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| How It Started, How It’s Going: Reducing Restraints at an Exceptional Student Education Center School |
| Monday, May 29, 2023 |
| 4:00 PM–4:50 PM |
| Convention Center 403/404 |
| Area: EDC/OBM; Domain: Service Delivery |
| Chair: Edward Justin Page (StepOne Neurodiversity Services) |
| Discussant: Elisa M. Cruz-Torres (Florida Atlantic University) |
| CE Instructor: Candace Barrett, M.S. |
| Abstract: Restraints have been used in educational and behavioral health institutions as a crisis intervention for individuals who exhibit dangerous and life-threatening behaviors. In educational settings, physical restraints are often used as a “last resort” to end behavioral episodes that may result in serious injury or death of the student and/or others in close proximity. While occasional use of physical restraint on students who engage in dangerous behaviors may be warranted, the U.S. Department of Education statistics on the use of restraints have established that students with disabilities are restrained at a disproportionately higher rate than their general education counterparts (U.S. Department of Education Civil Rights Data Collection Report, 2020). This symposium will focus on the restraint reduction efforts of two behavior analysts at a Florida exceptional student education (ESE) center school with a history of high rates of physical restraints on students. The first presentation will explore initial observations, preliminary actions, and early implementation of interventions by the resident behavior analyst at the school. The second presentation will expand on interventions implemented and continuing programming to maintain near zero levels of physical restraints three years after initial efforts to reduce restraints at this same school were implemented. Implications for practice will be discussed. |
| Instruction Level: Intermediate |
| Keyword(s): physical restraints, restraint reduction, staff training |
| Target Audience: Intermediate - Behavior analysts attending this session should have some understanding of working with schools and engaging in consultation and/or training with school staff. Knowledge of effective interventions for severe problem behaviors would also be beneficial. |
| Learning Objectives: At the conclusion of the presentation, participants will be able to:
1. Identify factors that may contribute to the overuse of physical restraints in educational and community settings.
2. Describe effective strategies for identifying skills deficits in school staff and explain effective training methods to remedy those deficits. |
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| An Examination of Factors Contributing to the Overuse of Restraints in an Exceptional Student Education Center School |
| JESSICA NAOMI CADETTE DUNN (Orlando Health) |
| Abstract: The use of physical restraints to address dangerous behaviors exhibited by students with disabilities has been a mainstay in the U.S. public school system for decades. Though physical restraints are used on students with and without disabilities, a review of national data exposes the disproportionate use of physical restraints, and potential overuse of restraints, on students with disabilities. During the 2017-2018 school year, students with disabilities made up approximately 13% of the school population, but accounted for approximately 80% of all restraint incidents in public school settings (U.S. Department of Education Civil Rights Data Collection Report, 2020). Behavior analysts have an ethical obligation to ensure that they maximize benefits and ensure they “do no harm” to their clients (BACB Ethics Code, 2020). Adhering to our ethical obligations requires that we continuously closely examine and address the use (and potential overuse) of intrusive intervention on our clients. This presentation will examine the factors that contributed to the overuse of physical restraints in a ESE center school setting and discuss considerations for lowering the use of physical restraints on students in similar settings. |
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| A Systematic Approach to Restraint Reduction at an Exceptional Student Education Center School |
| CANDACE BARRETT (University of Miami) |
| Abstract: Success in school-wide restraint reduction requires a thorough assessment of factors contributing to restraint use, targeted interventions at the student and staff level, and multi-level buy-in of these interventions by major stakeholders (e.g., school administration, teachers, support staff). Through close analysis, behavior analysts at an exceptional student education (ESE) center school identified probable variables leading to restraint overuse, with the staff knowledge gap as the major contributing factor. Using behavior skills training (BST) and in situ training (IST) to teach staff to identify and utilize appropriate procedures based on the intensity of the behaviors, the school-based staff demonstrated a 12% increase in knowledge from pre-test and post-test results. More importantly, the effects of training were best shown in the 42% decrease in Workers Compensation light duty claims, a 63% reduction in the use of physical restraints in the first school year, and a 93% decrease in the overall use of physical restraint in the second school year of implementation. This presentation will discuss the development of staff training and tools created to combat school staff skill deficits and decrease the use of physical restraints on students. |
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