Module 5: Severe Behavior Texas Behavior Support Initiative: Module 51.

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 RequirementsDefinition 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)


Legal RequirementsUse 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)

4


Legal RequirementsDefinition 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)


Legal RequirementsClarification 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)

6


Legal RequirementsClarification 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)7


Legal RequirementsTraining 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 58

Legal RequirementsDocumentation of Restraint

Day of restraint

Within 1 school day

Timely Manner

•Administrator/ designee (written or verbal)

•Parent --good faith effort (verbal)

•Parent---placed in mail or otherwise provided (written)

•Student Special Education Eligibility Folder for ARD consideration (written)

9 Texas Behavior Support Initiative: Module 5

Legal RequirementsNotification/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)


Legal RequirementsData Collection Requirement

• Cumulative data regarding use of restraint reported through Public Education Information Management System (PEIMS)

TAC 89.1053(d)


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


Pre-Correcting Problem Behavior

• Prevention or interruption of predictable problem behavior


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


Utilizing Effective Correction Procedures

• The goal is to interrupt the chain of behavior and assist the student in engaging in the present activities


Managing Off-Task Behavior

• Determine the motivation for the off-task behavior. Is it attention-getting or avoidance related?


Managing Provocative or Challenging Behavior

• The student’s behavior may escalate or become defused, depending on how the teacher addresses the problem


Responding to Disrespectful Behavior

• Delay responding• Avoid escalating

prompts• Respond calmly• Deliver appropriate

negative consequence


Managing Agitation

• Identify the signs of agitation

• Utilize

techniques to defuse it


Establishing Limits and Defusing Defiance

• Pre-teach procedures

• Present choices non-confrontationally

• Follow through

LIMITS


Managing Threats and Intimidating Behavior

Disengage and Get Assistance


Texas Behavior Support Initiative: Module 5 22Texas Behavior Support Initiative: Module 5 22

Phases of Escalating Behavior


Phase One: Calm

• On-task

• Follows rules and expectations

• Responsive to praise

• Initiates behavior

• Goal oriented

• Socially appropriate


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


Phase Two: Triggers/AntecedentsSchool-Based• Conflicts• Denial of

something needed• Something

negative is inflicted

• Changes in routine• Provocations

• Pressure• Interruptions• Ineffective

problem- solving• Academic errors• Corrections


Phase Two: Triggers/Antecedents

Non-School-Based• Family disruption• Health problems• Abuse• Nutrition• Sleep• Substance abuse• Gang involvement


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”


Managing the Agitation Phase

• Teacher support• Space• Choices• Preferred activities• Teacher proximity• Independent

activities

• Movement activities• Involvement of the

student• Relaxation activities


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


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


Phase Five: Peak

• Serious destruction of property

• Assault• Self-abuse• Severe tantrums• Hyperventilation• Screaming, running,

violence


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


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)


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


Phase Seven: Recovery

Return to Phase One: Calm

Assist student in returning to normal

activities


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


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

Crisis Management

• Systems response

• Safe strategies


Systems Response

• Planning

• Action

• Follow-up

39


Safe Strategies for Managing Behavioral

Crisis

• Before

• During

• After

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


Interventions After the Behavior Emergency

• Restore the environment

• Conduct debriefing session

• Develop problem-solving action plan

• Utilize additional strategies for chronic offenders

Follow-Up

• Gathering information

• Delivering consequences

• Providing support to victim as needed

• Restoring environment as needed

• Conducting a debriefing session


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?


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


Activity: Crisis ManagementSchoolwide 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


Activity: Crisis ManagementClassroom 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


Activity: ABC DefinitionsAntecedent 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


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


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


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

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


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


Module 5: Severe Behavior Texas Behavior Support Initiative: Module 51.

Documents

Transcript of Module 5: Severe Behavior Texas Behavior Support Initiative: Module 51.