Considerations for Seclusion and Restraint Use in School‐wide Positive Behavior Supports
Robert Horner and George SugaiCo‐directors OSEP Technical Assistance Center on Positive Behavioral Interventions and SupportApril 29, 2009 PDF Downlaod (160kb)
Seclusion and restraint refer to safety procedures in which a student is isolated from others (seclusion) or physically held (restraint) in response to serious problem behavior that places the student or others at risk of injury or harm. Concern exists that these procedures are prone to misapplication and abuse placing students at equal or more risk than their problem behavior. Concerns include the following:
- Seclusion and restraint procedures are inappropriately selected and implemented as“treatment” or “behavioral intervention,” rather than as a safety procedure.
- Seclusion and restraint are inappropriately used for behaviors that do not place the student or others at risk of harm or injury (e.g., noncompliance, threats, disruption).
- Students, peers, and/or staff may be physically hurt or injured during attempts to conduct seclusion and restraint procedures.
- Risk of injury and harm is increased because seclusion and restraint are implemented by staff who are not adequately trained.
- Use of seclusion and restraint may inadvertently result in reinforcement or strengthening of the problem behavior.
- Seclusion and restraint are implemented independent of comprehensive, function‐based behavioral intervention plans.
- The majority of problem behaviors that are used to justify seclusion and restraint could be prevented with early identification and intensive early intervention. The need for seclusion and restraint procedures is in part a result of insufficient investment in prevention efforts.
- Seclusion and restraint can be included as a safety response, but should not be included in a behavior support plan without a formal functional behavioral assessment (a process used to identify why the problem behavior continues to occur).
- Seclusion and restraint should only be implemented (a) as safety measures (b) within a comprehensive behavior support plan, (c) by highly trained personnel, and (d) with public, accurate, and continuous data related to (1) fidelity of implementation and (2) impact on behavioral outcomes (both increasing desired and decreasing problem behaviors).
School‐wide Positive Behavior Support
School‐wide Positive Behavior Support (SWPBS) is a systems approach to establishing the whole‐school social culture and intensive individual behavior supports needed for schools to achieve social and academic gains while minimizing problem behavior for all students. SWPBS is NOT a specific curriculum, intervention, or practice, but a decision making framework that guides selection, integration, and implementation of scientifically‐based academic and behavioral practices for improving academic and behavior outcomes for all students. A central feature of SWPBS is implementation of behavioral practices throughout the entire school. SWPBS defines practices that all students experience in all parts of the school and at all times of day.SWPBS emphasizes four integrated elements: (a) socially valued and measurable outcomes, (b) empirically validated and practical practices, (c) systems that efficiently and effective support implementation of these practices, and (d) continuous collection and use of data for decision‐making. These four elements are operationalized by five guiding principles:
- Invest first in prevention to establish a foundation intervention that is empirically validated to be effective, efficient and sustainable.
- Teach and acknowledge appropriate behavior before relying on negative consequences.
- Use regular “universal screening” to identify students who need more intense support and provide that support as early as possible, and with the intensity needed to meet the student’s need.
- Establish a continuum of behavioral and academic interventions for use when students are identified as needing more intense support.
- Use progress monitoring to assess (a) the fidelity with which support is provided and (b) the impact of support on student academic and social outcomes. Use data for continuous improvement of support.
Research Supporting Implementation of School‐wide Positive Behavior Support
- Schools are able to implement SWPBS as evidenced by more than 9000 schools using SWPBS across the nation.
- Schools that implement SWPBS demonstrate reductions in problem behavior and improved academic outcomes.
- Preliminary evaluation data indicate that more intensive individual student behavior support is perceived as more effective (and less likely to be needed) when SWPBS is implemented.
- Evaluation (but not experimental) data indicate that implementation of SWPBS is associated with reduction in the number of instances in which intensive interventions (including seclusion and/or restraint) are perceived as needed, increases the effectiveness of comprehensive interventions, and improvement in the maintenance of behavior support gains.
The development of this paper was supported in part by a grant from the Office of Special Education Programs, U.S. Department of Education (H029D40055). Opinions expressed herein are the author’s and do not reflect necessarily the position of the US Department of Education, and such endorsements should not be inferred. Contact: Rob Horner (Robh@uoregon.edu), OSEP Center on Positive Behavioral Interventions and Supports (www.pbis.org), University of Oregon, Eugene.
Families across the country are challenging a system they say has not only failed to educate and protect their children, but also endangered their lives.
Dozens of lawsuits have been filed against schools and districts as parents speak out against physical disciplinary methods that have injured or killed their children, ABC News reports. The families claim that an extensive abuse of harsh methods to restrain misbehaving students -- many with special needs -- has become a chronic problem in U.S. schools.
"I know I won't feel him hug me anymore, or say, 'I love you, mommy,'" Sheila Foster told ABC News of her son Corey, who died in April of cardiac arrest while being forced off a basketball court by school staff. "Someone has to be held accountable for this because my son is dead. And this shouldn't happen anymore to another child, to another family.'"
Foster has filed suit against Leake & Watts School, a residential center for at-risk youth in Yonkers, N.Y.
ABC's family interviews reflect the findings of a federal report released in March. Education Department officials found that schools physically restrained students 39,000 times during the 2009-2010 school year, and about 70 percent of cases involved students with special needs.
Schools also are reducing nonviolent intervention training, according to a survey by the American Association of School Administrators, as states lose grants and face budget cuts.
There are currently no federal standards for the use of seclusion and restraint in schools, and only 17 states have explicit laws that limit the use of such punitive measures.
Last year, Sen. Tom Harkin (D-Iowa) sponsored a bill that would ban the use of seclusion and restraint in schools, barring extreme circumstances. He sought to include it in a rewrite of the No Child Left Behind federal education law, but the process was stalled in Congress. Rep. George Miller (D-Calif.) filed a similar bill in the House.
Both proposals faced opposition from school officials, who said that the plans were too restrictive. The legislation, they said, didn't allow enough options for school employees to handle students with special needs. They also noted more children are being funneled into the public education system from special centers.
In recent years, schools have been criticized for the use of techniques including shock therapy and isolation booths -- otherwise known as "seclusion" or "scream" rooms -- and for restraining students in bags.
School officials have said such techniques are effective in calming unruly students, and are necessary to ensure that they don't hurt themselves or others. But the children and their parents say it's anything but therapeutic.
"It makes things worse because that's how I get angrier and angrier and suddenly I feel like bursting into flames," one boy told ABC News.
Experts are calling for teacher training in public schools as parents seek legislative support to curtail seclusion and restraint.
In a July Congressional hearing, parent Debbie Jackson testified to the effectiveness of nonviolent behavior modification at her son's Pennsylvania school.
The school reformed its previously common use of physical restraint, instead using a point system that awarded good behavior. Now, Jacksons's son, Elijah, wins awards for writing and art. "I was not used to Elijah being treated as a person," Jackson told members of Congress. "[The school] held Elijah responsible for his choices."