Guidelinestarestraintseclusion PDF

Oregon achieves . . . together!

Technical Assistance
&
Guidelines Manual
Use of Physical Restraint and Seclusion
November 2018
It is a policy of the State Board of Education and a priority of the Oregon Department of Education that there will be no
discrimination or harassment on the grounds of race, color, religion, sex, sexual orientation, national origin, age or
disability in any educational programs, activities or employment.
Persons having questions about equal opportunity and nondiscrimination should contact the Deputy Superintendent of
Public Instruction at the Oregon Department of Education, 255 Capitol Street NE, Salem, Oregon 97310; phone 503‐947‐
5697; fax 503‐378‐5156; or TDD 503‐378 2892.
OREGON DEPARTMENT OF EDUCATION

OFFICE OF STUDENT SERVICES


Table of Contents
Use of Physical Restraint and Seclusion in Oregon ..................................................................................................... 3
Physical Restraint and Seclusion OARs ........................................................................................................................ 5
Use of Physical Restraint ................................................................................................................................................. 6
Physical Restraint Q&A ............................................................................................................................................. 7
Use of Seclusion ............................................................................................................................................................. 12
Seclusion Q&A.......................................................................................................................................................... 13
Use of Physical Restraint and Seclusion in Early Intervention and
Early Childhood Special Education ........................................................................................................................ 19
Staff Training Requirements .......................................................................................................................................... 21
Staff Training Requirements Q&A .......................................................................................................................... 22
Documentation Requirements ....................................................................................................................................... 24
Documentation Requirements Q&A ....................................................................................................................... 25
Reporting Requirements ................................................................................................................................................ 29
Reporting Requirements Q&A ................................................................................................................................ 30
General Q&A.................................................................................................................................................................... 31
Sample Forms ................................................................................................................................................................. 33
Physical Restraint Incident Report – Option 1 ...................................................................................................... 34
Physical Restraint Incident Report – Option 2 ...................................................................................................... 39
Physical Restraint Debriefing Report ..................................................................................................................... 43
Seclusion Incident Report – Option 1 .................................................................................................................... 45
Seclusion Incident Report – Option 2 .................................................................................................................... 49
Seclusion Debriefing Report ................................................................................................................................... 52
Physical Restraint and/or Seclusion Incident Report........................................................................................... 54
Physical Restraint and/or Seclusion Debriefing Report – Condensed Version ................................................ 58
Student Incident Log ................................................................................................................................................ 59
Continuous Monitoring Form .................................................................................................................................. 60
Student Monitoring Form......................................................................................................................................... 62
Parent Notification Letter ........................................................................................................................................ 64
Administrative Approval Form ................................................................................................................................ 65
Quick Reference Guide .................................................................................................................................................. 66
Acronym Index ................................................................................................................................................................ 67

2


Use of Physical Restraint and Seclusion in Oregon
School districts, education service districts (ESDs) and school boards must have policies and
procedures in place that comply with the laws and rules regarding physical restraint and/or
seclusion. Oregon Administrative Rules 581-021-0550, 0553, 0556, 0559, 0563, and 0566
were created from HB 2939 in 2011. Physical restraint and/or seclusion can only be applied
if student behavior imposes a threat to the safety of the student or the safety of others, and if
other, less restrictive methods of controlling the behavior are ineffective. There are further
specific rules under which physical restraint and/or seclusion may be used in public
education programs. Rules include established time limits and parameters for seclusion
and/or physical restraint such as access to bathrooms, water breaks, and the continuous
monitoring of the situation by staff and administrators.
The statute and subsequent rules also specify the following:

 Parent(s)/Guardian(s) of students who are physically restrained and/or secluded are to
be notified, verbally or electronically, by the end of the school day in which the incident
occurred.
 Parent(s)/Guardian(s) of students who are physically restrained and/or secluded
must receive written documentation of the incident within twenty-four hours.
• Written documentation to parent(s)/guardian(s) must include the following:
• Date, time, and location of the physical restraint and/or seclusion;
• Description of the student’s behavior that prompted the physical
restraint and/or seclusion;
• Efforts of de-escalation and the alternative methods attempted
prior to the physical restraint and/or seclusion;
• Name(s) of personnel which administered the physical restraint
and/or seclusion;
• Description of the training status of personnel involved;
• Timely notification of a debriefing meeting and their right to
attend.
[OAR 581-021-0556(2)(b)(A-H)]
 Within two school days after each incident of physical restraint and/or seclusion
school personnel must convene a debriefing meeting to discuss and document the
incident.
 Parent(s)/Guardian(s) must receive timely notification of a debriefing meeting to be
held and of their right to attend the meeting. The notes from the meeting must be
shared with the parent(s)/guardian(s).
 Physical restraint and/or seclusion training programs approved by the Oregon
Department of Education (ODE) must meet the standards of the Department of
Human Services (DHS). The training of school personnel in physical restraint
and/or seclusion is required and must meet certain criteria, including being

3


grounded in evidence-based techniques and positive behavioral strategies, along
with teaching de-escalation methods, prevention and crisis response.
 Public education programs are required to select a training program from an
approved list compiled by ODE, and provide de-escalation, restraint and seclusion
training to school staff working with students in public education programs.
Public education programs are defined by the following:
a. Are for students in early childhood education, elementary school or secondary
school [OAR 581-021-0550(5)(a)];
b. Are under the jurisdiction of a school district, an ESD or another educational
institution or program [OAR 581-021-0550(5)(b)]; and,
c. Receive, or serve students who receive, support in any form from any program
supported, directly or indirectly, with funds appropriated to ODE [OAR 581-021-
0550(5)(c)].
 School districts and ESDs must prepare an annual report detailing the use of physical
restraint and/or seclusion for the previous school year and make this report available
to the public.

4


USE OF PHYSICAL RESTRAINT & SECLUSION OARs

OAR 581-081-0550 to 581-021-0570:
581-021-0550
Definitions - Click here
581-021-0553
Use of Physical Restraint and Seclusion in Public Education Programs - Click here
581-021-0556
Program’s Procedures Regarding Physical Restraint and Seclusion - Click here
581-021-0559
Reporting Requirements for the Use of Physical Restraint and Seclusion - Click here
581-021-0563
Approval of Physical Restraint and Seclusion Training Programs for School Staff -
Click here
581-021-0566
Required Use of Approved Restraint and Seclusion Programs - Click here
581-021-0568
Standards for Seclusion Rooms - Click here
581-021-0569
Use of Seclusion Cells Prohibited - Click here
581-021-0570
Complaint Procedures - Click here

5


Use of Physical Restraint
Physical Restraint Defined:

Physical restraint is the restriction of a student’s movement by one or more persons holding the
student or applying physical pressure upon the student. This does not include touching or
holding a student without the use of force for the purpose of directing the student or assisting
the student in completing a task or activity.
Physical restraint may be used as a part of a behavior intervention plan (BIP) when other, less
restrictive, interventions are deemed not effective and the student’s behavior imposes a threat of
imminent, serious bodily injury to themselves or others; or
In an emergency, a program administrator, teacher, program employee or volunteer may use

physical restraint as necessary to prevent a student from harming themselves or others in
accordance with [OAR 581-021-0553] and [OAR 581-021-0556].
Physical restraint can be used only for as long as the student’s behavior imposes a reasonable
threat of imminent, serious bodily injury to themselves or others [OAR 581-021-0553(2)(A)].
Staff will continuously monitor the student’s status during physical restraint [OAR 581-021-0553(2)(C)].
Training programs or systems of physical restraints selected for use in a program must include the
use of evidence-based techniques and skills training, positive behavior supports, conflict
prevention, de-escalation and crisis response techniques.
Only staff who are current with required training, in accordance with an approved training program,
may implement physical restraint with a student, except in cases of emergency as described in
[OAR 581-021-0553(B)(ii)].

6


Physical Restraint Q&A
1. Q: What does physical restraint mean?
A: Physical restraint means the restriction of a student's movement by one or

more persons holding the student or applying physical pressure upon the
student. It does not include the touching or holding of a student without the
use of force for the purpose of directing, re-directing, or prompting/assisting
the student in completing a task or activity [OAR 581-021- 0550(3)(a)&(b)]. The use
of chemical, mechanical and prone restraints are prohibited [OAR 581-021-
0553(1)].
2. Q: When can physical restraint be used?
A: Only when the student’s behavior imposes a reasonable, imminent threat of

serious bodily injury to themselves or others, and less restrictive interventions
have proven not to be effective.
3. Q: Is there a time limit for how long a student can be placed in physical restraint?
A: The student is physically restrained only until the student’s behavior no longer
poses a reasonable threat of imminent, serious bodily injury to the student or
others. If the restraint continues for more than thirty minutes, the following
must occur:
 The student must be provided access to the bathroom and water. This means
the student is offered water and a bathroom break. If the student is still in the
throes of escalated behavior, going to the bathroom at that moment may not
be prudent. Staff must exercise good judgement to avoid escalating the crisis
or safety risk. At every thirty-minute interval, the student must be offered water
and the opportunity to use the bathroom.
 Every fifteen minutes after the initial thirty minutes an administrator must
provide written authorization for the continuation of the restraint, including the
justification as to why it must be continued.
 School personnel must immediately attempt to notify the student’s

parent(s)/guardian(s), verbally or electronically.

