Wednesday, July 2, 2008
FYI: PaTTAN Announces Training Announcement
The Pennsylvania Department of Education, Bureau of Special Education and PaTTAN are proud to announce an exciting opportunity to participate in the 2008 National Autism Conference via live web casting. The Autism 101 strand will be available to view live from your computer. During the conference, simply visit the website www.outreach.psu.edu/conference/autism and click on the Live Web Cast page and follow the instructions on the days that you wish to participate. There is no fee to participate. Please continue to check the website for updated information. To prepare for viewing, visit the website up to two weeks prior to the National Autism Conference and view a test stream on the Live Web Cast page.
Sessions available for viewing through live webcasting
For complete session descriptions visit www.outreach.psu.edu/conference/autism
Progress Through PartnershipWhen: August 4 - 8, 2008
Location: Live Webinar
Monday, August 4th
1. Opening Keynote: Eustacia Cutler
2. Autism Research Update 2008, Duane Alexander
3. Updates on PA's Efforts to Provide Supports to Learners with ASD, John Tommasini
4. An Introduction to Autism Spectrum Disorders
Tuesday, August 5th
13. Comprehensive Autism Assessment for Intervention Planning
24. The Instructional Environment and Visual Strategies
Wednesday, August 6th
39. Elements of Effective Instruction for Learners with ASD
50. Curriculum Considerations
Thursday, August 7th
63. Strategies for Successful Inclusion
74. Preparing for Smooth Transitions
Friday, August 8th
89. Creating Partnerships with Families
101. I am a Student with Autism
Sessions available for viewing through live webcasting
For complete session descriptions visit www.outreach.psu.edu/conference/autism
Progress Through PartnershipWhen: August 4 - 8, 2008
Location: Live Webinar
Monday, August 4th
1. Opening Keynote: Eustacia Cutler
2. Autism Research Update 2008, Duane Alexander
3. Updates on PA's Efforts to Provide Supports to Learners with ASD, John Tommasini
4. An Introduction to Autism Spectrum Disorders
Tuesday, August 5th
13. Comprehensive Autism Assessment for Intervention Planning
24. The Instructional Environment and Visual Strategies
Wednesday, August 6th
39. Elements of Effective Instruction for Learners with ASD
50. Curriculum Considerations
Thursday, August 7th
63. Strategies for Successful Inclusion
74. Preparing for Smooth Transitions
Friday, August 8th
89. Creating Partnerships with Families
101. I am a Student with Autism
Labels:
Training Announcements
Wednesday, April 23, 2008
Local Special Needs Student Beaten On School Bus
INDUSTRY, Pa. (KDKA) ― http://kdka.com/local/Western.beaver.bus.2.706269.html
Cell phone video recorded by students captured the beating of a special needs student in Beaver County on a school bus.
A 17-year-old student allegedly beat a 16-year-old student unconscious on a Western Beaver school bus last week.
"It was just shocking and appalling that students would videotape it and that someone would even think about hitting someone who was disabled," Linda Lamantis, a parent, said.
"They're rude and one tries to outdo the other one," Connie Noah, a parent, said.
Parents and students outraged by the act gathered Tuesday evening, disgusted by what happened. "
And he was hit like 13, 14 times we heard," Gabrielle Noto, a student, said. "And he's a good kid though. Like, the way he is, he goes and talks to everyone,! he's really nice, he's a sweetheart and I don't think he deserved it at all."
Witnesses tell KDKA the incident happened in the parking lot at the Western Beaver High School. They also say the 17-year-old 11th Grader was unprovoked.
Additionally, witnesses say the bus driver tried to stop the fight but was blocked.
Industry Police are investigating the assault, trying to determine if students on the bus went as far as to bet on the winner of the fight.
KDKA's Marty Griffin reports the attacked student suffered a concussion, chipped teeth and had problems with his jaw. He's now back in school with a special escort.
The student accused in the assault has been suspended.
Cell phone video recorded by students captured the beating of a special needs student in Beaver County on a school bus.
A 17-year-old student allegedly beat a 16-year-old student unconscious on a Western Beaver school bus last week.
"It was just shocking and appalling that students would videotape it and that someone would even think about hitting someone who was disabled," Linda Lamantis, a parent, said.
"They're rude and one tries to outdo the other one," Connie Noah, a parent, said.
Parents and students outraged by the act gathered Tuesday evening, disgusted by what happened. "
And he was hit like 13, 14 times we heard," Gabrielle Noto, a student, said. "And he's a good kid though. Like, the way he is, he goes and talks to everyone,! he's really nice, he's a sweetheart and I don't think he deserved it at all."
