Saturday, March 16, 2019

States Take Note: How to Really Address the School Seclusion and Restraint Epidemic (Part II)



What State Departments of Education Need to Learn If Using PBIS to “Solve” This Problem

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Dear Colleagues,

Introduction

   The number of seclusions and restraints in our nation’s schools—whether involving general education students or students with disabilities (who are disproportionately represented in these events)—is a national tragedy and embarrassment.  This problem must be solved.

   But the resolution must be multi-layered.  While, top-down, it may require federal and/or state legislation, it eventually must be, bottom-up, functionally addressed in our schools as part of an effective multi-tiered system of supports and interventions.

   And if Congress or state legislatures get involved, they must have accurately, differentiated, and well-analyzed data.  This is because much of the current data have gaps, do not differentiate different student groups in meaningful ways, and have not been analyzed to determine the root causes of the behavioral situations that result in student seclusions and restraints.

   The need for accurate, differentiated, and well-analyzed data is particularly important at the present time.  Indeed, in mid-January (2019), the U.S. Department of Education’s Offices for Civil Rights (OCR) and Special Education and Rehabilitative Services (OSERS) announced an initiative to “address the inappropriate use of restraint and seclusion” on students with disabilities.  OCR and OSERS plans to attend to three specific areas: (a) Increasing the number of compliance reviews in districts across the country; (b) Disseminating more legal and intervention resources focused on prevention and alternative responses; and (c) Improving the integrity of incident reporting and data collection.

   Then, on February 27, 2019, an education subcommittee of the House of Representatives conducted a hearing where the number of seclusions and restraints across the country was updated, possible alternative approaches were outlined, and the role of the federal government in decreasing seclusions and restraints was discussed. 

   During this hearing, the U.S. Department of Education once again promoted George Sugai’s testimony.  Sugai has been the Co-Director of the National Positive Behavioral Interventions and Supports (PBIS) Technical Assistance (TA) Center since its inception in 1997.  This, and others’ testimony during this meeting, once again reinforced the point above—that comprehensive analyses of the root causes of the seclusion and restraint dilemma in our schools are not being presented to policymakers.  In fact, in some cases, Congress only hears what the U.S. Department of Education (and other federal agencies) want it to hear.

   Indeed, over the years, he (or his Co-Director colleague) are present any time Congress has a hearing on a significant social, emotional, behavioral, disciplinary, or related school crisis hearing.  This allows the U.S. Department of Education (and specifically, its Office of Special Education Programs—OSEP) to use its “bully pulpit” to singularly advocate their PBIS framework—a framework that has not been successful, and that has significant science-to-practice gaps.

   This last statement has been documented in numerous past Blogs:

October 7, 2017   Improving Student Outcomes When Your State Department of Education Has Adopted the Failed National MTSS and PBIS Frameworks:  Effective and Defensible Multi-Tiered and Positive Behavioral Support Approaches that State Departments of Education Will Approve and Fund (Part I of II)

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October 21, 2017   Improving Student Outcomes When Your State Department of Education Has Adopted the Failed National MTSS and PBIS Frameworks:  Effective Research-to-Practice Multi-Tiered Approaches that Facilitate All Students' Success (Part II of II)

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February 16, 2019   Redesigning Multi-Tiered Services in Schools:  Redefining the Tiers and the Difference between Services and Interventions

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   Following up on the February education subcommittee hearing, it is expected that Congressional Democrats will soon introduce legislation to ban the use of isolation and seclusion in schools, and to put major restrictions on physical restraints.