7


4. Q: Must the student be continuously monitored while being physically

restrained?
A: Yes. At a minimum, the staff administering the physical restraint must monitor
the student’s condition, making sure the student is not being unduly harmed
and is able to breathe. Whenever additional staff members are present, it is
best practice to have a staff member who is not involved in the physical
restraint monitoring the student’s condition at all times, including checking to
ensure that the student is able to breathe, is not being unduly harmed in any
way and the joints are not being overly pressured in some manner. The district
is expected to follow the guidelines provided by an approved training program
on the number of needed staff. Best practice often suggests at least three staff
members should be present. It is suggested that one to two staff members
implement the restraint and a third staff member monitors the student’s
condition and coordinates staff actions. Staff should be available to trade off on
the restraint, if needed, due to fatigue or other conditions.
5. Q: Is it considered physical restraint when a staff member is escorting a student

out of the classroom or down the hall and has physical contact with the
student by placing their hand on the student’s person, e.g. arm?
A: Physical restraint means the restriction of a student's movement by one or

more persons holding the student or applying physical pressure upon the
student. It does not include the touching or holding of a student without the
use of force for the purpose of physically re-directing/prompting the student or
assisting the student in completing a task or activity [OAR 581-021-0550(3)(a)].
6. Q: If a student calms down right away after being placed in a physical restraint is
the school required to notify the student’s parent(s)/guardian(s), complete a
physical restraint incident report and hold a debriefing meeting?
A: Yes. Every time a student is placed in a physical restraint, the school must give
the parent(s)/guardian(s) verbal or written notification by the end of the day the
incident occurred. Within two days of the incident, a documented debriefing
meeting by appropriate staff must occur and include all staff involved in the
incident. Parent(s)/Guardian(s) need to be invited to this debriefing in a timely
manner and must be provided a copy of the meeting notes [OAR 581-021-0556(4)].

8


7. Q: Educational programs that are located in facilities are subject to different

rules regarding the use of physical restraint and seclusion and are not subject
to the previously mentioned rules. What are these programs and what
regulations apply?
A:
 Educational programs located in treatment programs, juvenile detention

facilities as defined in ORS 419A.004, youth correctional facilities as
defined in ORS 420.005, and youth substance abuse programs are
subject to different regulations regarding the use of physical restraint and
seclusion.
 The rules for students in treatment programs can be referred to in Health

Systems Division: Behavioral Health Services - Chapter 309, Division
112, Use of Restraint for Patients in State Institutions.
 Students in juvenile detention facilities or youth correctional facilities are

subject to Division 490, Use of Time-Out, Room-lock Other, Isolation,
Safety Programs, Physical Intervention, and Restraint in OYA Facilities.
 Students placed in substance abuse programs that provide educational

programs are subject to OAR 309-022-0175 Restraint and Seclusion.
The law and administrative rules surrounding restraint and seclusion applies
only to students enrolled in public education programs. Public education
programs are defined by the following:
a) Are for students in early childhood education, elementary school or

secondary school [OAR 581-021-0550(5)(a)];
b) Are under the jurisdiction of a school district, an ESD or another educational

institution or program [OAR 581-021-0550(5)(b)]; and,
c) Receive, or serve students who receive, support in any form from any
program supported, directly or indirectly, with funds appropriated to ODE
[OAR 581-021-0550(5)(c)].

9


8. Q: When physical restraint is included in a student BIP, what guidelines are

used when responding to student behavior(s)?
A: When a BIP includes physical restraint as a means of responding to student

behavior(s), the use of physical restraint should be initiated only if “less
restrictive interventions would not be effective and the student’s behavior
imposes a reasonable threat of imminent, serious bodily injury to the student
or others” [OAR 581-021-0553(2)(a)(A)&(B)].
Guidelines for writing a behavior plan include, but are not limited to, the
following:
 Function-based;
 Specific about triggers of the behavior(s);
 Describes what the behavior(s) manifests as or looks like;
 Specifies how staff should intervene and respond to various behavior(s) and at
various stages;
 Specifies how to respond with continual, less restrictive intervention(s) at

various stages of escalation if needed, and;
 Specifies what behavior(s) would ultimately result in physical restraint and/or

seclusion after less restrictive measures have been rendered ineffective.
Again, physical restraint should be implemented only as specified in [OAR

581-021-0553 (2)(a)(A)&(B)], above, and implemented by staff trained in a de-
escalation/physical restraint program that is approved by ODE, except in an
emergency situation [OAR 581-021-0553(2)(c)(B)(i)].

10


9. Q: What would constitute mechanical restraint versus the use of adaptive

equipment to assist a student with a disability?
A: Mechanical restraint is prohibited in the State of Oregon and can never be

used to restrain a student who poses an imminent threat of serious bodily
injury to themselves or others. Protective and stabilizing devices to assist
students with disabilities (i.e. - for feeding, maintaining support/posture when
sitting/standing, swings to address sensory needs, etc.) do not represent
mechanical restraint [OAR 581-021-0550(2)(a)&(b)]. These devices are
recommended by the IEP team for providing access to FAPE for the student,
and are not to be used for behavior management, physical restraint, or for the
convenience of staff [OAR 581-021-0553(2)(b)].
Examples of Physical Restraint:

 Restriction of a student's movement by one or more persons holding the
student or applying physical pressure upon the student because there is
reasonable threat of imminent, serious bodily injury to themselves or
others.
 The student continues to resist after the implementation of less invasive
or restrictive measures and becomes escalated to the point of presenting
a reasonable threat of imminent, serious bodily injury to themselves or
others.
[OAR 581-021-0550(3)(a)&(b)]
Examples of Non-Physical Restraint:
 “Hand over Hand” prompting for instructional purposes.
 Re-directing the student from a potentially dangerous situation by taking
their hand or arm and gently guiding them away.
 The student willingly goes when physically escorted (i.e. - holding the hand,
arm around the shoulder) by a staff member.
 Providing deep pressure to a student who is in need of sensory input, as per
the student’s IEP.

11


Use of Seclusion
Seclusion Defined:
The involuntary confinement of a student alone in a room from which the student is physically
prevented from leaving. Seclusion does not include the removal of a student for a short period
of time to provide the student with an opportunity to regain self-control if the student is in a
setting from which the student is not physically prevented from leaving.
Seclusion may be used as a part of a BIP when other, less restrictive interventions are not effective
and the student’s behavior imposes a threat of imminent, serious bodily injury to themselves or
others; or
In an emergency, a program administrator, teacher, program employee or volunteer may use

seclusion as necessary to prevent a student from harming themselves or others in accordance with
[OAR 581-021-0553] and [OAR 581-021-0556].
Seclusion can be used only for as long as the student’s behavior imposes a reasonable threat of
imminent, serious bodily injury to themselves or others [OAR 581-021-0553(2)(A)].
Staff will continuously monitor the student’s status during seclusion [OAR 581-021-0553(2)(C)].
Only staff who are current with required training, in accordance with an approved training program,
may implement seclusion with a student, except in cases of emergency as described in [OAR 581-
021-0553(B)(ii)].

12


Seclusion Q&A
1. Q: What does seclusion mean?
A: Seclusion means the involuntary confinement of a student alone in a room from

which the student is physically prevented from leaving [OAR 581-021- 0550(6)].
2. Q: What does not constitute seclusion?
A: The removal of a student for a short time to provide the student with an
opportunity to regain self-control, if the student is in a setting from which the
student is not physically prevented from leaving. Seclusion may not be used for
discipline, punishment or the convenience of personnel of the public education
program.
3. Q: Is in-school suspension (ISS) the same thing as seclusion?
A: No. Seclusion means the involuntary confinement of a student alone in a

room, from which the student is prevented from leaving. Students in ISS have
access to staff and other students. Students in ISS are not involuntarily
confined alone in a room from which they are physically prevented from
leaving.
4. Q: Is there a time limit for how long a student can be placed in seclusion?
A: The student shall remain in seclusion only until the student’s behavior no
longer poses a reasonable threat of imminent, serious bodily injury to the
student or others. If the seclusion continues for more than thirty minutes, the
following must occur:
• The student must be provided access to the bathroom and water;
• School personnel must immediately attempt to verbally or electronically notify

parent(s)/guardian(s); and
• Every fifteen minutes after the first thirty minutes, an administrator must
provide written authorization for the continuation of the seclusion, including
the justification as to why it must be continued.


