Emergency Safety Intervention Part 2: Know Your ESI Data

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Fall 2013 2013 KSDE Annual Conference November 6, 2013 Emergency Safety Intervention Part 2: Know Your ESI Data Making data-informed decisions to guide professional development and embed evidence-based prevention and intervention strategies in schools to reduce ESI occurrences. David Eichler Kelcey Schmitz

Today we will Review ESI Regulations (briefly) Discuss prevention, de-escalation, and positive behavior support strategies Introduce the Escalation (or Acting Out) Cycle Discuss the importance of collecting, reviewing, and using data to inform school-wide, class-wide, and individual student system decision making Share an action planning tool for your building Q&A

Emergency Safety Intervention (ESI) Emergency Immediate danger Safety Immediate danger of student harming self or others Intervention Restraint or seclusion should only be used for limited periods of time and should cease immediately when the immediate danger of harm to self or others has dissipated.

Does KSDE Promote ESI? KSDE does not promote the use of ESI with any student. Every effort should be made to prevent the need for the use of restraint and for the use of seclusion. (U.S. Department of Education, Restraint and Seclusion: Resource Document, Washington, D.C., 2012 ) Please do not interpret the state regulations or this training to imply that KSDE endorses the use of seclusion or restraint with any student.

Will I Get Into Trouble for Using an ESI? There is no prohibition on the use of an emergency safety intervention. The intention of the regulation is to educate school personnel about the dangers of using an ESI with a student. The use of an ESI should never be taken lightly and always be the last step taken. If an ESI is used with a student, school personnel must follow the process set out in the regulations and in their district s policies and procedures.

Purpose of the ESI Regulations The primary purpose of the ESI regulations is to standardize when an ESI may be appropriate to use, if ever, and if used, to delineate the next steps that must be taken to prevent, or eliminate, the need for the use of ESI in the future.

Purpose of the ESI Regulations Violations of a school's code of conduct may necessitate the use of an ESI if the violation constituted action by the student that resulted in an immediate danger to the student or others. Not all violations of a school's code of conduct, such as failure to follow school rules or failure to follow teacher instruction, will constitute an immediate danger that would necessitate a permitted use of an ESI.

The Purpose of the Regulations The ESI regulations were not intended to prevent school personnel from using reasonable methods of instruction, care, or intervention to meet the educational, physical or emotional needs of students, or to prevent school personnel from ensuring the safety of all students and staff.

Technical Definition - Seclusion Seclusion is not a place, it is a process. Seclusion is identified by meeting three criteria: The student is (1) Placed in an enclosed area by school personnel. (2) Purposefully isolated from adults and peers. (3) Prevented from leaving, or reasonably believes that the student will be prevented from leaving, the enclosed area.

Technical Definition - Restraint Restraint can be chemical, mechanical, or physical. Chemical restraint means the use of medication to control a student s violent physical behavior or restrict a student s freedom of movement. It is prohibited. Mechanical restraint means any device or object used to limit a student s movement. It is prohibited unless ordered by a person appropriately licensed to issue the order for the device, for a specific student. Physical restraint means bodily force used to substantially limit a student s movement.

Focus on Prevention KSDE focuses on prevention. Any use of ESI must be reported under the regulations. ESI reporting is required for any student.

Why the focus on prevention? Because there are real dangers with using these kinds of interventions

ESI is not discipline Restraint or seclusion should never be used as punishment or discipline (e.g., placing in seclusion for out-of-seat behavior), as a means of coercion or retaliation, or as a convenience. (Principle 6, U.S. Department of Education, Restraint and Seclusion: Resource Document, Washington, D.C., 2012 )

Emergency? Let s consider that first word emergency. When is an incident a true emergency situation? Immediate danger to self; Immediate danger to others; Possibly for violent action that is destructive of property.

What is reasonable? Grandma Test YouTube Test OCR Test

ESI and Behavior Plans ESI should not be a planned intervention for a specific student under foreseeable circumstances. ESI is not an acceptable alternative to prevention.

ESI and Behavior Plans If you re planning for it, it means you can see it coming. If you can see it coming, every effort should be made for prevention.

ESI is not a tiered intervention. In an MTSS (or any tiered support system) tiers focus on prevention. Tiered systems utilize strategies that are planned and carried out to offer proactive positive behavioral supports to students.

ESI is not a tiered intervention. Using an ESI is reactive. It is only used when a student places themselves or others at risk of immediate harm.

ESI Duration ESI should be discontinued as soon as the immediate danger has passed.

Reporting and Documentation If an ESI occurs, it must be reported to the parents of the student within 2 school days Administration (per district policy) KSDE, via the quarterly reporting

Reporting and Documentation Check with your district for guidance on forms to use timelines for documentation, parent notification, and KSDE reporting to be completed.

If you use an ESI 1. Document it. 2. Learn from it. 3. Seek training on how to implement tiers of prevention and intervention.

After the fact In hindsight, some incidents no longer seem like emergencies. If seclusion or restraint was used, you must treat it as an Emergency Safety Intervention.

