Aversive Interventions Physical and Mechanical Restraints Presented by

Aversive Interventions, Physical and Mechanical Restraints Presented by: Clark County School District Student Support Services Division The Office of Compliance and Monitoring © 2009 Clark County School District

Aversive Interventions, Physical and Mechanical Restraints Office of Compliance and Monitoring Michael S. Harley, Esq. (IL) Compliance Officer Phoebe V. Redmond, Esq. Director Josh Loehr, Ed. D. Coordinator

Nevada Revised Statute 388. 521 -5315 Existing law (1999) prescribes the requirements for use of physical or mechanical restraint on a pupil with a disability who is enrolled in a private or public school. It also prohibits a person employed by a school district to use any aversive intervention on a pupil with a disability. Amended effective July 2009

What Are We Talking About? ? ? § Aversive interventions § Permissible physical and mechanical restraints that require a report § Physical and mechanical restraints that do not require a report

Aversive Intervention An aversive intervention means any of the following actions if the action is used to: § § Punish a student with a disability or Eliminate Reduce or Discourage maladaptive behavior of a student with a disability

Aversive Interventions § The use of noxious odor & tastes § The use of water, mists or sprays § The use of blasts of air § The use of chemical restraint Chemical restraint means the administration of drugs for the exclusive purpose of controlling behavior. (This term does not include the administration of drugs prescribed by a physician and used on a regular basis to treat disorders. )

Aversive Interventions § Verbal & mental abuse Verbal and mental abuse means actions or utterances that are intended to cause and actually cause severe emotional distress to a person. § Electric shock means the application of electric current to a person’s skin or body. § Deprivation of Necessities Denial or unreasonable delay of items needed to sustain the health of a person, regardless of the length of the deprivation, including, without limitation: § Food or liquid at a time when it is customarily served § Deprivation of medication

Aversive Interventions § The use of corporal punishment Corporal punishment means the intentional infliction of physical pain including without limitation to hitting, pinching or striking a student with a disability.

Aversive Interventions § Placement of a student alone in a room where release from the room is prohibited by a mechanism, including, without limitation: § § A lock A device An object positioned to hold door closed Otherwise prevent student from leaving the room § If a student is forced to perform an exercise: § Because he/she exhibited a behavior related to his/her disability § Exercise was harmful to his/her health § Nature of the student’s disability prevented the participation in the exercise

The Types of Restraints Defined § Physical restraint means the use of physical contact to limit a person’s movement or hold a person immobile § Mechanical restraint means the use of devices to limit a person’s movement or hold a person immobile, including, without limitation: § Mittens § Straps § Restraint chairs

Physical Restraint: Report required A physical restraint may be used on a student with a disability only if: § an emergency exists that necessitates the use of a physical restraint; § the restraint is used only for the period of time necessary to contain the behavior so that the student is no longer an immediate threat of causing physical injury to himself, others or causing severe property damage; and § the use of force cannot exceed what is reasonable and

Mechanical Restraint: Report required A mechanical restraint may be used on a student with a disability only if: § an emergency exists that necessitates the use of a mechanical restraint; § a medical order authorizing the use of a mechanical restraint from the pupil’s treating physician is included in the IEP before the application of the restraint; § the physician who signs the order or the attending physician examines the student as soon as practicable after the restraint: § the restraint is applied by a staff member who is trained and qualified to apply mechanical restraint; § the student is given the opportunity to move and exercise restrained body parts at least every 10 minutes for every 60 minutes of restraint (unless otherwise prescribed by the doctor who signed the order);

Mechanical Restraint: § a member of the staff of the school lessens or discontinues the restraint every 15 minutes to determine if the student will stop injury to himself without the use of the restraint; § the record of the student contains a notation of the time the restraint was lessened or discontinued, the response of the student and the response of the staff member who applied the restraint; § a member of the school staff continuously monitors the student during the time of the mechanical restraint; and

Mechanical Restraint: § the mechanical restraint is used only for the period of time necessary to contain the behavior so that the student is no longer an immediate threat of causing physical injury to self. § NOTE: no longer includes injury to others or causing severe damage to property

A Report (CCF 624) is Required § Any Aversive Intervention § Any Physical Restraint - Permissible or non-permissible § Any Mechanical Restraint - Permissible or non-permissible There are exceptions to this requirement:

No report (CCF 624) is required if physical restraint is used: § To assist a student to complete a task or response if the student does not resist the application of physical restraint or if his/her resistance is minimal in intensity and duration. - e. g. , hand over hand assistance

No report (CCF 624) if physical restraint is used: § to escort or carry the student to safety if the student is in danger in his present location (e. g. , fire or student running into street, however carrying a student off a bus requires a report and may be a violation); and § to conduct medical examinations or treatments that are necessary.

