Student Restraint Policy & Parental Consent Information

Discussion:  In its history, White Oak School has not had to conduct a single physical restraint of a student. This record of restraint-free operation is based on reliable preconditions.  Students are admitted to White Oak School primarily because they have a language-based learning disability in the areas of reading, spelling, written language and related skill areas or other communication-based challenges. The school specifically does not admit students with histories of primary social-emotional or behavioral disorders, because that is not the focus of our services.  A history or evidence of injurious, explosive or physically aggressive behaviors – the type of behaviors, in other words, that could conceivably lead to the need for a restraint – would preclude the student’s enrollment at the school.  Further, the school’s supportive teaching methodology, plus its one-to-three teacher-student ratio, create an environment of student enfranchisement, support, and individual recognition – the sort of environment that reduces any likelihood of aggressive or antisocial behavior.

Regardless of the school’s history and experience with this issue, state regulations nonetheless require that we distribute the school’s restraint policy to all parents annually, and that we also must obtain your annual written consent to this policy.  Our policy, then, is very brief:  Through the nature of our admitted population, through the attentive work of our faculty, through the enfranchisement that students feel in their program, and through the school’s policy of de-escalating any points of conflict, the school does not support, need or engage in restraint of students.  The school’s complete policy (Criterion 9.4) can be found below.

 We thank you for your cooperation with this regulation.

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PS Criterion #9.4 Physical Restraint

White Oak School Physical Restraint Policy

White Oak School administers physical restraint only in emergency situations of last resort when needed to protect a student and/or member of the school community from assault or imminent, serious, physical harm and with extreme caution in order to prevent or minimize any harm to the student as a result of the use of physical restraint.

Procedures and Training

(1)     Procedures. The School uses a variety of methods regarding appropriate responses to student behavior that may require immediate intervention. Such procedures are annually reviewed and provided to School staff and made available to parents/guardians of enrolled students. Such procedures include, but are not limited to:

• (a) Methods for preventing student violence, self-injurious behavior, and suicide, including de-escalation of potentially dangerous behavior occurring among groups of students or with an individual student. Due to the overall size of the school community, small class sizes and the 1:1 Tutorial period each day, students have the opportunity to develop strong, supported relationships with the School’s staff. The School’s philosophy, goals and curriculums foster a community of inclusive, respectful learners. Expressive and receptive language skills are specifically developed across curriculum areas, and important social pragmatics and communication skills are focused on in Oral Expression and in speech therapy. The School’s Director of Student Support Services provides a safe, supported space for conflict resolution, restorative practice, and social-emotional learning.
• (b)  Methods for engaging parents in discussions about restraint prevention and the use of restraint solely as an emergency procedure;
• School-home communication is critical for engaging parents in ensuring a safe school environment. Parents receive a copy of the School’s restraint policy at the beginning of each school year. Faculty and staff work closely with parents and guardians to provide support and guidance to students in order to prevent behaviors resulting in the need for restraint. Phone calls, conferences, emails, and Team meetings are some ways that home-school communication is established to accomplish this.
• (c)  A description and explanation of the program's alternatives to physical restraint; the school uses de-escalation techniques as an alternative to physical restraint, including providing the student time with a trusted faculty or staff member, space to de-escalate in a safe, supervised environment, reminders to access previously-practiced techniques, support from the Director of Student Support Services, or access to a preferred task to assist with regulation of emotions and reintegration into the school community.
• (d)  We prohibit medication restraint, mechanical restraint, prone restraint unless permitted pursuant to 603 CMR 46.03(1)(b), seclusion, and the use of physical restraint in a manner inconsistent with 603 CMR 46.00;

(2)     Required training for all staff. Such training occurs within the first month of each school year and, for employees hired after the school year begins, within a month of their employment. Training includes information on the following:

• (a)     White Oak's restraint avoidance policy and its prohibition of any prone, mechanical, medical, or seclusion restraint.
• (b)    Intervention that may preclude the need for restraint, including de-escalation of problematic behaviors;
• (c)    Types of restraints and related safety considerations, including information regarding the increased risk of injury to a student when an extended restraint is used;
• (d)    Administering physical restraint in accordance with known medical or psychological limitations and/or behavioral intervention plans applicable to an individual student; and
• (e)    Identification of program staff who have received in-depth training pursuant to 603 CMR 46.03(3) in the use of physical restraint.