   This two-part Blog series was written to try to get a more accurate picture of the current status of why seclusions and restraints occur in schools, and to present a “roadmap” of how to functionally and successfully begin to address the issues.
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A Review of Part I of this Two-Part Series

   In Part I of this Blog, the following areas were discussed:

  •  The definitions of seclusion and restraints

  • The historical and current incident levels of these actions in schools

  • The U.S. Department of Education’s formal attention to this issue since 2009

  • The U.S. Department of Education’s faulty advocacy of the PBIS framework as a solution to this problem


[CLICK HERE for Part I]

   In the end, we concluded Part I warning:

     Districts and schools to be cautious—if not wary—about the U.S. Department of Education’s (and, perhaps, your State Department of Education’s) advocacy of the PBIS (Positive Behavior Intervention and Supports) Framework as a viable one to help you decrease seclusions and restraints with your most behaviorally-challenging students.
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   In this Part II of the series, we will discuss:

  • My involvement, as an Expert Witness, in a number of federal court cases involving excessive numbers of seclusions and/or restraints of student with disabilities—especially those who demonstrate the most challenging behaviors.  Here, we will discuss the common characteristics of these cases from a legal and student perspective.

  • What state departments of education are providing (and not providing) relative to training professionals in their states in the interventions that will decrease or eliminate the need for student seclusions and restraints, and where the PBIS framework fits in

  • What analyses and specific interventions state departments of education need to provide to close the PBIS framework’s gaps so that school personnel can be more successful with behaviorally challenging students


[CLICK HERE for Part II]
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When Departments of Education Use PBIS to Decrease School Seclusions and Restraints

   One of my many professional “hats” involves my work as an Expert Witness across the county in federal and state court, and due process hearings.  Over the years, I have testified innumerable times in court cases related to the educational and special education rights of students; corporal punishment and effective interventions for students with social, emotional, and behavioral challenges; and school seclusions and restraints.  While I often work to advocate for students and their parents, I have accepted cases where I am defending districts and even state departments of education.

   Critically, I only take cases that I believe in. . . cases where I hopefully can make both a personal impact (for my clients), and a systemic impact at a broader level.

   Over the years, I have been an Expert Witness on a number of cases—in vastly different states—where students with disabilities have been secluded, restrained, and corporally punished.  Many of these cases involved students with significantly complex disabilities and/or with significant behavioral challenges that the schools were not addressing through intervention.

   I recently completed another case in this area which had direct implications to the training being provided at our state departments of education (SDoEs).  As I have noted in the past, what SDoEs do in areas related to students with behavioral challenges is always interesting to me as I worked for the Arkansas Department of Education for 13 years helping to oversee the training exactly in this area.

   Given my past experiences and the recently completed case, I have analyzed state-level seclusion and restraint data—some over a period of five school years, so that I can confidently make the recommendations in this Blog.

   Specifically at issue are schools that are secluding and/or restraining students with disabilities at an excessive level (sometime, many times per week).  Some of these students are being put in isolation rooms.  And many of these students are not receiving the strategic and/or intensive interventions to address the root causes of the students’ challenging behaviors, thereby resulting in the need to reactively seclude or restraint these students.

   Critically, if a school were to think (inappropriately) that a seclusion or restraint is a strategic intervention—in and of itself, then the intervention goal should be to change the student’s behavior such that no future seclusions or restraints are needed. 

   At this point, one would have to ask,

“How many seclusions or restraints provide enough data to tell the school that this ‘intervention’ is not working and should be stopped—triggering the need for new analyses and (hopefully) different and more successful interventions.”
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   My purpose in this Blog is not to re-defend past cases.  Instead, I want to make three points that are based on publicly available data—drawn largely from the state department of education level.
  • SDoEs are not fully analyzing their state’s seclusion and restraint data such that they understand the functional nature of the problem, and how and why the numbers are changing over time.
  • SDoEs often focus predominantly on the incident numbers.  They typically do not collect data that would help functionally identify the root causes of the student behaviors that are prompting the need for seclusions and restraints.
  • Many SDoEs are doing a lot of PBIS framework-driven training.  This training rarely (if at all) is aligned with the information and root cause analyses noted as needed in the two bullets above.  Moreover, the training rarely (if at all) is coherent, comprehensive, or scientifically-based.  The training misses many of the social, emotional, and behavioral interventions that, once again, can help prevent the need for crisis-oriented seclusions and restraints.
   Ultimately, my recommendation to all states using the PBIS framework to guide the professional development that they hope will help their districts and schools to avoid the need for student seclusions and restraints is to:

Scrap the framework and rebuild the professional development with a truly defensible science-to-practice model.  When SDoEs use the PBIS framework—from the National PBIS TA Center—they are using a framework (as previously document) that has no science-to-practice validity in this area. 