Witnesses tell KDKA the incident happened in the parking lot at the Western Beaver High School. They also say the 17-year-old 11th Grader was unprovoked.
Additionally, witnesses say the bus driver tried to stop the fight but was blocked.
Industry Police are investigating the assault, trying to determine if students on the bus went as far as to bet on the winner of the fight.
KDKA's Marty Griffin reports the attacked student suffered a concussion, chipped teeth and had problems with his jaw. He's now back in school with a special escort.
The student accused in the assault has been suspended.
Friday, April 18, 2008
Blog Talk Radio Tonight!
Families PLEASE JOIN THE blogtalkradio WAKEUP CALL SHOW TONIGHT FRIDAY APRIL 18, 2008 AT 8 PM EASTERN TIME.
We will be discussing the following:
Restraint and Seclusion
Creating Bills
Working with Legislatures
Getting parent support
Parents need to work together
Mediation
You are invited to log on and listen and call in to ask questions.
The call in line is 646-716-8675.
ENTER http://www.blogtalkradio.com/wakeupcallshow
or
Go to the http://communityactions.org and click on the blogtalkradio link at the RADIO page.
Please call in and let your voices be heard.
The call in line is 646-716-8675
We will be discussing the following:
Restraint and Seclusion
Creating Bills
Working with Legislatures
Getting parent support
Parents need to work together
Mediation
You are invited to log on and listen and call in to ask questions.
The call in line is 646-716-8675.
ENTER http://www.blogtalkradio.com/wakeupcallshow
or
Go to the http://communityactions.org and click on the blogtalkradio link at the RADIO page.
Please call in and let your voices be heard.
The call in line is 646-716-8675
Monday, March 10, 2008
Suit: District Ignored Abuse of Special Ed Kids
By MENSAH M. DEAN
Philadelphia Daily News
deanm@phillynews.com 215-854-5949
Special-education students at Martha Washington Elementary School this fall allegedly were forced by their teacher to fistfight in the middle of the classroom. They allegedly were forced to stand with their hands raised in the air for two hours, missing lunch.
Their teacher at the West Philadelphia school also verbally abused the students, calling one "black, crispy and ashy," and another "turtle," who, because of mental and physical disabilities, moved and spoke slowly, according to allegations made in a whistle-blower lawsuit filed Thursday in U.S. District Court. The defendants are the School District of Philadelphia and Community Council for Mental Health and Mental Retardation, Inc., a nonprofit company the district employs to provide care for special-needs children.
In the lawsuit, Perlyn Severe-Clarke, 36, a clinical therapist, and Tracy Brice, 39, an associate counselor, allege that they were fired by Community Council in December after complaining to a supervisor about the alleged ongoing abusive behavior and language exhibited by the classroom teacher, who also worked for the company.
The terminations came less than a week after Brice used her cell-phone camera to record one of the teacher's instigated fights, the lawsuit claims.
"I believe that the conduct on the teacher's part was disturbing to them," Jill Fisher, the plaintiffs' attorney, said yesterday. "They reported it to their superiors on several different occasions . . . and they were rewarded for their efforts by being fired."
The plaintiffs are seeking reinstatement, back pay and unspecified monetary and punitive damages, said Fisher, of the Philadelphia firm of Zarwin, Baum, DeVito, Kaplan, Schaer and Toddy, P.C.
Also named in the lawsuit are employees of Community Council and the school district, including interim Chief Executive Officer Tom Brady and the principal of Martha Washington Elementary, Carolyn Jackson.
Jackson yesterday did not return a Daily News phone call to her school, on 44th Street near Lancaster Avenue.
"Because this is a pending legal matter the district is unable to comment at this time," said Fernando Gallard, the district's chief spokesman.
Earl Bradford, executive director of Community Council, at 49th Street and Wyalusing Avenue, declined to comment, but did refute the basis of the lawsuit.
"The allegation is outrageous, and it will be appropriately adjudicated in a court of law," he said by phone yesterday.
"It's in litigation. We have insurance and a lawyer has been assigned to it," Bradford added.
Fisher said that the defendants violated the state's Whistleblower Law by terminating her clients after they made a good-faith report of suspected child abuse in accordance with the state's Child Protective Services Law.
When they were terminated - Brice on Dec. 17 and Severe-Clarke on Dec. 18 - a Community Council supervisor said it had been due to tardiness, though neither had received notices for being tardy before. The company supervisor read both plaintiffs a letter, reportedly from Principal Jackson, telling them that they were no longer wanted at the school.
Both were also told by the supervisor that Community Council was not about to lose its contract with the district because of them, said Fisher, who herself worked as a special-education teacher for the district in the 1980s.