(3)     In-depth staff training in the use of physical restraint. At the beginning of each school year, the Head of School or their designee identifies the program staff that are authorized to serve as a school-wide resource to assist in ensuring proper administration of physical restraint.

(4)     Content of in-depth training. In-depth training in the proper administration of physical restraint includes, but is not limited to:

• (a)     Appropriate procedures for preventing the need for physical restraint, including the de-escalation of problematic behavior, relationship building and the use of alternatives to restraint;
• (b)    A description and identification of dangerous behaviors on the part of students that may indicate the need for physical restraint and methods for evaluating the risk of harm in individual situations in order to determine whether the use of restraint is warranted;
• (c)    The simulated experience of administering and receiving physical restraint, instruction regarding the effect(s) on the person restrained, including instruction on monitoring physical signs of distress and obtaining medical assistance;
• (d)    Instruction regarding documentation and reporting requirements and investigation of injuries and complaints; and
• (e)    demonstration by participants of proficiency in administering physical restraint.

Determining When Physical Restraint May Be Used

(1)     Use of restraint. Physical restraint may be used only in the following circumstances by trained personnel: in emergency situations of last resort, after other lawful and less intrusive alternatives have failed or been deemed inappropriate;

(2)     Limitations on use of restraint. Physical restraint shall be limited to the use of such reasonable force as is necessary to protect a student or another member of the school community from assault or imminent, serious, physical harm.

(3)   Safest method. A person administering physical restraint shall use the safest method available and appropriate to the situation subject to the safety requirements set forth in 603 CMR 46.05(5). Floor restraints, including prone restraints otherwise permitted under 603 CMR 46.03(1)(b), shall be prohibited unless the staff members administering the restraint have received in-depth training according to the requirements of 603 CMR 46.04(3) and, in the judgment of the trained staff members, such method is required to provide safety for the student or others present.

(4)     Prohibitions. Physical restraint is prohibited in the following circumstances:

• (a)  As a means of punishment, or
• (b)  As a response to property destruction, disruption of school order, a student's refusal to comply with a school rule or staff directive, or verbal threats that do not constitute a threat of imminent, serious, physical harm.

(5)     Duration of restraint. A person administering physical restraint shall discontinue such restraint as soon as possible. If, due to unusual circumstances, a restraint continues for more that twenty (20) minutes, it shall be considered an "extended restraint" for purposes of the reporting requirements in 603 CMR 46.06.

(6)     Safety requirements. Additional requirements for the use of physical restraint:

• (a)     No restraint shall be administered in such a way that the student is prevented from breathing or speaking. During the administration of a restraint, a staff member shall continually monitor the physical status of the student, including skin color and respiration. A restraint shall be released immediately upon a determination by the staff member administering the restraint that the student is no longer at risk of causing imminent physical harm to him or herself or others.
• (b)    Restraint shall be administered in such a way so as to prevent or minimize physical harm. If, at any time during a physical restraint, the student demonstrates significant physical distress, the student shall be released from the restraint immediately, and school staff shall take steps to seek medical assistance.
• (c)  If a student is restrained for a period longer than 20 minutes, program staff shall obtain the approval of the Head of School. The approval shall be based upon the student's continued agitation during the restraint justifying the need for continued restraint.
• (d)    Program staff shall review and consider any known medical or psychological limitations and/or behavioral intervention plans regarding the use of physical restraint on an individual student.
• (e)    Following the release of a student from a restraint, the program shall implement follow-up procedures. These procedures shall include reviewing the incident with the student to address the behavior that precipitated the restraint, reviewing the incident with the staff person(s) who administered the restraint to discuss whether proper restraint procedures were followed, and consideration of whether any follow-up is appropriate for students who witnessed the incident.