The fact that I have been an Expert Witness in so many of these cases nationwide, in states where the SDoEs are using the PBIS framework, suggests (at the very least) that the framework has not successfully addressed the types of serious student behaviors that districts then are responding to with seclusions and restraints. 

   From my perspective, SDoEs who find themselves at this point should not a “remodeling project” that “tinkers around the edges.”  They need to level the entire system, and re-build it from the ground up.
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   To prepare this Blog, we analyzed five years of seclusion and restraint data from a sample state using publicly available information.

Section I:  Fully Analyzing the State’s Seclusion and Restraints Data
  • Over the five school years reported in the Blog (from the 2012-13 school year through the 2016-17 school year), the total number of public school students educated in the state increased, and—with some variation—there was a net increase in the number of students with disabilities served.
  • During the 2012-2013 school year, the first year that a state requirement to track seclusion and restraints was in place, there were 6,540 separate and recorded seclusions and restraints across the state for students with disabilities.  These numbers decreased by 364 reported incidents to 6,176 by the 2014-15 school year, but the numbers increased during the next two years by 2,119 incidents to 8,295 by the end of the 2016-17 school year. 
  • When the state data for the number of students with disabilities were disaggregated by the thirteen disability areas identified in the Individuals with Disabilities Act (IDEA, 2004), the number of students identified with Other Health Impairments (up 17.6%), Intellectual Disabilities (up 6.6%), Developmental Delays (up 19.1%), Emotional Disturbances (up 4.7%), and Autism (up 42.1%) increased over the five-year period studied.  The remaining eight disability areas (e.g., Specific Learning Disabilities, Speech or Language Impairments) either decreased in the statewide number of students or remained constant.
  • The four top student disability areas receiving seclusions and restraints in the state for the 2012-13 through 2016-17 school years were:  Autism (with a five-year increase of 48.0%), Emotional Disturbance (up 12.5%), Other Health Impairments (up 31.8%), Developmental Delays (up 70.0%).
   Our analysis concluded that, clinically, it is not surprising that the four disability areas that most involve students with significantly challenging behavior are represented over the remaining nine disability areas, and that Autistic and students with Emotional Disturbances received significantly more seclusions and restraints than even the other two “top four” disability areas.

   At the same time, while the seclusion and restraint increases are troubling, the concern is offset by the fact (see above) that the number of students in these disability areas also increased during the same period of time.  But even here, the seclusion and restraint increases were higher than the disability population increases—especially for students with Developmental Delays and Other Health Impairments.

   One of our major conclusions/recommendations: In order to change the incident levels of seclusions and restraints with behaviorally challenging students, these data suggest that professional development programs—at the SDoE and district levels—should focus on the social, emotional, and behavioral issues that are common to students with autism, emotional disturbances, developmental delays, and other health impairments.
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Section II:  Analyzing the Root Causes of the Behaviors Triggering Seclusions and Restraints

   In a past life, I was the PBIS lead and primary contact in the Arkansas Department of Education for 13 years.  Given this, I am fully aware of the intricacies within the National PBIS TA Center’s blueprint for Tier II, Tier III, and PBIS/School-based Mental Health intervention training.

   And the intensive training needed to address the social, emotional, and behavioral root causes that result in schools needing to seclude and/or restrain students with autism, emotional disturbances, developmental delays, and other health impairments is wholly insufficient.