13


5. Q: Must a student be continuously monitored while in seclusion and what

does this mean?
A: Yes. Continuous monitoring means that a staff member shall keep the student
in full view at all times while the student remains in seclusion.
6. Q: If a student calms down right away after being placed in seclusion is the
school required to notify their parent(s)/guardian(s), complete a seclusion
incident report and hold a debriefing meeting?
A: Yes. Every time a student is placed in seclusion the school must give the
parent(s)/guardian(s) verbal or electronic notification by the end of the school
day, and written documentation within twenty-four hours [OAR 581-021-
0556(2)(a-b)]. Within two days of the incident, a documented debriefing meeting
needs to occur, including staff involved in the seclusion.
Parent(s)/Guardian(s) need to be notified of the debriefing in a timely manner
and of their right to attend the meeting, and provided a copy of the debriefing
documentation [OAR 581-021-0556(4)(a)].
7. Q: What is the definition of a student being alone in a room?
A: Being alone means that the student is physically separated from others, and,
by the definition of seclusion, is ‘prevented from leaving’ the room. The
student is alone in the room where the seclusion is occurring. There are no
other students or staff in the room. The student, however, is continually
visually monitored by staff.
8. Q: Does staff need to be in the room with the student to keep them in full view
or could there be a window or half door separating the student from the staff?
A: The room used for seclusion must allow staff full view of the student in all
areas of the room. The staff must be able to easily access and intervene with
the student if needed for safety.
Windows and half doors are permissible as long as the student is in full view

14


of the staff, and equally the student can see out of the room. The door must
8.
open outward and contain a port of shatterproof glass or plastic through
cont.
which the entire room may be viewed from outside; half doors are acceptable
options when direct visual monitoring can occur [OAR 581-021-0568(d)].
9. Q: What is an appropriate seclusion area/room?
A: An appropriate seclusion area/room is free of potential harmful objects, such

as unprotected light fixtures, electrical outlets and items that could be used as
weapons. It must be an area/room that will ensure the safety of the student
and all involved. The area/room must not be isolated from the school staff of
the facility. The main feature defining seclusion is that the student is alone in
an area/room and is physically prevented from leaving the area/room. See
seclusion room standards and specifications [OAR 581-021-0568].
10. Q: What are the standards for rooms used for seclusion?
A: The standards for seclusion rooms are:
 Any wall that is part of the room used for seclusion must be part of the
structural integrity of the room (not free standing cells or portable units
attached to the existing wall or floor), and must be no less than sixty-four
square feet;
 The room must not be isolated from school staff of the facility;
 Doors must be unlocked or equipped with immediate-release locking

mechanisms;
 The door must open outward and contain a port of shatterproof glass or
plastic through which the entire room may be viewed from outside; half doors
are acceptable options when direct visual monitoring can occur;
 The room must not contain protruding, exposed, or sharp objects;
 The room must not contain free standing furniture;
 Windows must be transparent for both staff and the student to see in/out, and
made of unbreakable or shatterproof glass or plastic. Non-shatterproof glass
must be protected by adequate climb-proof screening;

15


10.  There must not be exposed pipes or electrical wiring in the room. Electrical
cont. outlets must be permanently capped or covered with a metal shield secured
by tamper-proof screws. The room must contain lights that must be recessed
or covered with screening, safety glass or unbreakable plastic. Any cover, cap
or shield must be secured by tamper-proof screws;
 The room must meet State Fire Marshal safety, fire and health standards. If
sprinklers are installed, they must be recessed or covered with a cage. If pop-
down type, sprinklers must have breakaway strength of less than eighty
pounds. In lieu of sprinklers combined smoke and heat detectors must be
used with similar protective design or installation;
 The room must be ventilated. Heating and cooling vents must be secure and
out of reach;
 The room must be designed and equipped in a manner that would not allow a
student to climb up a wall;
 Walls, floors and ceiling must be solidly and smoothly constructed, to be

cleaned easily and have no rough or jagged portions; and
 Seclusion cells are prohibited [OAR 581-021-0569].
11. Q: What does “structural integrity” mean when determining whether a room
used for seclusion is a seclusion cell? (Note: the law indicates ‘Seclusion
Cell’ means a freestanding, self-contained unit, and any wall that is part
of the room used for seclusion must be part of the structural integrity of
the room).
A: Structural Integrity (April, 2014) largely refers to those objects’

soundness of design and construction, including safety and workability.
Structural integrity is an essential component of all structural engineering
projects, …buildings, …and other structures that…apply to the safety of
humans. Retrieved from: http://www.ehow.com/about_6510702_define-
structural- integrity.html#ixzz32Bnv5wxC
The intent of the seclusion room statutes was to ensure that any rooms
built met certain standards. Stick built with their own existing walls or
stick built to blend with existing walls versus being panels that are bolted
to the floor and walls, or freestanding units [OAR 581-051-0568].

16


12. Q: What constitutes safe screening to ensure student safety from lights, electrical
outlets, windows, etc., as noted in the seclusion standards [OAR 581-021-0568]?
A: It would be prudent for safety screens to be designed in a manner keeping

students’ fingers from becoming entangled in the screens.
13. Q: When seclusion is included in a student’s BIP, what guidelines are used when
responding to student behaviors?
A: When a BIP includes seclusion as a means of responding to student behavior,

the use of seclusion is initiated only when other, less restrictive interventions
have been deemed ineffective and the student’s behavior imposes a
reasonable threat of imminent, serious bodily injury to themselves or others
[OAR 581-021-0553(2)(a)(A-B)].
Examples of seclusion:
 The student is alone and prevented from leaving the room after a “room clear”
with the teacher/staff person on the outside of the room.
 The student is physically separated from others in the classroom and is

prevented from leaving the designated area with the teacher/staff person
outside of the designated area.
Examples that are not seclusion:
 The room is “cleared” and a teacher/staff person remains in the room with the
student to assist with behavior management.
 The student is physically separated from others in the classroom in a

designated area and there is a teacher/staff person present with that student
in the designated area.

17


Use of Physical Restraint and Seclusion in Early Intervention
and Early Childhood Special Education
This section applies to the use of physical restraint and seclusion in Early Intervention (EI) and
Early Childhood Special Education (ECSE).
Physical Restraint Defined:

Physical restraint is the restriction of a child’s movement by one or more persons holding the
child or applying physical pressure upon the child. This does not include touching or holding a
child without the use of force for the purpose of directing the child or assisting the child in
completing a task or activity.
Seclusion Defined:
The involuntary confinement of a child alone in a room from which the child is physically
prevented from leaving. Seclusion does not include the removal of a child for a short period of
time to provide the child with an opportunity to regain self-control if the child is in a setting from
which the child is not physically prevented from leaving.
EI/ECSE is considered a public education program, which must meet the following criteria:
a) Serves students in early childhood education, elementary or secondary school;

b) Is under the jurisdiction of a school district, ESD or other educational institution or
program; and
c) Receives, or serves students who receive, support in any form from any program
supported, directly or indirectly, with funds appropriated to ODE.
In providing care and educational instruction to young children there will always be some physical
contact for guiding, directing, prompting or preventing harm. It is normal and natural for an adult to
guide or direct a child by gently laying a hand on the child’s shoulder, back, arm, or clasping the
child’s hand. It is also normal and natural to briefly hold a child in an effort to calm or comfort the
child. It may be necessary for an adult to hold a child on their lap to maintain the child’s attention or
to provide structure or security for some activities. An adult may use their body to block a child from
exiting an area of safety or entering a dangerous area. These normal, typical activities that adults
use to guide, direct and protect children are not considered physical restraint.
Seclusion is NOT an acceptable option for use with young children. A young child should
NEVER be left alone in a room.
If a child is not in need of physical restraint to prevent threat of imminent, serious bodily injury to
themselves or others, the child could be removed or separated from other children ‘for a short time
to provide the child with an opportunity to regain self-control in a setting from which the child is not