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Reporting Requirements

(1)     Circumstances under which a physical restraint occurs must be reported. Program staff shall report the use of physical restraint as specified in 603 CMR 46.06(2) after administration of all physical restraints, including those that result in any injury to a student or staff member, or any physical restraint of a duration longer than twenty minutes.

(2)     Informing school administration. The program staff member who administered the restraint shall verbally inform the Head of School of the restraint as soon as possible, and by written report no later than the next school working day. The written report shall be provided to the Head of School or their designee, except that the Head shall prepare the report if the Head has administered the restraint. The Head or their designee shall maintain an on-going record of all reported instances of physical restraint, which shall be made available for review by the Department of Elementary and Secondary Education, upon request.

(3)     Informing parents and LEAs. The Head of School shall make reasonable efforts to verbally inform the student's parent and the student’s LEA of the restraint on the same day of the event, and shall notify both by written report sent either within three school working days of the restraint to an email address provided by the parent for communications about the student, or by regular mail postmarked no later than three school working days of the restraint. If the program customarily provides a parent of a student with report cards and other necessary school-related information in a language other than English, the written restraint report shall be provided to the parent in that language. The Head of School shall provide the student and the parent an opportunity to comment orally and in writing on the use of the restraint and on information in the written report. Any associated state agencies will also be notified in the same time frame.

(4)     Contents of report. The written report required by 603 CMR 46.04(2) and (3) shall include:

• (a)   The names and job titles of the staff who administered the restraint, and observers, if any; the date of the restraint; the time the restraint began and ended; and the name of the administrator who was verbally informed following the restraint.
• (b)    A description of the activity in which the restrained student and other students and staff in the same room or vicinity were engaged immediately preceding the use of physical restraint; the behavior that prompted the restraint; the efforts made to de-escalate the situation; alternatives to restraint that were attempted; and the justification for initiating physical restraint.
• (c)    A description of the administration of the restraint including the holds used and reasons such holds were necessary; the student's behavior and reactions during the restraint; how the restraint ended; and documentation of injury to the student and/or staff, if any, during the restraint and any medical care provided.
• (d)    Information regarding any further action(s) that the School has taken or may take, including any disciplinary sanctions that may be imposed on the students.
• (e)    Information regarding the opportunities for the student's parents or guardians to discuss with School officials the administration of the restraint, any disciplinary sanctions that may be imposed on the student and/or any other related matter.

(5)   Administrative review. The Head of School conducts a monthly review of school-wide restraint data. This review considers patterns of use of restraints by similarities in the time of day, day of the week, or individuals involved; the number and duration of physical restraints school-wide and for individual students; the duration of restraints; and the number and type of injuries, if any, resulting from the use of restraint. The Head of School determines whether it is necessary or appropriate to modify the school's restraint prevention and management policy, conduct additional staff training on restraint reduction/prevention strategies, such as training on positive behavioral interventions and supports, or take such other action as necessary or appropriate to reduce or eliminate restraints.

(6)   Report all restraint-related injuries to the Department. When a physical restraint has resulted in an injury to a student or program staff member, the program shall upload the written report required by 603 CMR 46.06(4) to the Department via the state’s security portal no later than three school working days of the administration of the restraint. The program shall also upload the record of physical restraints maintained by the Head of School pursuant to 603 CMR 46.06(2) for the 30-day period prior to the date of the reported restraint. The Department shall determine if additional action by the program is warranted and, if so, shall notify the program of any required actions within 30 calendar days of receipt of the required written report(s). Reports of any restraint-related injuries will also be reported to the student’s parents, LEA and any associated state agencies on the same day of the event.

(7)   Report all physical restraints to the Department. White Oak School collects and annually reports data to the Department regarding the use of physical restraints. Such data is reported in a manner and form directed by the Department.