Severe-Clarke began working for the company in Jan. 2006 and Brice was hired in May 2007. At the time of their firing, they worked in the same classroom with the teacher named in the lawsuit, serving 12 children aged 9 to 13.
"Having been a special-education teacher, I just was shocked and appalled at what I was hearing and at the response of the company to rush and fire my clients when they were just doing their jobs," Fisher said.
"The biggest question is, are there other acts of abuse or mistreatment or neglect by staff members that are being now - or have been in the past - covered up? The concern for the school children's safety and well being is the reason for my clients blowing the whistle," she said.
"But can the same be said for the school district and the private company? Who, or what, were they concerned about? Those questions have to be answered," the lawyer added.
District spokesman Gallard could not say how much Community Council is being paid.
The company has 120 employees in 40 district classrooms providing emotional-support services to students with a range of disabilities, including serious emotional disturbances, Gallard said. *
Find this article at:
http://www.philly.com/dailynews/local/20080308_Suit__District_ignored_abuse_of_special-ed_kids.html?adString=pdn.news/local;!category=local;&randomOrd=031008033214
Philadelphia Daily News
deanm@phillynews.com 215-854-5949
Special-education students at Martha Washington Elementary School this fall allegedly were forced by their teacher to fistfight in the middle of the classroom. They allegedly were forced to stand with their hands raised in the air for two hours, missing lunch.
Their teacher at the West Philadelphia school also verbally abused the students, calling one "black, crispy and ashy," and another "turtle," who, because of mental and physical disabilities, moved and spoke slowly, according to allegations made in a whistle-blower lawsuit filed Thursday in U.S. District Court. The defendants are the School District of Philadelphia and Community Council for Mental Health and Mental Retardation, Inc., a nonprofit company the district employs to provide care for special-needs children.
In the lawsuit, Perlyn Severe-Clarke, 36, a clinical therapist, and Tracy Brice, 39, an associate counselor, allege that they were fired by Community Council in December after complaining to a supervisor about the alleged ongoing abusive behavior and language exhibited by the classroom teacher, who also worked for the company.
The terminations came less than a week after Brice used her cell-phone camera to record one of the teacher's instigated fights, the lawsuit claims.
"I believe that the conduct on the teacher's part was disturbing to them," Jill Fisher, the plaintiffs' attorney, said yesterday. "They reported it to their superiors on several different occasions . . . and they were rewarded for their efforts by being fired."
The plaintiffs are seeking reinstatement, back pay and unspecified monetary and punitive damages, said Fisher, of the Philadelphia firm of Zarwin, Baum, DeVito, Kaplan, Schaer and Toddy, P.C.
Also named in the lawsuit are employees of Community Council and the school district, including interim Chief Executive Officer Tom Brady and the principal of Martha Washington Elementary, Carolyn Jackson.
Jackson yesterday did not return a Daily News phone call to her school, on 44th Street near Lancaster Avenue.
"Because this is a pending legal matter the district is unable to comment at this time," said Fernando Gallard, the district's chief spokesman.
Earl Bradford, executive director of Community Council, at 49th Street and Wyalusing Avenue, declined to comment, but did refute the basis of the lawsuit.
"The allegation is outrageous, and it will be appropriately adjudicated in a court of law," he said by phone yesterday.
"It's in litigation. We have insurance and a lawyer has been assigned to it," Bradford added.
Fisher said that the defendants violated the state's Whistleblower Law by terminating her clients after they made a good-faith report of suspected child abuse in accordance with the state's Child Protective Services Law.
When they were terminated - Brice on Dec. 17 and Severe-Clarke on Dec. 18 - a Community Council supervisor said it had been due to tardiness, though neither had received notices for being tardy before. The company supervisor read both plaintiffs a letter, reportedly from Principal Jackson, telling them that they were no longer wanted at the school.
Both were also told by the supervisor that Community Council was not about to lose its contract with the district because of them, said Fisher, who herself worked as a special-education teacher for the district in the 1980s.
Severe-Clarke began working for the company in Jan. 2006 and Brice was hired in May 2007. At the time of their firing, they worked in the same classroom with the teacher named in the lawsuit, serving 12 children aged 9 to 13.
"Having been a special-education teacher, I just was shocked and appalled at what I was hearing and at the response of the company to rush and fire my clients when they were just doing their jobs," Fisher said.
"The biggest question is, are there other acts of abuse or mistreatment or neglect by staff members that are being now - or have been in the past - covered up? The concern for the school children's safety and well being is the reason for my clients blowing the whistle," she said.
"But can the same be said for the school district and the private company? Who, or what, were they concerned about? Those questions have to be answered," the lawyer added.
District spokesman Gallard could not say how much Community Council is being paid.