18


physically prevented from leaving’ [OAR 581-021-0550(6)(a)]. The child being removed or separated
from other children is to always be accompanied by an adult.
Physical restraint does not include placing children in tray chairs, high chairs and/or other adapted
equipment for physical support or instructional purposes. Mechanical restraint is prohibited by law,
although mechanical restraint does not include placing a child in a protective or stabilizing device
ordered by a licensed physician.
Discretion must be used to ensure that placement in such chairs or adapted equipment meets the
instructional or physical support needs of the child and is not used to restrict the child’s mobility.
The use of a safety harness during bus transportation is not considered restraint when it is used as
an appropriate safety precaution when the child is in a moving vehicle.
EI/ECSE programs must select and be trained in the use of one of ODE’s approved physical
restraint programs [OAR 581-021-0566].
Physical restraint shall not be used as a form of discipline, punishment or for the convenience of
personnel in the public education program [OAR 581-021-0553(2)(b)].
Physical restraint may be used only for as long as the child’s behavior poses a reasonable threat of
imminent, serious bodily injury to themselves or others and only when less restrictive interventions
would not be effective [OAR 581-021-0553(2)(a)(A)(B)].
Staff must continuously monitor a child’s status during physical restraint.
For those children suspected or determined that physical restraint may be necessary, the use of
physical restraint shall be included in a behavioral intervention plan (BIP) that is referenced in the
child’s Individualized Family Service Plan (IFSP) or Individualized Education Plan (IEP). The
behavior plan is to be signed by the parent(s)/guardian(s) to indicate their agreement with the plan.
Each program shall have a documented process for annual review of the use of physical restraint
that is available to the local public education program who has jurisdiction of the EI/ECSE program.
The annual report also needs to be submitted to the Deputy Superintendent of Public Instruction.
Physical restraint shall be used with extreme caution, and only when needed, to ensure the safety
of the child and/or others, or in accordance with the child’s IFSP/IEP and BIP, and Oregon statutes
and administrative rules regarding restraint and seclusion [OARs 581-021-0550, -0553, -0556, -0559, -
0563, -0566, -0568, -0569, and -0570].

19


Staff Training Requirements
Oregon rules allow the use of physical restraint and/or seclusion in a public education program only
under the following conditions:
 When other, less restrictive interventions would not be effective and the student’s behavior
imposes a threat of imminent, serious bodily injury to themselves or others; and
 For only as long as the student imposes a threat of imminent, serious bodily injury to
themselves or others.
After exhausting all less restrictive interventions that have been deemed ineffective, give the
student a warning, whenever possible, that if the student harms or attempts to harm themselves or
others, physical restraint may occur for their protection. This may help the student regain control of
their behavior.
Staff members using physical restraint and/or seclusion must be trained in an ODE approved de-
escalation/physical restraint and seclusion program. The district or program may select from an
ODE approved training program list.
If physical restraint and/or seclusion is part of a BIP, the plan must address a variety of
interventions to prevent and de-escalate a crisis situation, and staff should use those interventions
unless there is the threat of imminent, serious bodily injury to the student or others. When physical
restraint and/or seclusion are included in a BIP, the team must include proactive preventions to
attempt to de-escalate the student first.
Continuous monitoring of a student during physical restraint and/or seclusion is mandatory. A

student must always be able to breathe and speak during physical restraint and/or seclusion.
Never restrain a student longer than absolutely necessary. The training will increase awareness of
the physiological and emotional signs associated with a student starting to calm or de-escalate.
When appropriate, let the student know as that soon as they become calm the process of releasing
the physical hold can begin.
School personnel and staff should avoid power struggles with students.
Whenever possible, physical restraint should not be used in front of other students. It is more
respectful of the student in crisis and minimizes the impact of the event on others. It would be

20


preferable to clear the room of other students when a student is in crisis in order to protect the
students and provide privacy for the student being restrained.
Verbal threats or refusal to comply with staff directives or school rules do not warrant physical
restraint and/or seclusion.
Physical restraint and/or seclusion may not be used for discipline, punishment or the convenience
of personnel of the public education program.
Physical restraint must be applied in such a way that is safe and only reasonable force is used.
Ideally, the staff member(s) monitoring the student during the physical restraint and/or seclusion
would have rapport with the student to assist with recovering from the crisis.
Staff Training Requirements Q&A

1. Q: What does [OAR 581-021-0553(2)(c)(B)(i)] mean when it states that only staff who
are current in the required training in accordance with an ODE approved
training program may impose physical restraint and/or seclusion with a student
except when an emergency exists?
A: Staff must be trained in a program approved by ODE, and selected by the

district/school program, to implement physical restraint and/or seclusion on a
student, except in an emergency situation that may require an untrained staff
member to implement physical restraint and/or seclusion upon a student, in
accordance with the law and rules regarding physical restraint and seclusion
[OAR 581-021- 0553(2)(c)(B)(i)].
2. Q: Must staff be trained in the use of physical restraint and/or seclusion before
restraining a student in an emergency situation?
A: No. In an emergency situation a school administrator, teacher, or other school

employee who is not trained may use physical restraint and/or seclusion if a
student’s behavior poses a reasonable threat of imminent, serious bodily injury
to themselves or others [OAR 581-021-0553(2)(c)(B)(ii)].

21


3. Q: Can a school employee who has not been trained in an approved training
program by ODE use physical restraint and/or seclusion on a student when the
use of physical restraint and/or seclusion is included in the student’s BIP?
A: Yes, but only if it is an emergency situation. When physical restraint and/or

seclusion are used as part of a BIP in the student’s IEP or Section 504 plan, best
practice and compliance with the law requires staff to be trained. Staff working
with a student who has physical restraint and/or seclusion as a possible
intervention in a BIP need to be trained in an approved training program
addressing de-escalation procedures and the proper use of physical restraint
and/or seclusion.

22


Documentation Requirements
Oregon rules allow the use of physical restraint and/or seclusion in a public education program only
under the following conditions:
 When other, less restrictive interventions were deemed ineffective and the student’s
behavior imposes a threat of imminent, serious bodily injury to themselves or others; and
 For only as long as the student imposes a threat of imminent, serious bodily injury to
themselves or others.
Staff using physical restraint and/or seclusion must be trained in an ODE approved de-
escalation/physical restraint and seclusion program. The district or program may select from an
ODE approved training program list. In an emergency, staff not trained may perform the physical
restraint and/or seclusion, and that must be documented.
If physical restraint and/or seclusion is part of a BIP, the plan must address a variety of
interventions to prevent and de-escalate a crisis situation, and staff should use those interventions
unless there is the threat of imminent, serious bodily injury to the student or others. When physical
restraint and/or seclusion are included in a BIP, the team must include proactive preventions to
attempt to de-escalate the student first.
Continuous monitoring of a student during physical restraint and/or seclusion is mandatory. A

student must always be able to breathe and speak during physical restraint and/or seclusion.
Physical restraint and/or seclusion may not be used for discipline, punishment, or the convenience
of personnel of the public education program.
Physical restraint must be applied in such a way that is safe and only reasonable force is used.
Ideally, the staff member(s) monitoring the student during the physical restraint and/or seclusion
would have rapport with the student to assist with recovering from the crisis.
Document the incident report as soon as possible after the incident. Each staff member or person
involved should document their own version of the incident.

23


Documentation Requirements Q&A

1.
Q: What are the requirements for parent(s)/guardian(s) notification after the use of
seclusion and/or physical restraint?
A: Parent(s)/Guardian(s) must be notified following an incident involving the use

of physical restraint and/or seclusion. Notification must include the following:
 Parent(s)/Guardian(s) notified verbally or electronically of the incident by the
end of the school day when the incident occurred;
 Parent(s)/Guardian(s) receive written documentation of the incident within
twenty-four hours of the incident that provides a description of the physical
restraint and/or seclusion which includes the date, times when the physical
restraint and/or seclusion began and ended, the location, a description of the
student's activity that prompted the use of physical restraint and/or seclusion,
efforts used to de-escalate the situation, the names and training status of the
personnel of the public education program who administered the physical
restraint and/or seclusion; and
 Parent(s)/Guardian(s) provided with a timely notification of a debriefing meeting
to be held within two days and of the parent(s)/guardian(s) right to attend the
meeting [OAR 581-021-0556(1)&(2)(a)&(b)(A-H); and (4)(a)].
2.
Q: What is meant by a documented debriefing by appropriate staff? Who should
be included and when must the debriefing occur?
A: A debriefing meeting is held regarding the use of physical restraint and/or

seclusion within two school days of the incident and must include all
personnel of the public education program who were involved in the incident
and any other appropriate personnel [OAR 581-021-0556(4)(a)], and must be
documented. Parent(s)/Guardian(s) have the right to attend this debriefing
meeting and must be notified in a timely matter of this meeting after the
physical restraint and/or seclusion. Written notes must be taken of the
debriefing meeting, and a copy of the written notes must be provided to
parent(s)/guardian(s) of the student.