Unsure if an action was an ESI? Any time school or district personnel have a question ("gray area") of whether or not action taken by school personnel constitutes the use of an ESI, school personnel should, at minimum, communicate with parents about the actions taken by school personnel with their child and document the incident even if school personnel ultimately determine that the action taken did not amount to the use of ESI, per the regulations.

A KSDE Priority: We are charged with making every effort to curtail the need for ESI through the use of preventive strategies and supports for all students.

School Personnel Training District policies shall include school personnel training consistent with nationally recognized training programs on the use of ESI. Training shall address prevention techniques, deescalation techniques, and positive behavioral intervention strategies; Training shall be designed to meet the needs of personnel as appropriate to their duties and potential need to use an ESI; and Schools and programs shall maintain documentation on training provided and those who attended.

Factors Contributing to Inappropriate Use of ESI Inability of the teacher to remain composed when dealing with challenging behaviors displayed by aggressive students Lack of knowledge and/or confidence in the area of classroom management High level of teacher stress can lead to difficulty with managing student behavior (Ryan, 2013)

Preventative Steps to Minimize the Need for ESI Utilize evidence-based instructional strategies (e.g. systematic instruction, differentiated instruction, explicit instruction, scaffolding, sufficient practice) Develop a hierarchical behavior management plan, Develop and enforce ESI policy, Provide training in crisis de-escalation strategies, (Ryan, 2013)

Two Approaches to Challenging Behavior 1. The student is the problem and needs to be dealt with using punishment and/or discipline. 2. The student is using the behavior to have a need met and needs to manage negative behaviors and learn desired behaviors.

Rather than getting angry or frustrated with students who exhibit undesirable behavior, primary prevention plans encourage an instructional approach in which desired behaviors are defined, taught, practiced, and reinforced. (Lane, Kalberg, Menzies, 2009, p. 27)

CONTINUUM OF SCHOOL-WIDE INSTRUCTIONAL & POSITIVE BEHAVIOR SUPPORT Primary Prevention: School-/Classroom- Wide Systems for All Students, Staff, & Settings FEW ~5% ~15% SOME Tertiary Prevention: Specialized Individualized Systems for Students with High-Risk Behavior Secondary Prevention: Specialized Group Systems for Students with At-Risk Behavior ALL ~80% of Students

Function-based Thinking: Behavior is Communicative Student Behavior Attention Tangible Sensory Escape, Avoid or Delay From Adults From Peers Toy, food, other desired object Flapping, Rocking, Spinning, Tapping, etc. Person, Place, Demand, Unpleasant situation

Kansas Department of Education s Vision on Behavior and Academics Schools use a multi-tier approach that addresses behavior, social and academics simultaneously. Schools look closely at all the pieces they already have in place then reevaluate what needs to be revised or added. Social and behavioral curriculums are taught with as much rigor and fidelity as academic subjects. Meaningful data are collected and used to make decisions regarding programming.

Primary Prevention Examples Provide effective instruction Promote school connectedness through building trusting relationships Cultivate a school climate that promotes physical and psychological safety Establish effective positive school discipline Utilize good classroom management techniques

Typical Escalating Behavior Sequence Student and teacher escalation often mirror each other Student behaviors are followed by a consequence, which may escalate behavior As consequences become more severe, student behaviors become more intense (Colvin & Sugai, 1989)

The Escalation Cycle High Peak Low Behavior Intensity Calm Acceleration Agitation Trigger De-escalation Recovery Time Colvin & Sugai, 1989

Effects of Escalating Phases Calm Student is cooperative. Trigger Student experiences a series of unresolved conflicts. Agitation Student exhibits increase in unfocused behavior. Acceleration Student displays focused behavior. Peak Student is out of control & displays most severe problem behavior. De-escalation Student displays confusion but with decreases in severe behavior. Recovery Student displays eagerness to participate in nonengagement activities. Colvin & Sugai, 1989

Four Key Strategies 1. Teach and reinforce expected behavior skills. 2. Identify how to intervene early in the escalation sequence. 3. Identify environmental factors that can be manipulated. 4. Identify replacement behaviors that can be taught.

Whether the problem behavior is managed safely or not or is defused In a large measure depends on YOUR INITIAL RESPONSE -Dr. Geoff Colvin

Resources Required More Continuum of Behavior Support Least Intensive to Most Intensive Emergency Safety Intervention Intervention to reverse or prevent negative consequence Consider Special Education Referral Refer to Tier 3 Supports/ FBA/BIP Prevent and reduce the need for ESI Use least restrictive methods possible Function-based thinking/ Tier 2 Supports such as Check -in/checkout Redirect, pre-correct and other strategies to minimize or neutralize the trigger, diffusion and de-escalation strategies Cue and prompt expected behavior, proximity, pre-teach, transition cues Teach and reinforce behavioral expectations, active supervision, provide choices, routines Less Schmitz, 2013 41

The best time to intervene on problem behavior is when the behavior is not occurring (Carr et al., 2002, p.9) Behavior Intensity Antecedent Behavior Consequence Setting Event Time

Examples of ESI Prevention Related De-escalation Identifying triggers and intervening early Universal screening for behavior Functional communication Function-based thinking School Culture/Climate Continuum of behavior supports Training Topics Bullying prevention SECD standards and curriculum Teaching expectations Classroom management Differentiated instruction Conflict resolution Culturally relevant social skills instruction PBIS/MTSS

Data Collection and Review of All Instances of ESI Districts shall establish a procedure for the collection, maintenance, and periodic review of the use of ESI at each school. Districts shall develop a system to collect and maintain documentation for each use of an ESI. Information maintained by the school on the use of ESI shall be compiled and submitted, at least biannually, to the district superintendent or district designee.