The company has 120 employees in 40 district classrooms providing emotional-support services to students with a range of disabilities, including serious emotional disturbances, Gallard said. *
Find this article at:
http://www.philly.com/dailynews/local/20080308_Suit__District_ignored_abuse_of_special-ed_kids.html?adString=pdn.news/local;!category=local;&randomOrd=031008033214
Friday, February 22, 2008
Teacher Ordered to Trial for Assaulting Students
Feb 21, 2008 04:33 PM EST
By Scott Schaffer
A teacher will stand trial on charges she assaulted some of her students who were part of a special education program in one Luzerne County school district. Angela Kairo-Scibek, 41, left central court in Wilkes-Barre today after hearing from a judge that she will stand trial on charges of simple assault, and endangering the welfare of children.
Angela Kairo-Scibek was ordered to stand trial on charges she assaulted some special education students in the Wyoming Valley West School District.
Three students testified in court that Kairo-Scibek smacked them with a ruler when she was their teacher at Main Street Elementary School in Plymouth.
According to the testimony, some of the abuse was severe enough to leave bruises and the students were instructed not to tell anyone about the abuse or it would continue.
Two of the children testified that Kairo-Scibek would tell them it was time to play a game called "child abuse" and they were it.
Some parents became emotional in court listening to their children tell the tales of the alleged abuse. One 13-year-old girl testified that Kairo-Scibek put a pillow over her face, told her not to scream and smacked her with a ruler.
"How difficult was it for her to hear her students on the witness stand testifying against her today? Nocito: "There were numerous, numerous inconsistencies and they're the one's that we'll be exploring. They will be explored at trial," said Frank Nocito, Kairo-Scibek's attorney.
He pointed out that a police search of the classroom turned up no pillow and no ruler.
Assistant District Attorney Jenny Roberts said she's confident the testimony from her young witnesses will hold up at trial.
"It's always difficult when your witnesses are children and especially in this particular case because as you know in this case the witnesses are special needs children," Roberts conceded.
No one was available for comment this afternoon from Wyoming Valley West School District.
Newswatch 16 reported in December that Kairo-Scibek was suspended with pay last year after the allegations came to light.
By Scott Schaffer
A teacher will stand trial on charges she assaulted some of her students who were part of a special education program in one Luzerne County school district. Angela Kairo-Scibek, 41, left central court in Wilkes-Barre today after hearing from a judge that she will stand trial on charges of simple assault, and endangering the welfare of children.
Angela Kairo-Scibek was ordered to stand trial on charges she assaulted some special education students in the Wyoming Valley West School District.
Three students testified in court that Kairo-Scibek smacked them with a ruler when she was their teacher at Main Street Elementary School in Plymouth.
According to the testimony, some of the abuse was severe enough to leave bruises and the students were instructed not to tell anyone about the abuse or it would continue.
Two of the children testified that Kairo-Scibek would tell them it was time to play a game called "child abuse" and they were it.
Some parents became emotional in court listening to their children tell the tales of the alleged abuse. One 13-year-old girl testified that Kairo-Scibek put a pillow over her face, told her not to scream and smacked her with a ruler.
"How difficult was it for her to hear her students on the witness stand testifying against her today? Nocito: "There were numerous, numerous inconsistencies and they're the one's that we'll be exploring. They will be explored at trial," said Frank Nocito, Kairo-Scibek's attorney.
He pointed out that a police search of the classroom turned up no pillow and no ruler.
Assistant District Attorney Jenny Roberts said she's confident the testimony from her young witnesses will hold up at trial.
"It's always difficult when your witnesses are children and especially in this particular case because as you know in this case the witnesses are special needs children," Roberts conceded.
No one was available for comment this afternoon from Wyoming Valley West School District.
Newswatch 16 reported in December that Kairo-Scibek was suspended with pay last year after the allegations came to light.
Friday, November 16, 2007
Exceptional Parent Magazine
Eliminating Restraint, Seclusion, and Aversives in Our Schools: A parent’s thoughts on why we’re stuck and how to move forward
By Pat Amos
Sept 30, 2007
Reprinted with Permission
In the small hours of a recent night I found myself in a hospital emergency room waiting for my son’s release after treatment of a seizure. As I sat decompressing, I heard a group of hospital staff assemble in the corridor and then heard the word “restraint.” After a quarter-century as an advocate for people with disabilities, few words get me to my feet faster. I edged closer to the curtain to listen in.
The discussion turned on a hospital credentialing review that was to occur later that day, and I realized with growing satisfaction that it was a model of its kind. Staff reviewed the hospital’s policies that restricted restraint to dire emergencies, and the strict procedures to be followed in the event that such an emergency could not be prevented. Doctors were to be called, permissions obtained, oversight provided, brevity and safety stressed. They talked about the debriefing and extensive documentation that would be required of them should they ever participate in a restraint. It was clear from the hushed tones and careful recitals of these healthcare staff that they understood the gravity of the subject and their medical responsibility to “do no harm.”