24


3. Q: What is the purpose of the debriefing meeting and what issues should be
reviewed by the debriefing team?
A: The primary purpose of the debriefing is to review the incident and take any
actions necessary to reduce the chances that such an incident will reoccur.
The debriefing session provides an opportunity to discuss the circumstances
resulting in the use of physical restraint and/or seclusion. After reviewing the
incident report and checking for accuracy, the debriefing team conducts a
review of the factor(s) that precipitated the event, the de-escalation
technique(s) used, the physical restraint technique(s) utilized, outcome(s) of
the intervention(s), including any injuries to student(s) or staff that may have
resulted from the incident, prior incidents of physical restraint and/or seclusion
utilized with the student, and any other relevant factors that the debriefing
team deems appropriate. The team may decide to initiate a functional
behavior assessment and set up a BIP to address the behavior if deemed
appropriate. If a BIP is already in place, the team might want to consider
modifying the plan and/or conducting further function-based assessments to
assist with modifying or enhancing the effectiveness of the BIP. Best practice
would suggest a function-based BIP is developed after the second incidence
of physical restraint and/or seclusion is implemented with a student. If a
student is involved in five incidents in a school year involving physical restraint
or seclusion, a team consisting of personnel of the public education program
and a parent or guardian of the student must be formed for the purposes of
reviewing and revising the student's behavior plan and ensuring the provision
of any necessary behavioral supports.
The law indicates that a BIP must be adjusted after five incidents leading
to physical restraint.

25


4. Q: Districts and public education programs are required to report annually, at both
local and/or district and state levels, the use of physical restraint and seclusion.
What is the purpose of this annual review and what is needed to fulfill the
document process requirement?
A: The primary purpose of the annual reporting is to ensure that all district policies
are being implemented regarding the use of physical restraint and seclusion
and to determine if current district practices have been effective in improving
student behavior(s) and minimizing the use of physical restraint and seclusion.
 The annual report requires each entity that has jurisdiction over a public
education program to prepare a local report available to the districts’
stakeholders at the local level, as well as prepare and submit to the
Superintendent of Public Instruction an annual report detailing the use of
physical restraint and seclusion for the preceding school year, minimally
including the following:
 The total number of incidents involving physical restraint;
 The total number of incidents involving seclusion;
 The total number of seclusions in a locked room;
 The total number of students placed in physical restraint;
 The total number of students placed in seclusion;
 The total number of seclusion rooms available, with a description that includes
the location of those rooms and their designation (solely used for seclusion);
 The total number of incidents that resulted in injuries or death to students or
personnel as a result of the use of physical restraint and/or seclusion;
 The number of students placed in physical restraint and seclusion more than
ten times in the course of a school year, including an explanation of the steps
taken by the public education program to decrease the use of physical
restraint and seclusion for each student;
 The number of incidents in which the personnel of the public education
program administering physical restraint and seclusion were not trained;
and
 The demographic characteristics of all students upon whom physical restraint
and seclusion was imposed, including race, ethnicity, gender, disability status,
migrant status, English proficiency, and status as economically disadvantaged,
unless the demographic information would reveal personally identifiable
information about an individual student.
[OAR 581-021-0559(1)(a-j)]

26


5. Q: Is a separate incident log required for each student?
A: Best practice suggests that an incident log be maintained for each student
involved in a physical restraint and/or seclusion incident to facilitate “tracking” of
behavior. Depending on the specifics, the situation or circumstances associated
with the student (i.e. special education or general education), the log might be
filled in different ways and retained accordingly in compliance with the law and
district policies and procedures.

27


Reporting Requirements
When physical restraint and/or seclusion is necessary as an emergency procedure to prevent harm
to the student or others, parent(s)/guardian(s) must:
 Be notified of the physical restraint and/or seclusion either verbally or electronically by the
end of the school day of the incident;
 Receive written documentation of the incident within twenty-four hours that provides a
description of the physical restraint and/or seclusion;
 Be informed in a timely manner of a debriefing meeting to be held within two days and of
their right to attend the meeting; and
 Written notes must be taken of the debriefing meeting, and a copy of the written notes must
be provided to parent(s)/guardian(s).
Each entity that has jurisdiction over a public education program must prepare and submit to the
Superintendent of Public Instruction an annual report detailing the use of physical restraint and
seclusion for the preceding school year.
This annual report must be made available to the following:
 The public at the entity’s main office and the website of the entity;
 The school board or governing body overseeing the entity;
 If the entity is an ESD, the component school districts of the ESD;
 If the entity is a public charter school, the sponsor of the public charter school; and
 Parent(s)/Guardian(s) of students in a public education program, who shall be advised at
least once each school year about how to access the report.

28


Reporting Requirements Q&A

1.
Q: What are the annual reporting requirements?
A: The annual reporting requirements regarding physical restraint and

seclusion include that all incidents occurring the preceding school year must
be collected and made available by the local school district, entity,
consortium or cadre that has jurisdiction over the school district, ESD,
EI/ECSE or component school districts. The report must also be submitted
to the Superintendent of Public Instruction. [OAR 581-021-0559].
2.
Q: When making the annual report available to the public, what are the
responsibilities of the entities that have jurisdiction over a public education
program?
A: The annual report must be made public to the following:
 The Superintendent of Public Instruction via the state restraint and

seclusion collection;
 The entity’s main office and website;
 The school board or governing body overseeing the entity;
 If the entity is an ESD, the component school districts of the ESD;
 If the entity is a public charter school, the sponsor of the public charter
school;
The parent(s)/guardian(s) of students in a public education program shall

be advised, at least once each school year about accessing the annual
report.
3. Q: Is an incident report required for each student?
A: Yes. An incident report will be maintained for each student involved in a

physical restraint and/or seclusion incident to facilitate “tracking” of
behavior. Sample student incident reports are provided at the end of this
document.

29


General Questions Regarding Students with Accommodation
Plans and/or Special Needs
General Q&A
1.
Q: When should seclusion and/or physical restraint be included in a BIP?
A: If a student is on an IEP or Section 504 plan and the team could reasonably
foresee that the student may require seclusion and/or physical restraint,
either due to the nature and severity of the student’s behavior and/or a
history of the use of seclusion and/or physical restraint, then steps are
taken to include the use of seclusion and/or physical restraint in the BIP.
Prior to the implementation of any BIP that includes physical restraint and/or
seclusion, a functional behavior assessment must be completed.
2.
Q: Should a BIP be developed for students currently on an IEP or 504 plan if

the student’s behavior results in the use of seclusion and/or physical
restraint?
A: If the student with an IEP or 504 plan has been secluded and/or physically
restrained and does not have a BIP including seclusion and/or physical
restraint, then the appropriate individuals (IEP team, 504 plan team) need to
promptly meet and consider the need for a BIP. When the plan is developed
following the completion of a functional behavior assessment, the team
needs to determine whether or not to include seclusion and/or physical
restraint as a possible safety intervention. The BIP needs to specify the
behaviors and interventions to be implemented by staff at various levels and
stages to de-escalate behavior utilizing less invasive interventions. Physical
restraint and/or seclusion are last resort interventions after less restrictive
measures have been deemed ineffective.

30


3.
Q: What actions should a district take when a student who has not been
identified as eligible for special education or a 504 plan is subjected to
frequent seclusions and/or physical restraints?
A: If there is a suspected disability, the student must be promptly referred for

consideration of eligibility for special education or a Section 504 plan. In
addition, the team needs to consider the development of a BIP that may
include seclusion and/or restraint, even if the student is not found eligible
under IDEA or Section 504. Best practice would suggest conducting a
functional behavior assessment and implementing a behavior intervention
plan after two incidents of physical restraint and/or seclusion. However, the
law requires reviewing and revising the student’s behavior plan and
ensuring the provision of any necessary behavior supports after five
incidences involving restraint and/or seclusion.

