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Statement of principles
Human rights Safety for students and staff Behavior is communication: unsafe behavior requires evaluation to determine causes Restraint is a treatment failure Restraint is an emergency intervention and should not be used as a primary intervention IEPs should not contain restraint except in emergency safety plans The district can benefit from years of research and implementation of restraint reduction in inpatient and adult settings
Follow the law (emergency only, no mechanical restraint, no seclusion, training, documentation, parent notification) All restraints documented, whether <5 minutes or not No prone restraint No transport restraint Building-based supervision and accountability for restraint monitoring, prevention, and reduction District-wide accountability for restraint Failure to document restraint is unacceptable Restraint triggers parental consent request for FBA, immediate review of behavioral interventions
Public reporting of number of restraints, number of children involved in restraint, ages of children restrained
Professional Recommendations (Jurgensen, Cutler)
Jurgensen: More training focused on de-escalation, particularly for staff working with children at risk of restraint FBA procedures require review (entry criteria) Multiple restraints trigger review of placement Training to distinguish between emergency restraint and restraint as an intervention Preventative restraint should be prohibited Only appropriately trained staff may intervene/”help” in a restraint Staff may not move a child as a part of restraint Physical restraint monitor at every elementary school to “process” restraints Questions and concerns immediately referred to Pupil Services Clarify role of director of health services Define school nurse’s role in restraints, notify immediately Cutler: All staff trained in MA restraint law; annual training and certification Protocol that nurse checks students after restraint and documents findings Enforcement: No children should be carried Enforcement: No prone holds unless specific training Enforcement of deviation from use of approved, trained restraints School-wide restraint log monitored by administrator, analysis of patterns Clear hierarchy of supervisory roles Revised form: Nurse’s signature, administrative review signature, indication of information to principal, indication of parental notification, signatures of all staff involved. All restraints, regardless of duration, written up and parents informed.
Attention to safety in all time out spaces Staff must be accessible to child in time out space at all times