How ironic, I thought, that my daylight hours are so often spent with parents whose children who have been harmed by casual and multiple restraint use in their schools, at the hands of the very adults entrusted with their care. It is no longer a secret that every day, across our country, special education students are grabbed and immobilized, tied and strapped to chairs, and held in basket holds and prone restraints that are known to cause asphyxia. Sometimes frightened children are dragged to seclusion rooms, a form of restraint involving forced isolation. Despite the fact that they are known to cause injury, intense psychological trauma, and even death, these extreme methods are justified as education, discipline, or behavior therapy. Under these reassuring guises they tend to be used repeatedly and with impunity. Sometimes they are written into a child’s Behavior Intervention Plan (BIP) or Individualized Education Plan (IEP), and sometimes they fly under the radar, with parents uninformed.
Either way, the easy and reckless use of restraint in our schools stands in stark contrast to the cautious avoidance with which restraint use is now expected to be approached in hospital, rehabilitation, nursing care, mental health, and related medical settings. What many school systems still see as a viable treatment or plan, health care systems increasingly repudiate as a failure of treatment and a failure to plan. How did our nation’s special education system get to a place where school teachers and classroom aides rush in where medical professionals fear to tread? And what is our exit strategy?
The short answer to why children with disabilities remain at unnecessary risk in their schools is a nationwide failure of leadership. While our education system refuses to face the problem, hospitals, nursing homes, and mental health treatment settings have recognized and acted to end the serious risks associated with the use of restraint and seclusion. Federal and state authorities and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) now impose significant restrictions on its use and require specialized staff training, rigorous review of each usage, and detailed data reporting. Advocates and their Congressional allies achieved passage of the Children’s Health Act of 2000, which offers significant protections to children in mental health settings. The President’s New Freedom Commission on Mental Health (2003) set forth a vision for safe, humane services. And the Centers for Medicare and Medicaid Services (CMS) have taken a leadership role in shedding light on the dangers of restraint and seclusion, enforcing higher standards and accountability across the programs they fund.
In contrast, many state education agencies continue to operate without regulating, or with regulations that specifically allow, the use of non-emergency restraint, seclusion, and even aversive “punishers” (which have no justification even as emergency responses) on children with disabilities. In fact, the New York State Department of Vocational and Educational Services recently widened the array of aversives it would permit for use on school children with disabilities. This patchwork of dangerous and inequitable state-level special education regulations, although neither evidence-based nor in sync with the protections children receive in other settings, is quietly accepted by the federal government. This apathy must end. In an education system dedicated to producing lifelong learners, it is time for our leaders to learn new lessons from the successful reduction and elimination of restraint and seclusion in other service systems.
These lessons are turning out to be encouragingly clear and simple. The National Technical Assistance Center (NTAC), National Association of State Mental Health Program Directors, has analyzed the Core Strategies leading to successful restraint/seclusion reduction and elimination in mental health settings and compiled them into a 6-point lesson plan. With a little curriculum modification, I believe we can make this lesson accessible to the education system:
1. Leadership Toward Organizational Change. This first strategy identified by NTAC requires the organizational leader or CEO – for schools read “principal” – to define and articulate “a vision, values and philosophy” resulting in an action plan based on “continuous quality improvement.” That leader must then be present and involved in “witnessing” any time a restraint occurs. “Witnessing” is a surprisingly simple and powerful concept that forces a problem into awareness and demands personal accountability. Imagine how witnessing could change the culture of a school: no hiding restraint and its aftermath behind closed doors, no looking the other way, no deniability. To lead with integrity, those in power would have to become active learners engaged in discovering what happened, why it happened, and how to prevent it from happening again.
2. Use of Data to Inform Practice. Now that evidence-based practices have become part of the common language of the education system, this strategy translates easily. Schools need to follow the example of health care facilities and pay rigorous attention to gathering data on restraint use: by classroom, school, district, characteristics of the individual and situation, and other informative variables. An all-too-common practice in special education has been to bury restraint usage in students’ IEPs or BIPs, reporting data only on “emergency” restraint – an emergency being, for practical purposes, any restraint use that has not been given prior permission in a student’s plan. However, a “planned emergency” is not only an oxymoron but an incentive to write restraint into more students’ plans. State education systems will undoubtedly try other ingenious strategies to avoid facing the data – for example, Pennsylvania’s State Board of Education recently proposed new regulations that would exempt restraints of no more than 30 continuous seconds from being counted as restraints, no matter how many were performed in a row or how much aggregate time a student spent in this way. This is where national-level leadership, from the U.S. Department of Education to Congress, has to get tough. Continuous quality improvement can only build on a foundation of hard data.