31


Sample Forms
Physical Restraint Incident Report – Option 1
Physical Restraint Incident Report – Option 2
Physical Restraint Debriefing Report
Seclusion Incident Report – Option 1
Seclusion Incident Report – Option 2
Seclusion Debriefing Report
Physical Restraint and/or Seclusion Incident Report
Physical Restraint and/or Seclusion Debriefing Report – Condensed Version
Student Incident Log
Continuous Monitoring Form
Student Monitoring Form
Parent Notification Letter
Administrator Approval Form

32


PHYSICAL RESTRAINT INCIDENT REPORT (OPTION 1)
‘Physical restraint’ means the restriction of a student's movement by one or more persons holding
the student or applying physical pressure upon the student [OAR 581-021- 0550(3)(a&b)].
Physical restraint may also be used in the case of an emergency circumstance when trained
personnel are not immediately available due to the unforeseeable nature of the emergency
circumstance [OAR 581-021-0553(2)(B)(ii)].
A. Student Information
Student Name: SSID Number: Date of □ IEP Grade:

Birth:
□ 504 Plan
□ BIP
B. School Information
School: Address: District:
C. Incident Description
Date Incident Occurred: Time Restraint Began: Time Restraint Ended:
□ a.m. □ p.m. □ a.m. □ p.m.

Location of incident: Behavior(s) that lead to restraint:
□ Classroom
□ Hall
□ Cafeteria
□ Playground
□ Other:
______________________

33


Behavior(s) directed at: Description of activity in which the restrained student

or other students were engaged in immediately
□ Staff preceding the use of physical restraint:
□ Peers
□ Self
□ Other:
___________________
Thorough description of efforts made to de-escalate and alternatives to physical restraint that
were attempted:
Restraint methodology used: Physical restraint hold(s) used:
Why was the use of physical restraint necessary?

34


How restraint ended (check all that apply):
□ Determination by staff member(s) that student was no longer a risk to themselves

or others
□ Intervention by administrator(s) to facilitate de-escalation
□ Law enforcement personnel arrived
□ Staff sought medical assistance
□ Other (describe):
_______________________________________________________________________
_______________________________________________________________________
Student behavior during restraint: Student behavior after restraint:
Staff member(s) responsible for continuous Description of any injury to student(s) and/or staff
monitoring of student status during the and any medical/first aid care provided (as per
physical restraint: district policy, if injury occurred, complete
‘injury/accident report’ in addition to this form):
D. Staff Administering Restraint

35


Name: Position: Certified to Name of approved *Received prior
administer restraint restraint training:
restraints: methodology:
□ Yes □ Yes
□ No □ No
□ Yes □ Yes
□ No □ No
□ Yes □ Yes
□ No □ No
□ Yes □ Yes
□ No □ No
□ Yes □ Yes
□ No □ No
*If the staff member(s) involved with the restraint is not trained in an approved restraint
methodology, explain why not below:
E. Observers
Staff member(s)/other adult witness(es) Student(s):
Include name and position:
F. Parent(s)/Guardian(s) Notification1

36


1
Verbal or electronic notification of parent(s)/guardian(s) following the use of physical restraint is required by the end of
the school day the incident occurred; written notification is required within twenty-four hours [OAR 581-021-
0556(2)(a&b)].
Name of parent(s)/guardian(s) Documented attempt(s) to Contacted by the following
contacted: contact parent(s)/guardian(s) if staff member(s)
________________________ unable to contact verbally Include name and position:
________________________ Describe:
Phone number:
________________________
Date and time of contact:

________________________
□ a.m. □ p.m.
This report has been prepared by:
Signature: Position:
Address: Phone Number:
G. Continuous Physical Restraint Needed after Thirty (30) Minutes

Time (Every fifteen minutes): Administrator Signature and Parent(s)/Guardian(s)
Justification: Contacted:
Time: Immediately - Time/Date:
Staff member(s) making

Time: contact:
*Attempt(s) to contact -
Time/Date:
Time:
Electronic Telephone Direct

(Circle one)
Time:
*Continue to attempt contact
even if voicemail message has
been left.

37


PHYSICAL RESTRAINT INCIDENT REPORT (OPTION 2)
‘Physical restraint’ means the restriction of a student's movement by one or more persons holding
the student or applying physical pressure upon the student [OAR 581-021- 0550(3)(a&b)].
Physical restraint may also be used in the case of an emergency circumstance when trained
personnel are not immediately available due to the unforeseeable nature of the emergency
circumstance [OAR 581-021-0553(2)(B)(ii)].
Student Name: SSID Number: Date of Birth:
□ IEP □ 504 Plan □ BIP Grade: School:
Incident description:
Date Incident Occurred: Time Restraint Began: Time Restraint Ended:

□ a.m. □ p.m. □ a.m. □ p.m.
Location of incident: Behavior(s) that lead to physical restraint:
□ Classroom
□ Hall
□ Cafeteria
□ Playground
□ Other:
________________
Behavior(s) directed at: Description of activity in which the restrained student or other
□ Staff students were engaged in immediately preceding the use of
physical restraint:
□ Peers
□ Self
□ Other:

38


Thorough description of efforts made to de-escalate the situation and alternatives to physical
restraint that were attempted:
Restraint methodology used: Physical restraint hold(s) used:
Student behavior during restraint: Student behavior after restraint:
Why was the use of physical restraint How restraint ended (check all that apply):
necessary?
□ Determination by staff member(s) that
student was no longer a risk to
themselves or others
□ Intervention by administrator(s) to
facilitate de-escalation

___________________________________
___________________________________

39


Staff member(s) responsible for continuous Description of any injury to student(s) and/or
monitoring of student status during the physical staff and any medical/first aid care provided (as
restraint: per district policy, if injury occurred complete
‘injury/accident report’ in addition to this form):
Staff Administering Restraint
Name: Position: Certified to Name of approved Received prior

administer restraint restraint training:
restraints: methodology:
□ Yes □ Yes
□ No □ No
□ Yes □ Yes
□ No □ No
□ Yes □ Yes
□ No □ No
□ Yes □ Yes
□ No □ No
Observers
Parent(s)/Guardian(s) Notification2:
2
Verbal or electronic notification of parent(s)/guardian(s) following the use of physical restraint is required by the end of
the school day the incident occurred; written notification is required within twenty-four hours [OAR 581-021-
0556(2)(a&b)].

40


________________________ unable to contact verbally Include name and position:
________________________ Describe:
Phone number:
________________________

________________________
□ a.m. □ p.m.
This report has been prepared by

Name: Position: Date:

41


PHYSICAL RESTRAINT DEBRIEFING REPORT
Within two school days of using physical restraint a documented debriefing meeting by appropriate
staff, including staff involved in the restraint, must occur. Parent(s)/Guardian(s) must be informed of
the debriefing in a timely manner, with an invitation to join the debriefing meeting [OAR 581-021-
0556(4)(a)]. The purpose of the debriefing is to review the incident and the specifics surrounding it,
preferably from a function-based perspective, and take any necessary actions to reduce the
chances that such an incident will reoccur.
Student Name: SSID Number: Date of □ IEP Grade:

Birth:
□ 504 Plan
□ BIP
Date of Debriefing: Time of Debriefing: Location of Debriefing:
C. Debriefing Notes

42


D. Further Action(s) to be Taken
E. Signatures of Meeting Attendants
Name: Position: Signature:
F. This report has been prepared by
Name: Position: Address: Phone Number:

43


SECLUSION INCIDENT REPORT (OPTION 1)
‘Seclusion’ means the involuntary confinement of a student alone in a room from which the student
is physically prevented from leaving [OAR 581-021-0550(6)].
Student Name: SSID Number: Date of Birth: □ IEP Grade:
□ 504 Plan
□ BIP
C. Incident Description
Date Incident Occurred: Time Seclusion Began: Time Seclusion Ended:
□ a.m. □ a.m.
□ p.m. □ p.m.
Location of incident: Behavior(s) that lead to seclusion:
□ Classroom
□ Hall
□ Cafeteria
□ Playground
□ Other:
_______________
Behavior(s) directed at: Description of activity student(s) engaged in immediately
□ Staff preceding the use of seclusion:
□ Peers
□ Other:
_______________

44


Thorough description of efforts made to de-escalate and alternatives to seclusion attempted:
Why was the use of seclusion necessary? How seclusion ended (Check all that apply):
student no longer required seclusion
□ Intervention by administrator(s) to
facilitate de-escalation
□ Other (Describe):
_______________________________
_______________________________
Student behavior during seclusion: Student behavior after seclusion:
Staff member(s) responsible for continuous Location of seclusion room:

monitoring of student status during seclusion: _____________________________________
Seclusion room meets the following criteria:
□ Allows staff full view of the student in all
areas of the room
□ Free of potentially hazardous conditions,
such as: unprotected light fixtures and
electrical outlets

45


D. Observers
E. Parent/Guardian Notification3
3
Verbal or electronic notification of parent(s)/guardian(s) following the use of seclusion is required by the end of the
school day the incident occurred; written notification is required within twenty-four hours [OAR 581-021-
0556(2)(a&b)].
unable to contact Include name and position:
Describe:
Phone number:

□ a.m.
□ p.m.
F. Documentation of Continuous Seclusion Needed After Thirty (30) Minutes
Time (To be documented Administrator signature and Parent(s)/Guardian(s)

every fifteen minutes) justification contacted
Immediately - Time/Date:
Time:
Staff member(s) that made

Time:
contact:
Time:
Attempt(s) to contact -
Time/Date:
Time:
Time: (Circle One)

46


*Continue attempting to
Time: contact – even if message left
G. This report has been prepared by
Name: Position: Address: Phone:

47


SECLUSION INCIDENT REPORT (OPTION 2)
‘Seclusion’ means the involuntary confinement of a student alone in a room from which the student
is physically prevented from leaving [OAR 581-021-0550(6)].
Student Name: SSID Number: Date of Birth:
Grade: School:
□ IEP □ 504 Plan □ BIP
Incident Description
Date Incident Occurred: Time Seclusion Began: Time Seclusion Ended:
□ a.m. □ p.m. □ a.m. □ p.m.
Location of incident: Behavior(s) that lead to seclusion:
□ Classroom
□ Hall
□ Cafeteria
□ Playground
□ Other:
_______________________
Behavior(s) directed at: Description of activity in which the student(s) were engaged in
immediately preceding the use of seclusion:
□ Staff
□ Peers
□ Other:
______________________

48


Thorough description of efforts made to de-escalate and alternatives to seclusion that were
attempted:
Student behavior during seclusion: Student behavior after seclusion:
Location of seclusion room: How seclusion ended (Check all that apply):
___________________________________
Seclusion room meets the following criteria:
student no longer required seclusion
□ Allows staff full view of the student in all
□ Intervention by administrator(s) to facilitate
areas of the room
de-escalation
□ Free of potentially hazardous conditions
□ Other (Describe):
such as: unprotected light fixtures and
electrical outlets
Staff member(s) responsible for continuous monitoring of student status during seclusion
Name and position:
Observers
Staff member(s)/other adult witness(es) Student(s)
Name and position:

49


Parent(s)/Guardian(s) Notification4
4
Verbal or electronic notification of parent(s)/guardian(s) following the use of seclusion is required by the end of the
school day the incident occurred; written notification is required within twenty-four hours [OAR 581-021-
0556(2)(a&b)].
Describe:
Phone number:
□ a.m.
□ p.m.
Documentation of Continuous Seclusion Needed After Thirty (30) Minutes
Time (To be documented Administrator signature and Parent(s)/Guardian(s)

every fifteen minutes) justification contacted
Immediately - Time/Date:
Time:
Staff member(s) that made

Time: contact:
Time: Attempt(s) to contact -

Time/Date:
Time:
(Circle one)
Time:
*Continue to attempt contact

Time:
even if voicemail message left
This incident report has been prepared by
Name: Position: Date:

50


SECLUSION DEBRIEFING REPORT
Within two school days of the use of seclusion, a documented debriefing by appropriate staff must
occur, including staff involved in the seclusion [OAR 581-021-0556(4)(a)]. The purpose of the debriefing
is to review the incident and the specifics surrounding it, preferably from a function-based
perspective, and take any necessary actions to reduce the chances that such an incident will
reoccur. Those attending the debriefing meeting shall have the opportunity to review the Seclusion
Report documenting the incident.
Student Name: SSID Number: Date of Birth: □ IEP Grade:
□ 504 Plan
□ BIP
Date of Debriefing: Time of Debriefing: Location of Debriefing:
C. Debriefing Notes

51


D. Follow-up Actions
Signatures of those attending the debriefing Name: Position:

meeting:

52


PHYSICAL RESTRAINT AND/OR SECLUSION INCIDENT REPORT
Student Name: Incident Type:
Date of Birth:
SSID Number:
Date of Incident:
School Name: Number of incidents this school year:
□ IEP
□ 504 Plan
□ BIP Including the current incident in this report, every five

Approved training program used for incidents an IEP meeting, including the
physical restraint: parent(s)/guardians(s), must be held for the purpose of
reviewing and revising the student’s behavior plan, and
ensuring the provision of any necessary behavioral
supports.
Time restraint started: Time restraint ended: Total time of restraint:
□ a.m. □ a.m.
□ p.m. □ p.m.
Location of restraint (circle one):
Classroom Hall Cafeteria Playground Other (describe):
Time seclusion started: Time seclusion ended: Total time of seclusion:

□ a.m. □ a.m.
□ p.m. □ p.m.
Location of seclusion:
□ Allows staff full view of the student in all areas of the room

53


□ Is free of potentially hazardous conditions (unprotected fixtures/outlets)
Staff involved in the incident

Responsible
Certified to for
Administered administer Observed continuous
Name: Position: restraint: restraints: incident: monitoring:
□ Yes □ Yes □ Yes □ Yes
□ No □ No □ No □ No
Description of student activity that prompted the use of physical restraint and/or seclusion:
Description of efforts used to de-escalate the situation and the alternatives to physical restraint
and/or seclusion that were attempted:

54


Description of behavior(s) during physical restraint and/or seclusion (taken from continuous
monitoring form):
Description of any injury to student(s) and/or staff and any medical or first aid care provided* (as
per district policy, if injury occurred complete separate forms as needed in addition to this form):
*If serious bodily injury or death of a student occurs, written notification must be sent within twenty-four hours to the
Department of Human Services, the superintendent, and if applicable, to the union representative for the affected
party. A record of injuries and/or death must be maintained by the district. Contact the building administrator to report
this information.
How physical restraint and/or seclusion ended:
□ Determination by staff member(s) that the student was no longer a risk to themselves or
others
□ Intervention by administrator(s) to facilitate de-escalation
_______________________________________________________________________
Parent(s)/Guardian(s) Notification5
5
Verbal or electronic notification of parent(s)/guardian(s) following the use of physical restraint and/or seclusion is
required by the end of the school day the incident occurred; written notification is required within twenty-four hours
[OAR 581-021-0556(2)(a&b)].
Name of parent(s)/guardian(s) Documented attempts to Contacted by the following
Describe:

55


Phone number:
□ a.m.
□ p.m.
Method of Contact
□ In Person □ Phone □ Written Notice □ Other (Describe):
Date parent(s)/guardian(s) invited to debriefing meeting:
Parental/Guardian attendance is not required, but inviting them to the debriefing meeting is required. Written notes
must be taken of the debriefing meeting, and a copy of the written notes must be provided to the
parent(s)/guardians(s) of the student [OAR 581-021-0556(4)(a)].
This report has been prepared by

56


PHYSICAL RESTRAINT AND/OR SECLUSION DEBRIEFING REPORT
(CONDENSED VERSION)
Within two school days of the use of physical restraint and/or seclusion, a documented debriefing by
appropriate staff must occur, including staff involved in the incident [OAR 581-021-0556(4)(a)]. The
purpose of the debriefing is to review the incident and the specifics surrounding it, preferably from a
function-based perspective, and take any necessary actions to reduce the chances that such an
incident will reoccur. Those attending the debriefing meeting shall have the opportunity to review the
Physical Restraint and/or Seclusion Incident Report.
Debriefing Information
Date, time and location of debriefing:
Debriefing notes:
Further action(s) to be taken:
Signature of debriefing meeting attendees: Name: Position:

Copy of Debriefing Report sent to parent(s)/guardian(s) □ Yes; Date:

57


STUDENT INCIDENT LOG
Student Name: SSID Number:
Date: Type of Incident: Duration of Incident: Comments:

58


CONTINUOUS MONITORING FORM
State law requires continuous monitoring by personnel of the public education program for the
duration of the physical restraint and/or seclusion.
Student Name: SSID Number: Date of Birth: □ IEP
□ 504 Plan
□ BIP
School Name: Incident Type: Date and Location of
□ R: Physical Restraint Time of Incident:
Incident:
□ S: Seclusion
Write the actual time under the five-minute increments listed in the left column. Attach completed
form to the Incident Report.
Time Incident Continuous Monitoring Details (What is the student doing?) Staff Initials
Start □ R
□ S
5m □ R
□ S
10m □ R
□ S
15m □ R □ Alert administrator or designee
□ S
20m □ R
□ S
25m □ R
□ S
*30m □ R □ Administrator approval and justification required to
□ S continue physical restraint and/or seclusion
□ Opportunity for student to access bathroom and water
□ Parent Notification:
□ Who made contact:
□ Method of contact:
*At the thirty minute mark and every fifteen minutes thereafter, the following must happen:
□ Administrator or designee signature is required to continue;

59


□ Parent(s)/Guardian(s) must be contacted immediately; and

□ Administrative Approval for Continued Use of Physical Restraint and/or Seclusion form
must be completed.
Time Incident Continuous Monitoring Details (What is the student doing?) Staff Initials
35m □ R
□ S
40m □ R
□ S
□ S continue
50m □ R
□ S
55m □ R
□ S
*60m □ R □ Student given opportunity to access bathroom and
□ S water
65m □ R
□ S
70m □ R
□ S
□ S continue

60


STUDENT MONITORING RECORD
STUDENT MONITORING FORM
Name of Student:_______________________ Name of School:_________________________

Date:_________________ Start Time:_______________
Time: Incident Details of Student Behavior: Staff Comments:

Type: Initials:
5m □ Seclusion □ Sitting □ Yelling □ Quiet Voice
□ Physical □ Standing □ Swearing □ Calm Body
Restraint □ Laying □ Hitting/Kicking □ De-escalating
15m □ Seclusion □ Sitting □ Yelling □ Quiet Voice Alert Admin.
Bathroom? □ Accepted □ Rejected Staff Initials: Comments:
Water? □ Accepted □ Rejected Staff Initials: Comments:
Parent □ Yes □ No Staff Initials: Comments:

contact
made?