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Special Circumstances

(1)     Special Circumstances - Students with Disabilities. Restraint administered to a student with a disability pursuant to an Individualized Education Plan ("IEP") or other written plan developed in accordance with state and federal law to which the public education program and the student's parent or guardian have agreed shall be deemed to meet the requirements of 603 CMR 46.02(5), the training requirements set forth in 603 CMR 46.04, and the reporting requirements set forth in 603 CMR 46.06 shall apply.

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A description of the program’s training requirements for all staff;

Agenda:

• Review Key Definitions (See 603 CMR46.00 Handout)
• Review White Oak’s restraint avoidance policy
• Risks of restraints
• Identification of Trained Staff
• Conflict Deescalation Strategies

Conflict Deescalation- Important Concepts

Non-Verbal Communication

When a student’s behavior is escalating there are key strategies you want to always keep in mind. First is how you are standing, be sure to consider your-

1. Proximity- Make sure to always give the student space. When someone is in distress, they need more space than typical. Be sure to give them that space and if you need to move into their bubble do so slowly and let them know.
2. Position- Stand to the side and not directly in front of them
3. Posture- Keep yourself bent at the knee which makes you ready to react in case the situation does escalate.

*All of this together is considered to be the Supportive Stance

Verbal Communication

Paying close attention to your verbal communication is important when trying to deescalate a student. The words you use can make or break a situation. A few things to consider are:

1. Word choice - you want to make sure you are careful with your words and being supportive of the student. Even if the student did something wrong, your goal in what you are saying should be to deescalate the situation, not punish them.
2. Vocabulary - keep what you say simple. When someone is in distress or crisis they are not able to understand high level thoughts and it can even escalate the situation more if they start to feel confused by what you are saying
3. Short - keep what you say short. Less words can go a long way. What they often need is space.

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Paraverbal Communication

While what we say is important, how we say it can be just as important. Paying close attention to our paraverbal communication which is the verbal part of speech excluding the actual words.

1. Pay attention to your tone - Think of all the different ways you can say “What’s going on?”
2. Pay attention to volume - raising your volume can escalate the situation
3. Speak slowly and clearly and listen when the student is speaking.

Rational Detachment

In order to effectively deal with a person in distress or crisis, you have to be rationally detached. To put it simply you have to be in a place where you are not taking the situation personally. If you start to take the situation personally, it is important that you call for help and have someone else handle the situation.

What do you do if a situation continues to escalate?

1. Remove the audience if possible- this could mean moving the student in distress to safe place (if possible) or removing the other students in the area
2. Call for assistance- what you need the help for will vary depending on the situation
3. Remove any escalating factors- recognize you may be an escalating factor
4. Think about the Verbal Escalation Continuum visual and how to respond appropriately as the situation escalates.

After a Crisis

Once the situation has been deescalated it is important to debrief and work on a path forward to repair the relationship with the student

1. Document the events the best you can
2. Meet with administration to discuss the situation
3. Debriefing with the student afterwards is an important toward repairing the relationship
4. Reflect on what could be done differently (if anything) in the future

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A description of the intensive training for staff who serve as restraint resources for the program:

White Oak School uses the CPI Nonviolent Crisis Intervention Training program from the Crisis Prevention Institute.

Data and Documentation:

The program conducts a monthly review of data and documentation on the program’s use of restraint. A documentation log is maintained by the assistant to the Head of School and the information is reported to DESE annually through the security portal as required. The Head of School or his/her designee maintains an on-going record of all instances of physical restraint, which is made available for review by the Department upon request.

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Procedure for receiving and investigating complaints regarding restraint practices:

All complaints regarding restraint practices should be made in writing to the Head of School or her/his designee. The complaint will be investigated thoroughly by interviewing all parties involved and reviewing video footage as necessary. A written report of the investigation will be issued to the complainant, the sending school district, and DESE.