Tuesday, November 20, 2007

Best Practices in Behavior Management

Many have emailed me personally about the Best Practice Guidelines from the Children's Welfare League of America (CWLA). Some inquired as to how they came about, others asked for the specific guidelines and why Cherry Hill does not follow them.

Let me begin by explaining how the CWLA came to their conclusions on what is considered "Best Practice." The CWLA was a participant in the Children's Health Act of 2000. They also wrote the Best Practice Guidelines for Behavior Management. Through their acquired experience they became all too familiar with the dangers associated with restraining special needs children, as many had incurred significant injuries and in some cases children actually died from the use of physical restraint. The CWLA was also familiar with the psychological impact that restraint and seclusion had on special needs children. These children became more anxious, and their behaviors worsened when secluded. After several years of writing and re-writing their guidelines on restraint and seclusion, the CWLA came to realize that the bigger problem was that restraint and seclusion could not possibly be part of any "Best Practice" approach. These techniques needed to be prevented and eliminated as much as possible. Restraint and seclusion serve no educational value and these practices injure and in some cases led to the death of special needs children.

The CWLA was also aware that training alone was not enough to reduce restraint and seclusion. Although staff training is a key aspect, many times the core leadership, needs to be changed in order to facilitate the culture change necessary to eliminate the need for restraint and seclusion. "To truly reduce, if not eliminate these aversive techniques, it would require a change in leadership and a change in the organizational culture." (quote from the CWLA's report on preventing and reducing the use of restraint and seclusion.)

After numerous revisions of their Best Practice Guidelines, by September 2003 they changed the name of the grant to Best Practices in Behavior Support and Intervention: Preventing and Reducing the Use of Restraint and Seclusion.

The five goals for the Best Practices in Behavior Support and Intervention are:
1. Staff will use restraint and seclusion in emergency situations only when absolutely necessary to maintain the safety of themselves, [students], and others.
2. Eliminate the unnecessary use of restraint and seclusion.
3. Reduce the risk of deaths.
4. Reduce injuries among [children] and staff.
5. Reduce the duration of restraint and seclusion.
6. Increase debriefing with children, family members, and staff.

*Please note: As these goals were written to include children in residential facilities, I have substituted the word "resident" with the word "student" or "children" as necessary.

The CWLA strongly recommends the establishment of an Oversight Committee to monitor the reduction of such aversive techniques. The committee should include executive leadership (administrators), supervisors, staff members (teachers and aides), advocates and parents. The sole focus of the oversight committee is to monitor the campaign to reduce the use of restraint and seclusion.

  • The committee must be empowered to implement changes (NETI, 2003).
  • It should ensure that an executive team leader is on-call and that staff immediately report every incident of restraint and seclusion to him or her.
  • The committee should carefully review every physical intervention incident, take responsibility for recommending any program or policy revisions based on incident review, and make sure that staff members are receiving the necessary resources to realize the committee's mission (Abrams, 2001).

The CWLA strongly believes that every time physical interventions become necessary it is an indication that the child's program has failed.

How can this help our special needs children in Cherry Hill?
First, we as a community must come to the realization that the Best Practice Guidelines must be adhered to in educating our special needs population. This will help both our special needs population as well as our typical students. It will also provide for training of our teachers and aides that are working with our children on a daily basis.

I think we can all agree that aversive techniques do not "teach" our children the skills to maintain themselves in a socially appropriate manner. Restraint and seclusion do not foster a child's development and do not serve any educational value.

Teaching the appropriate skills so that children can regulate their own behavior and focusing on the positive interventions for behavior modification should be the standard approach in our school district. It also happens to be the law. Any school administrator that does not comprehend this essential concept in behavior management should not be a school administrator.

Moving Forward:
Many parents have voiced their concerns about the use of physical restraint and seclusion as it applies to our special needs children. The blog that focused on this topic has continued to receive reader comments, which are now in excess of 130! While I am reasonably sure that the Board of Education continues to follow this blog, I think it may be important for parents to address the BOE about this topic during the next BOE meeting (Tuesday 11/27/07, 7:00 PM at Clara Barton Elementary School).

I think the BOE needs to hear from parents, as it pertains to the concerns regarding restraint and seclusion practices. Our BOE should also be made "officially" aware of the fact that parents have tried to follow the Chain of Command in resolving this critical issue. The fact that administrators, including our Superintendent, refused to address the matter with parents, does not mean that parents did not attempt to follow the Chain of Command. We have been given the usual runaround and parents need to advise the BOE of this.

If you are a parent that has tried to follow the Chain of Command, only to be referred back to the first link - it is important that you let the BOE know this. It is my understanding that our administrators position is that they have not received any complaints about this situation.

It is highly possible that the BOE was given a watered down version of this padded closet and it's uses. It may be important for the BOE to hear the other side of this issue and learn more about this padded closet and the detrimental impact it could have on our children.

It has become apparent that many have lost faith in our current school administration. The fact that our administrator's even allowed this padded closet to be constructed, let alone defended its' use, is grounds for any parent to question the morals and integrity of our administrators. To add insult to injury, many were denied access to administrators when we had questions about this matter. Also, some of the comments that were left on the two prior blogs, presumably from administrators; have now led to a serious lack of confidence in the administration's ability or willfulness to provide a safe learning environment for our children. This too, needs to be brought to the attention of the BOE.

If we approach the BOE, during public comment, in a thoughtful and dignified manner, explaining our overall concerns, I believe we can make a great deal of progress and set forth measures to eliminate these aversive techniques in the future and hopefully foster an environment where parents, teachers and administrators can work together for the common good of our children.

There is some indication that our teachers support our position on this issue. We have had several teachers write in on the blog that have indicated the lack of training in regards to applying these positive interventions. Our teachers and aides have been requesting this critical training for some time. They are interested in applying these positive strategies to not only "teach" our children the necessary skills but also to reduce the incidents of restraint and seclusion. With all of the issues that our teaching staff is facing (working without a contract) I applaud them for taking the time to support parents on this issue.

Please join me at the next BOE meeting to stand up for the children in Cherry Hill that require positive behavioral supports. Mark your calendar for Tuesday, November 27, 2007 at 7:00 PM. This meeting is at Clara Barton Elementary School.

Since many have asked, and a few administrators have alluded to the fact that this padded closet did not exist, I am providing the pictures of the padded closet for anyone interested in viewing them. You will quickly realize why I do not like referring to this as a Quiet Room, as it was quite literally a padded closet! Click here to see the photos.

Please Note: I am not supplying these photos to "stir the pot" as an administrator accused me of recently. I want readers to see exactly what we are referring to and form their own conclusions.

*Originally published in the Courier Post, Autism Blog, Kathi Magee: On Autism, 11/20/07.