61


Administration Approval (Required to continue):
Time: Incident Details of Student Behavior: Staff Comments:
Type: Initials:
Restraint □ Laying □
Hitting/Kicking □ De-escalating
Bathroom? □ Accepted □ Rejected Staff Initials: Comments:
Water? □ Accepted □ Rejected Staff Initials: Comments:
Parent □ Yes □ No Staff Initials: Comments:

contact
made?

62


PARENT(S)/GUARDIAN(S) NOTIFICATION LETTER
This is a sample letter to notify the parent(s)/guardian(s) of a student who was involved in an
incident with an untrained staff member.
Replace all italicized words with the appropriate terms/names.
Dear Parent(s)/Guardian(s)
On Date, Student Name was involved in an Incident Type. Personnel involved in the incident, who
administered the Physical Restraint and/or Seclusion had not received training from a program
approved by the Oregon Department of Education. In accordance with OAR 581-021-0556, this
letter is to notify you that this occurred.
The reason an untrained staff member was involved in the incident was reason. The debriefing
meeting for this incident will be held on date at time. If you have any questions about this incident,
please contact me via phone at phone number.
Sincerely,
Name, Title
Signature

63


ADMINISTRATIVE APPROVAL FOR CONTINUED USE OF PHYSICAL RESTRAINT AND/OR
SECLUSION
Every fifteen minutes after the first thirty minutes of the physical restraint and/or seclusion, an
administrator for the public education program must provide written authorization for the
continuation of the physical restraint and/or seclusion. This includes providing justification for the
physical restraint and/or seclusion continuing [OAR 581-021-0553(3)(c)].
Administrator Name (Please Print):________________________ Time:____________
Reason for continued use of: (Circle One) Physical Restraint Seclusion
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Expiration Time of Approval

(15 Minutes):
Administrator Signature:_________________________________

Administrator Name (Please Print):________________________ Time:____________
Reason for continued use of: (Circle One) Physical Restraint Seclusion
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Expiration Time of Approval

(15 Minutes):
Administrator Signature:_________________________________

64


Quick Reference Guide to Physical Restraint and Seclusion
ONLY enter into physical restraint and/or seclusion in the case of imminent danger to
persons
DURING Physical Restraint and/or Seclusion:

1. Staff will constantly monitor student in physical restraint and/or seclusion;
2. Staff will notify administrator as soon as possible;
3. For physical restraint and/or seclusion exceeding thirty minutes:
a. Administrator will sign approval every fifteen minutes;
i. Use administrator approval form, provided by the district.
b. District personnel will immediately notify parent(s)/guardian(s) verbally or
electronically;
c. Adequate access to bathroom and water will be provided to the student every thirty
minutes.
AFTER Physical Restraint and/or Seclusion:

1. District personnel will notify parent(s)/guardian(s) by the end of the school day, verbally or
electronically;
2. Written notification will be provided to parent(s)/guardian(s) within twenty-four hours;
a. Use parent(s)/guardian(s) notification form, provided by the district.
3. An Incident Report will be completed by those involved in the physical restraint and/or
seclusion;
a. Use incident reporting form, provided by the district.
4. A Debriefing Meeting will be held within two school days after each incident of physical
restraint and/or seclusion;
a. Parent(s)/Guardian(s) must receive timely notification of a debriefing meeting to be
held and of their right to attend the meeting;
b. The notes from the meeting must be shared with the parent(s)/guardian(s);
c. Use debriefing form, provided by the district.

65


Acronym Index
BIP – Behavior Intervention Plan
DHS – Department of Human Services
ECSE – Early Childhood Special Education
EI – Early Intervention
ESD – Education Service District
FAPE – Free Appropriate Public Education
IDEA – Individuals with Disabilities Education Act
IEP – Individualized Education Program
IFSP – Individualized Family Support Plan
ISS – In-School Suspension
ODE – Oregon Department of Education

66

Guidelinestarestraintseclusion PDF

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Guidelinestarestraintseclusion PDF

Uploaded by

Copyright:

Available Formats

Oregon achieves . . . together!

Use of Physical Restraint and Seclusion

OREGON DEPARTMENT OF EDUCATION

OREGON DEPARTMENT OF EDUCATION

The statute and subsequent rules also specify the following:

OREGON DEPARTMENT OF EDUCATION

OREGON DEPARTMENT OF EDUCATION

USE OF PHYSICAL RESTRAINT & SECLUSION OARs

OREGON DEPARTMENT OF EDUCATION

Physical Restraint Defined:

In an emergency, a program administrator, teacher, program employee or volunteer may use

OREGON DEPARTMENT OF EDUCATION

A: Physical restraint means the restriction of a student's movement by one or

2. Q: When can physical restraint be used?

A: Only when the student’s behavior imposes a reasonable, imminent threat of

 School personnel must immediately attempt to notify the student’s

OREGON DEPARTMENT OF EDUCATION

4. Q: Must the student be continuously monitored while being physically

5. Q: Is it considered physical restraint when a staff member is escorting a student

A: Physical restraint means the restriction of a student's movement by one or

OREGON DEPARTMENT OF EDUCATION

7. Q: Educational programs that are located in facilities are subject to different

 Educational programs located in treatment programs, juvenile detention

 The rules for students in treatment programs can be referred to in Health

 Students in juvenile detention facilities or youth correctional facilities are

 Students placed in substance abuse programs that provide educational

a) Are for students in early childhood education, elementary school or

b) Are under the jurisdiction of a school district, an ESD or another educational

OREGON DEPARTMENT OF EDUCATION

8. Q: When physical restraint is included in a student BIP, what guidelines are

A: When a BIP includes physical restraint as a means of responding to student

 Specific about triggers of the behavior(s);

 Describes what the behavior(s) manifests as or looks like;

 Specifies how to respond with continual, less restrictive intervention(s) at

 Specifies what behavior(s) would ultimately result in physical restraint and/or

Again, physical restraint should be implemented only as specified in [OAR

OREGON DEPARTMENT OF EDUCATION

9. Q: What would constitute mechanical restraint versus the use of adaptive

A: Mechanical restraint is prohibited in the State of Oregon and can never be

Examples of Physical Restraint:

OREGON DEPARTMENT OF EDUCATION

In an emergency, a program administrator, teacher, program employee or volunteer may use

OREGON DEPARTMENT OF EDUCATION

A: Seclusion means the involuntary confinement of a student alone in a room from

2. Q: What does not constitute seclusion?

3. Q: Is in-school suspension (ISS) the same thing as seclusion?

A: No. Seclusion means the involuntary confinement of a student alone in a

• The student must be provided access to the bathroom and water;

• School personnel must immediately attempt to verbally or electronically notify

OREGON DEPARTMENT OF EDUCATION

5. Q: Must a student be continuously monitored while in seclusion and what

7. Q: What is the definition of a student being alone in a room?

OREGON DEPARTMENT OF EDUCATION

9. Q: What is an appropriate seclusion area/room?

A: An appropriate seclusion area/room is free of potential harmful objects, such

A: The standards for seclusion rooms are:

 Doors must be unlocked or equipped with immediate-release locking

 The room must not contain protruding, exposed, or sharp objects;

 The room must not contain free standing furniture;

OREGON DEPARTMENT OF EDUCATION

 Walls, floors and ceiling must be solidly and smoothly constructed, to be

 Seclusion cells are prohibited [OAR 581-021-0569].

A: Structural Integrity (April, 2014) largely refers to those objects’