3. Workforce Development. NTAC calls for the development of “trauma informed systems of care,” a different and broader focus than the mere promotion of physical safety during restraint. Trauma-informed care promotes responsibility for the emotional wellbeing of children. It is based on research from psychology, child development, and neuroscience that shows that children exposed to high stress situations tend to develop challenging behaviors which in turn expose them to further stress. The take-home message—or take-to-school message—is that using restraint, seclusion or other aversives to change the behavior of students with disabilities is the type of stressor that can lead to the development of attentional, motivational, impulse-control, and mental health problems. These problems, in turn, can lead to behavior that is mistakenly blamed on the disability and subjected to further trauma-inducing responses, such as more restraint. An understanding of this vicious cycle and how to stop it must become part of every educator’s skill set.
4. Use of Seclusion/Restraint Prevention Tools. This strategy from mental health settings is paralleled by the requirement under the Individuals with Disabilities Education Improvement Act (IDEIA) that IEP teams approach a child through “positive behavior interventions and strategies,” which in turn should trigger a Functional Behavioral Assessment (FBA) when a Behavior Intervention Plan is needed. What the special education system lacks is comprehensive implementation of those tools. For example, California’s Protection and Advocacy, Inc. (PAI) recently gave that state’s schools an “F” for failure to confront widespread abuses of restraint and seclusion. In the cases PAI investigated, schools failed to utilize the significant preventative tools at their disposal: there were no proactive plans to address known problems, and no meetings were convened after a restraint to discuss changes in the IEP or to arrange for an FBA. NTAC notes that “This strategy relies heavily on the concept of individualized treatment.” Similarly, schools fail their students when they fail to individualize.
5. Consumer Roles in Inpatient Settings. Successful strategies in mental health settings involve “the full and formal inclusion of consumers, children, families and external advocates in various roles and at all levels in the organization to assist in the reduction of seclusion and restraint.” In our schools, this would translate into greatly increased parental involvement, welcoming parents and advocates as resources who have valuable insights and proactive strategies to impart on behalf of individual children. It would also translate into welcoming parents and students to participate in debriefing interviews when problems occur, and encouraging their participation in the development of relevant school and district policies. Operating with this level of openness and transparency has been a frightening prospect for many schools, yet the experiences of the mental health system demonstrate the importance of meaningful inclusion of all stakeholders in achieving successful systems change.
6. Debriefing Techniques. This final Core Strategy insists that every use of restraint or seclusion is meaningful and must be analyzed to avoid repetition. No such event can be accepted as unimportant, unavoidable, or part of someone’s routine plan. In our schools, the student and student’s family must be central to this process. If educators truly believe in the value of critical thinking, they need to put this skill into action instead of unthinkingly making the same dangerous responses over and over.
None of these six Core Strategies involve rocket science, but seeing them implemented will involve leadership at the highest levels of our federal Department of Education and among members of Congress. The mental health community made great strides in restraint and seclusion prevention, despite disbelief and opposition, when visionary national leaders connected with an organized and supportive grassroots constituency. Similarly, parents, families, and self-advocates must insist that our schools stop lurching from tragedy to tragedy and be guided by strong national policies that are proven effective in preventing these dangerous, inhumane practices. Each time the use of restraint, seclusion or other aversives comes to light we must loudly, publicly, and relentlessly “witness”— and insist that our leaders witness with us.
NTAC’s “Six Core Strategies to Reduce the Use of Seclusion and Restraint” and related planning tools can be accessed through the web site of The National Association of State Mental Health Program Directors: http://www.nasmhpd.org/ntac.cfm
------------------------------------------------------------------------------------------------
Pat Amos, M.A., has been an advocate for people with disabilities for over 25 years. She is a founder of Autism Support and Advocacy in Pennsylvania (ASAP) and of The Family Alliance to Stop Abuse and Neglect, past president of the Greater Philadelphia Autism Society, and past president of the Autism National Committee. Currently she is a member of the Board of Directors of TASH, an international organization that promotes equity, opportunity, and inclusion for all individuals with disabilities. Pat's family includes three young adults with significant sensorimotor differences.
By Pat Amos
Sept 30, 2007
Reprinted with Permission
In the small hours of a recent night I found myself in a hospital emergency room waiting for my son’s release after treatment of a seizure. As I sat decompressing, I heard a group of hospital staff assemble in the corridor and then heard the word “restraint.” After a quarter-century as an advocate for people with disabilities, few words get me to my feet faster. I edged closer to the curtain to listen in.
