: Module 5 4

Legal Requirements Definition of Emergency Emergency means a situation in which a student’s behavior poses a threat of: imminent, serious physical harm to the student or others; or imminent, serious property destruction TAC 89.1053(b)(1) Texas Behavior Support Initiative: Module 5 5

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 student’s hand), prevent a potentially harmful action (e.g., running into the street), teach a skill, or provide comfort TAC 89.1053(f) Texas Behavior Support Initiative: Module 5 6

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) Texas Behavior Support Initiative: Module 5 7

Legal Requirements Training on Use of Restraint Who? By 4/1/03—Core campus team (administrator and general/special education personnel likely to use restraint) After 4/1/03—Personnel 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) Texas Behavior Support Initiative: Module 5 8

Legal Requirements Documentation of Restraint Day of restraint Within 1 school day Timely Manner Student Special Education Eligibility Folder for ARD consideration (written) Administrator/ designee (written or verbal) Parent --good faith effort (verbal) Parent---placed in mail or otherwise provided (written) Texas Behavior Support Initiative: Module 5 9

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) Texas Behavior Support Initiative: Module 5 10

Legal Requirements Data Collection Requirement Cumulative data regarding use of restraint reported through Public Education Information Management System (PEIMS) TAC 89.1053(d) 2003-04 Texas Behavior Support Initiative: Module 5 11

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 Texas Behavior Support Initiative: Module 5 12

Pre-Correcting Problem Behavior Prevention or interruption of predictable problem behavior Texas Behavior Support Initiative: Module 5 13

Pre-Correction Procedures Identify context and predictable behavior Specify expected behavior Modify context Conduct behavior rehearsal Provide strong reinforcement for expected behaviors Prompt expected behaviors Monitor the plan Texas Behavior Support Initiative: Module 5 14

Utilizing Effective Correction Procedures The goal is to interrupt the chain of behavior and assist the student in engaging in the present activities Texas Behavior Support Initiative: Module 5 15

Managing Off-Task Behavior Determine the motivation for the off-task behavior. Is it attention-getting or avoidance related? 16 Texas Behavior Support Initiative: Module 5

Managing Provocative or Challenging Behavior The student’s behavior may escalate or become defused, depending on how the teacher addresses the problem Texas Behavior Support Initiative: Module 5 17

Responding to Disrespectful Behavior Delay responding Avoid escalating prompts Respond calmly Deliver appropriate negative consequence Texas Behavior Support Initiative: Module 5 18

Managing Agitation Identify the signs of agitation Utilize techniques to defuse it Texas Behavior Support Initiative: Module 5 19

Establishing Limits and Defusing Defiance Pre-teach procedures Present choices non-confrontationally Follow through LIMITS Texas Behavior Support Initiative: Module 5 20

Managing Threats and Intimidating Behavior Disengage and Get Assistance Texas Behavior Support Initiative: Module 5 21

Phases of Escalating Behavior Texas Behavior Support Initiative: Module 5

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

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 Texas Behavior Support Initiative: Module 5

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 Texas Behavior Support Initiative: Module 5

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

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” Texas Behavior Support Initiative: Module 5

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

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 Texas Behavior Support Initiative: Module 5

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 Texas Behavior Support Initiative: Module 5

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

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 Texas Behavior Support Initiative: Module 5

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) Texas Behavior Support Initiative: Module 5

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 Texas Behavior Support Initiative: Module 5

Assist student in returning to normal activities Phase Seven: Recovery Return to Phase One: Calm Assist student in returning to normal activities Texas Behavior Support Initiative: Module 5

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

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 Texas Behavior Support Initiative: Module 5

Crisis Management Systems response Safe strategies Texas Behavior Support Initiative: Module 5 38

Systems Response Planning Action Follow-up Texas Behavior Support Initiative: Module 5 39

Safe Strategies for Managing Behavioral Crisis Before During After Texas Behavior Support Initiative: Module 5 40

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 Texas Behavior Support Initiative: Module 5

Interventions After the Behavior Emergency Restore the environment Conduct debriefing session Develop problem-solving action plan Utilize additional strategies for chronic offenders Texas Behavior Support Initiative: Module 5

Follow-Up Gathering information Delivering consequences Providing support to victim as needed Restoring environment as needed Conducting a debriefing session Texas Behavior Support Initiative: Module 5 42

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? Texas Behavior Support Initiative: Module 5 43

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 Texas Behavior Support Initiative: Module 5 44

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

Activity: Crisis Management Schoolwide Procedures Before District Crisis Management Plan Train staff Organize school crisis team Develop system for requesting assistance During Implement safety procedures Support crisis team Secure other students/staff After Implement documentation procedures Debrief crisis team members Texas Behavior Support Initiative: Module 5

Activity: Crisis Management Classroom Procedures Before Develop procedure for room clears Select location and assignments for students Teach staff to use room clears Teach room clears to students Communicate with parents, staff, and students During Implement plan Monitor student health and safety After Document incident Follow debriefing plan for students Texas Behavior Support Initiative: Module 5

Activity: ABC Definitions Antecedent Behavior Consequence Function During cooperative learning and group activities, when reprimanded by teacher and/or when teased by peers Student runs from the classroom Replacement: Student able to leave group setting to work independently Teacher chases student and sends student home Escape or avoid task and/or peers Texas Behavior Support Initiative: Module 5

Activity: ABC Interventions* *Not to all be used at same time Antecedent Behavior Consequence Adapt instruction-indiv. instruction Expectations-allow student choice of indep. or smaller group Provide safe area to use when feels like running Direct instruction-social skills training Practice/modeling how to cope with teasing Replacement behavior-teach appropriate method to ask to work independently Training to reduce anxiety from interactions with peers Reinforcement for staying in area—contract, point system, self-management Texas Behavior Support Initiative: Module 5

Activity: Systemic Interventions Classroom Schoolwide Pair with sympathetic peer Teach and model tolerance Allow students to choose group members Mentoring program Bullying prevention programs Social skills training groups Texas Behavior Support Initiative: Module 5

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 Texas Behavior Support Initiative: Module 5

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 Texas Behavior Support Initiative: Module 5 52

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 Texas Behavior Support Initiative: Module 5 53