Uses for ESI Data To inform training needs Identify effective alternatives to ESI To assess effectiveness of interventions, and allow for changes to the plan when interventions are not successful Analyze data regularly

Questions to Help Analyze Building Data ESI has been used with what percentage of students? With how many students has ESI been used more than once? When does ESI occur most often? Month Day Time Where does ESI occur most often? What situations are identified as leading to an ESI? What other data can help us dig deeper to analyze the problem?

Analyzing ESI Data Under what conditions was ESI used? What specific procedure was implemented? How long was the procedure used? Who was involved in the situation? What happened immediately and later after ESI was terminated? How was debriefing conducted (e.g., by whom, when, where) and what were the outcomes? What preventive strategies were/could be put in place?

Example of Individual Student ESI Data Minutes in Seclusion - Student A 90 80 70 60 50 40 30 20 10 0

Example of Individual Student ESI Data 30 Minutes in Seclusion - Student B 25 20 15 10 5 0

Example of Individual Student ESI Data 60 Minutes in Seclusion - Student C 50 40 30 20 10 0

Key Messages ESI FOR EMERGENCIES ONLY All behavior serves a purpose. Student behavior change starts with adult behavior change. Approach behavior change in the same manner academics are taught. Knowing what predicts problem behavior is the first step in preventing it. Diffuse behavior by interrupting EARLY in the escalation sequence/cycle. Prevent or reduce the use of ESI by using positive behavior interventions.

Building Level ESI Action Plan What information do we need? Who is responsible? By When? How will we know it is done? Data Collection and Review Training/Support for Faculty and Staff

2013-2014 Behavior Training Opportunities & Resources Behavior Training Event Link on KSDE TASN ESI Part 1 & Part 2 (recorded webinar), Early Childhood ESI, Safety First for Early Childhood, In the Driver s Seat, IRIS Ed Reduce Classroom Behavior Problems (30-min. K- 12 prof. development video course FREE until the end of 2013) http://bit.ly/11dgcbv MTSS Books in a Bag (book studies) Spring Behavior Training ESI Data Based Decision Making & De-escalation TASN Event Email List www.ksdetasn.org Request assistance (the BLUE button) www.ksdetasn.org

Supports for Schools and Families Kansas State Department of Education Resources and presentations. http://ksde.org/default.aspx?tabid=3119 United States Department of Education U.S. Department of Education, Restraint and Seclusion: Resource Document, Washington, D.C., 2012. www.ed.gov/policy/restraintseclusion Technical Assistance System Network (TASN) School and families may request assistance www.ksdetasn.org Multi-Tiered Systems of Support (MTSS) System-wide practices to support behavioral and academic needs www.kansasmtss.org

Contact Information Deb McVey deb@kansasmtss.org Slides can be found on the KSDE TASN ESI Resource page: http://ksdetasn.org/cms/index.php/esiresources

References Carr, E. G., Dunlap, G., Horner, R. H., Koegel, R. L., Turnbull, A. P., Sailor, W., Anderson, J., Albin, R. W., Koegel, L. K., & Fox, L. (2002). Positive behavior support: Evolution of an applied science. Journal of Positive Behavior Interventions, 4, 4-16, 20. Colvin, G. (2004). Managing the cycle of acting-out behavior in the classroom. Eugene, OR: Behavior Associates. Colvin, G., & Sugai, G. (1989). Managing escalating behavior (2 nd ed.). Eugene, OR: Behavior Associates. Hershfeldt, P.A., Rosenberg, M.S. & Bradshaw, C.P. (2010) Function based thinking: A systematic way of thinking about function and its role in changing student behavior problems. Beyond Behavior 19(2). Lane, K. L., Kalberg, J. R., & Menzies, H. M.(2009). Developing schoolwide programs to prevent and manage problem behaviors: A step-by-step approach. New York: Guilford Press. Ryan, J. (2013, June 19). Are there better alternatives to seclusion and restraint? {Blog Post} Retrieved from http://www.cmhnetwork.org/media-center/morning-zen/are-there better-alternatives-to-seclusionand- restraint. Simonsen, B., Sugai, G., Freeman, J., Kern, L., & Hamton, J. (under review). Ethical and professional guidelines for crisis procedures. Education and Treatment of Children. U.S. Department of Education, Restraint and Seclusion: Resource Document, Washington, D.C., 2012.