The discussion turned on a hospital credentialing review that was to occur later that day, and I realized with growing satisfaction that it was a model of its kind. Staff reviewed the hospital’s policies that restricted restraint to dire emergencies, and the strict procedures to be followed in the event that such an emergency could not be prevented. Doctors were to be called, permissions obtained, oversight provided, brevity and safety stressed. They talked about the debriefing and extensive documentation that would be required of them should they ever participate in a restraint. It was clear from the hushed tones and careful recitals of these healthcare staff that they understood the gravity of the subject and their medical responsibility to “do no harm.”
How ironic, I thought, that my daylight hours are so often spent with parents whose children who have been harmed by casual and multiple restraint use in their schools, at the hands of the very adults entrusted with their care. It is no longer a secret that every day, across our country, special education students are grabbed and immobilized, tied and strapped to chairs, and held in basket holds and prone restraints that are known to cause asphyxia. Sometimes frightened children are dragged to seclusion rooms, a form of restraint involving forced isolation. Despite the fact that they are known to cause injury, intense psychological trauma, and even death, these extreme methods are justified as education, discipline, or behavior therapy. Under these reassuring guises they tend to be used repeatedly and with impunity. Sometimes they are written into a child’s Behavior Intervention Plan (BIP) or Individualized Education Plan (IEP), and sometimes they fly under the radar, with parents uninformed.
Either way, the easy and reckless use of restraint in our schools stands in stark contrast to the cautious avoidance with which restraint use is now expected to be approached in hospital, rehabilitation, nursing care, mental health, and related medical settings. What many school systems still see as a viable treatment or plan, health care systems increasingly repudiate as a failure of treatment and a failure to plan. How did our nation’s special education system get to a place where school teachers and classroom aides rush in where medical professionals fear to tread? And what is our exit strategy?
The short answer to why children with disabilities remain at unnecessary risk in their schools is a nationwide failure of leadership. While our education system refuses to face the problem, hospitals, nursing homes, and mental health treatment settings have recognized and acted to end the serious risks associated with the use of restraint and seclusion. Federal and state authorities and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) now impose significant restrictions on its use and require specialized staff training, rigorous review of each usage, and detailed data reporting. Advocates and their Congressional allies achieved passage of the Children’s Health Act of 2000, which offers significant protections to children in mental health settings. The President’s New Freedom Commission on Mental Health (2003) set forth a vision for safe, humane services. And the Centers for Medicare and Medicaid Services (CMS) have taken a leadership role in shedding light on the dangers of restraint and seclusion, enforcing higher standards and accountability across the programs they fund.
In contrast, many state education agencies continue to operate without regulating, or with regulations that specifically allow, the use of non-emergency restraint, seclusion, and even aversive “punishers” (which have no justification even as emergency responses) on children with disabilities. In fact, the New York State Department of Vocational and Educational Services recently widened the array of aversives it would permit for use on school children with disabilities. This patchwork of dangerous and inequitable state-level special education regulations, although neither evidence-based nor in sync with the protections children receive in other settings, is quietly accepted by the federal government. This apathy must end. In an education system dedicated to producing lifelong learners, it is time for our leaders to learn new lessons from the successful reduction and elimination of restraint and seclusion in other service systems.
These lessons are turning out to be encouragingly clear and simple. The National Technical Assistance Center (NTAC), National Association of State Mental Health Program Directors, has analyzed the Core Strategies leading to successful restraint/seclusion reduction and elimination in mental health settings and compiled them into a 6-point lesson plan. With a little curriculum modification, I believe we can make this lesson accessible to the education system:
1. Leadership Toward Organizational Change. This first strategy identified by NTAC requires the organizational leader or CEO – for schools read “principal” – to define and articulate “a vision, values and philosophy” resulting in an action plan based on “continuous quality improvement.” That leader must then be present and involved in “witnessing” any time a restraint occurs. “Witnessing” is a surprisingly simple and powerful concept that forces a problem into awareness and demands personal accountability. Imagine how witnessing could change the culture of a school: no hiding restraint and its aftermath behind closed doors, no looking the other way, no deniability. To lead with integrity, those in power would have to become active learners engaged in discovering what happened, why it happened, and how to prevent it from happening again.