   In short, most SDoEs do not have, and are not enacting, a systematic strategic plan to specifically and effectively address the assessment-to-intervention professional development needs of its districts and schools relative to their most behaviorally-challenging students. 

   Indeed, many SDoEs have never conducted an analysis of the students with autism, developmental delays, emotional disturbances, and other health impairments who are being frequently secluded or restrained to determine:
  • The underlying reasons for their many behavioral challenges;
  • The interventions needed by these students, and the interventions that were actually being delivered;
  • What schools were successfully doing, during significant behaviorally-challenging situations, to resolve the situations without the need for seclusions or restraints; and
  • What schools were not doing, during similar challenging situations, that resulted in seclusions or restraints.
   Only with this information could the SDoE truly and strategically plan for the professional development and on-site technical assistance needs of these schools and their students.

   The remainder of this section of the Blog delineated a number of critical root cause examples for students’ challenging behavior.

[CLICK HERE for the complete Blog message.]
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Section III:  What Strategic or Intensive Interventions Can Replace the Need for Seclusions and Restraints

   In my experience, SDoEs are doing a lot of PBIS training, but it often is occurring in the absence of the analyses discussed immediately above.

   But, critically, most SDoEs’ PBIS training is missing the many strategic and intensive (“Tier II and Tier III” in the PBIS world) social, emotional, and behavioral interventions that, once again, could help prevent the need for crisis-oriented or reactive seclusions and restraints.  In addition, it is missing the training in when and how to involve out-of-district community professionals who need to provide medical, clinical, and therapy-related supports to the most-challenging students.

   The remainder of this section of the Blog listed some of the interventions that all state departments of education need to consider for future training as related to preventing the need for seclusions and restraints.  These were organized in three categories: (a) Emotional Control and Coping Interventions/Therapies; (b) Student Motivation Interventions; and (c) Social Skill (and other) Instruction Interventions.

[CLICK HERE for the complete Blog message.]
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Summary

   In all of my years of interacting with OSEP, the National PBIS TA Center, state departments of education, and districts/schools using the PBIS framework, very few of the interventions identified in Section III have ever been systematically included (if at all) in their PBIS training programs, materials, or protocols.  These omissions can now be added to the other significant issues that I have previously discussed relative to the PBIS framework (see the Blog citations in the Introduction of this message), and they reinforce the PBIS caution stated clearly in the first Blog in this two-part series.

   Relative to any court case, there rarely are any real winners.  Court cases involving students with disabilities do not occur unless (a) the students either are not receiving appropriate services, supports, and/or interventions; or (b) parents and school personnel are having serious disagreements and are at an impasse

   Without being naïve, we need to design the multi-tiered systems that “work” even for students with the most significant social, emotional, and behavioral challenges.  The national seclusion and restraint data are telling us that we are falling short.  

   And the same data are telling us that many SDoEs need to (re)look at their data, and (re)develop their plans to address the professional development, consultation, and technical assistance flaws in their current approaches to preventing and diminishing the need for seclusions and restraints—especially with students with disabilities.

   Finally, I am hopeful that these re-conceptualizations will include a serious look at the poor science-to-practice track record of the PBIS framework, and a complete move away from this framework and its suggested practices.
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   As always, I appreciate your dedication in reading and thinking deeply about these messages.  As always, I am trying not just to critique the current (and historical) state of our educational affairs across the country, but to suggest field-tested and proven “other ways” to help us get the student, staff, and school outcomes that we all want.

   If any of you—with your school or district team—would like to talk with me by phone, Skype, Google Hangouts, etc. about any of these (or other school improvement, academics or student discipline, or multi-tiered services) issues or practices, all you need to do is contact me and get on my schedule.  The first conference call is totally free.

   Meanwhile, some of you are on Spring Break. . . and others have it coming up.  I hope that you enjoy your time off. . . it is well-deserve.

   Until the next Blog, be successful and well !!!

[To read the entire Blog:  CLICK HERE ]

Best,

Howie