Module 5: Severe Behavior

1
Module 5 Severe Behavior
Texas Behavior Support
Initiative Module 5
1
2
Module 5 Agenda

• Legal Requirements
• Defusing Behavior
• Crisis Management
• Critical Attributes
• Case Study

Texas Behavior Support Initiative Module 5
2
3
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 students body.
• TAC 89.1053(b)(2)

3
Texas Behavior Support Initiative Module 5
4
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)

Texas Behavior Support Initiative Module 5
4
5
Legal RequirementsDefinition of Emergency

• Emergency means a situation in which a students
  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
6
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 students 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
7
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)

Texas Behavior Support Initiative
Module 5
7
8
Legal RequirementsTraining on Use of Restraint

• Who?
• By 4/1/03Core campus team (administrator and
  general/special education personnel likely to use
  restraint)
• After 4/1/03Personnel 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
9
Legal RequirementsDocumentation 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
10
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)

Texas Behavior Support
Initiative Module 5
10
11
Legal RequirementsData 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
12
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
13
Pre-Correcting Problem Behavior

• Prevention or interruption of predictable problem
  behavior

Texas Behavior Support
Initiative Module 5
13
14
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
15
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
16
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
17
Managing Provocative or Challenging Behavior

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

Texas Behavior Support
Initiative Module 5
17
18
Responding to Disrespectful Behavior

• Delay responding
• Avoid escalating prompts
• Respond calmly
• Deliver appropriate negative consequence

Texas Behavior Support
Initiative Module 5
18
19
Managing Agitation

• Identify the signs of agitation
• Utilize techniques to defuse it

Texas Behavior Support Initiative
Module 5
19
20
Establishing Limits and Defusing Defiance

• Pre-teach procedures
• Present choices non-confrontationally
• Follow through

LIMITS
Texas Behavior Support Initiative
Module 5
20
21
Managing Threats and Intimidating Behavior

• Disengage and Get Assistance

Texas Behavior Support Initiative Module
5
21
22
Phases of Escalating Behavior
23
Phase One Calm

• On-task
• Follows rules and expectations
• Responsive to praise
• Initiates behavior
• Goal oriented
• Socially appropriate

24
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

25
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

26
Phase Two Triggers/Antecedents

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

27
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

28
Managing the Agitation Phase

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

• Movement activities
• Involvement of the student
• Relaxation activities

29
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

30
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

31
Phase Five Peak

• Serious destruction of property
• Assault
• Self-abuse
• Severe tantrums
• Hyperventilation
• Screaming, running, violence

32
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

33
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)

34
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

35
Phase Seven Recovery

• Return to Phase One
• Calm

Assist student in returning to normal
activities
36
Things to Avoid

• Getting in the students face
• Discrediting student
• Nagging or preaching
• Arguing
• Engaging in power struggles
• Tugging or grabbing the student
• Cornering the student
• Shouting or raising voice

37
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

38
Crisis Management

• Systems response
• Safe strategies

Texas Behavior Support Initiative
Module 5
38
39
Systems Response

• Planning
• Action
• Follow-up

Texas Behavior Support Initiative
Module 5
39
40
Safe Strategies for Managing Behavioral Crisis

• Before
• During
• After

Texas Behavior Support Initiative
Module 5
40
41
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

42
Interventions After the Behavior Emergency

• Restore the environment
• Conduct debriefing session
• Develop problem-solving action plan
• Utilize additional strategies for chronic
  offenders

43
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
44
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
45
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
46
Critical Attributes

• Development
• Program Review
• Additional Considerations

47
Activity Crisis Management
48
Activity Crisis Management
49
Activity ABC Definitions
50
Activity ABC InterventionsNot to all be used
at same time
51
Activity Systemic Interventions
52
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

53
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
54
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