2. Use of Data to Inform Practice. Now that evidence-based practices have become part of the common language of the education system, this strategy translates easily. Schools need to follow the example of health care facilities and pay rigorous attention to gathering data on restraint use: by classroom, school, district, characteristics of the individual and situation, and other informative variables. An all-too-common practice in special education has been to bury restraint usage in students’ IEPs or BIPs, reporting data only on “emergency” restraint – an emergency being, for practical purposes, any restraint use that has not been given prior permission in a student’s plan. However, a “planned emergency” is not only an oxymoron but an incentive to write restraint into more students’ plans. State education systems will undoubtedly try other ingenious strategies to avoid facing the data – for example, Pennsylvania’s State Board of Education recently proposed new regulations that would exempt restraints of no more than 30 continuous seconds from being counted as restraints, no matter how many were performed in a row or how much aggregate time a student spent in this way. This is where national-level leadership, from the U.S. Department of Education to Congress, has to get tough. Continuous quality improvement can only build on a foundation of hard data.
3. Workforce Development. NTAC calls for the development of “trauma informed systems of care,” a different and broader focus than the mere promotion of physical safety during restraint. Trauma-informed care promotes responsibility for the emotional wellbeing of children. It is based on research from psychology, child development, and neuroscience that shows that children exposed to high stress situations tend to develop challenging behaviors which in turn expose them to further stress. The take-home message—or take-to-school message—is that using restraint, seclusion or other aversives to change the behavior of students with disabilities is the type of stressor that can lead to the development of attentional, motivational, impulse-control, and mental health problems. These problems, in turn, can lead to behavior that is mistakenly blamed on the disability and subjected to further trauma-inducing responses, such as more restraint. An understanding of this vicious cycle and how to stop it must become part of every educator’s skill set.
4. Use of Seclusion/Restraint Prevention Tools. This strategy from mental health settings is paralleled by the requirement under the Individuals with Disabilities Education Improvement Act (IDEIA) that IEP teams approach a child through “positive behavior interventions and strategies,” which in turn should trigger a Functional Behavioral Assessment (FBA) when a Behavior Intervention Plan is needed. What the special education system lacks is comprehensive implementation of those tools. For example, California’s Protection and Advocacy, Inc. (PAI) recently gave that state’s schools an “F” for failure to confront widespread abuses of restraint and seclusion. In the cases PAI investigated, schools failed to utilize the significant preventative tools at their disposal: there were no proactive plans to address known problems, and no meetings were convened after a restraint to discuss changes in the IEP or to arrange for an FBA. NTAC notes that “This strategy relies heavily on the concept of individualized treatment.” Similarly, schools fail their students when they fail to individualize.
5. Consumer Roles in Inpatient Settings. Successful strategies in mental health settings involve “the full and formal inclusion of consumers, children, families and external advocates in various roles and at all levels in the organization to assist in the reduction of seclusion and restraint.” In our schools, this would translate into greatly increased parental involvement, welcoming parents and advocates as resources who have valuable insights and proactive strategies to impart on behalf of individual children. It would also translate into welcoming parents and students to participate in debriefing interviews when problems occur, and encouraging their participation in the development of relevant school and district policies. Operating with this level of openness and transparency has been a frightening prospect for many schools, yet the experiences of the mental health system demonstrate the importance of meaningful inclusion of all stakeholders in achieving successful systems change.
6. Debriefing Techniques. This final Core Strategy insists that every use of restraint or seclusion is meaningful and must be analyzed to avoid repetition. No such event can be accepted as unimportant, unavoidable, or part of someone’s routine plan. In our schools, the student and student’s family must be central to this process. If educators truly believe in the value of critical thinking, they need to put this skill into action instead of unthinkingly making the same dangerous responses over and over.
None of these six Core Strategies involve rocket science, but seeing them implemented will involve leadership at the highest levels of our federal Department of Education and among members of Congress. The mental health community made great strides in restraint and seclusion prevention, despite disbelief and opposition, when visionary national leaders connected with an organized and supportive grassroots constituency. Similarly, parents, families, and self-advocates must insist that our schools stop lurching from tragedy to tragedy and be guided by strong national policies that are proven effective in preventing these dangerous, inhumane practices. Each time the use of restraint, seclusion or other aversives comes to light we must loudly, publicly, and relentlessly “witness”— and insist that our leaders witness with us.
NTAC’s “Six Core Strategies to Reduce the Use of Seclusion and Restraint” and related planning tools can be accessed through the web site of The National Association of State Mental Health Program Directors: http://www.nasmhpd.org/ntac.cfm
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Pat Amos, M.A., has been an advocate for people with disabilities for over 25 years. She is a founder of Autism Support and Advocacy in Pennsylvania (ASAP) and of The Family Alliance to Stop Abuse and Neglect, past president of the Greater Philadelphia Autism Society, and past president of the Autism National Committee. Currently she is a member of the Board of Directors of TASH, an international organization that promotes equity, opportunity, and inclusion for all individuals with disabilities. Pat's family includes three young adults with significant sensorimotor differences.
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