No Report (CCF 624) is required if the Mechanical Restraint is used : § to treat the medical needs of the student; § to provide proper body alignment to a student; or § to protect a student who is known to be at risk of § to position a student who injury to self because of has physical disabilities lack of coordination or in a manner prescribed frequent loss of in the student’s IEP. consciousness;

All Staff are required to view the DVD through Pathlore § § § § Administrators Teachers Instructional assistants Playground aides Lunchroom staff PE aides FASAs § § § Bus drivers Bus aides Office staff Custodial staff Any/all CCSD employees

Disciplinary Action A person who intentionally uses an aversive intervention or intentionally violates the requirement of this statute is subject to disciplinary action.

CCF 624 Student Name____ Grade level___ Incident date____ Time____ School Name/Phone Number____ Area ____ Eligibility____ Name/Title of person completing report_________ Names/Titles of persons restraining student________ Type of Report __Physical Restraint __Mechanical Restraint __Aversive Intervention

CCF 624 Reason for Restraint/Intervention ___ Protect physical safety of student ____ Protect physical safety of others ___ Protect against severe property damage ____ other Description of incident ___________________________________________ Documents Attached (please describe)__________ Duration of Restraint/Aversive _____________ Duration/Description of Interventions Attempted Prior To Use of Restraint/Aversive

CCF 624 Site Administrator Report (Check all that apply) __Verification of account __ Reviewed need for personnel action __ Admin review of written report __ Plan Implemented to Avoid recurrence __ Verification of emergency __ Report sent to Distribution __ Scheduled Training Site Administrator Signature____________ Position ____ Parent Notification Method(s) by which parent was informed of incident_____ Date _____ Person responsible for notifying parent ____ Date form sent to parent _____

Administrative Investigation § Incident as reported by staff § Interview school staff § Interview witnesses (students) § Interview victim § Written summary of results § Supply OCM the investigation summary if requested § Compare summary with written account

Administrative Investigation § Incident as reported by parent (complete form using parent information) § Interview teachers and support staff § Interview witnesses (students) § Interview victim § Interview parent § Written summary of investigation

Administrative Investigation § If allegation involves possible abuse by school staff : § Notify supervisor § Notify school police § Student examined by school nurse § Follow District policy for reporting abuse § Possible CPS involvement (mandated reporters)

CCF 624 (Cont. ) Notice to Parents If you have any concerns or questions regarding the information contained in this report, please be advised that your options include, but are not limited to: Contacting/meeting with the staff members(s) involved Contacting/meeting with the administrators Contacting the Student Support Services Division at 799 -1020 Contacting your student’s school to convene an IEP meeting Completing a Clark County School District Public Concern Form (CCF-660). This form can be obtained at any school site or from the Education Center. Please see reverse side of this form for a summary of the statute

CCF 624 (Cont. ) Distribution Fax: To SSSD/Compliance within 24 hours (799 -1066) Original: Confidential file (Educational Section underneath eligibilities) Copies: Area Superintendent Cumulative file Parent IEP team

Review § Three (3) restraints § OCM notifies school § School reviews circumstances of the use of the restraints § School provides a report to OCM on its findings § Five (5) restraints § IEP review at meeting with required members and proper notification § include in IEP additional methods to ensure restraint does not continue § LEA reports date of IEP meeting to OCM

Corrective Action Plan (CAP) When an aversive intervention or non-permissible physical or mechanical restraint is used, it is a violation and a CAP must be submitted to the State Department of Education for approval within 30 calendar days.

CAP Components § Detailed factual incident report is included in the CAP. § Plan to ensure that the aversive or nonpermissible physical or mechanical restraint does not reoccur. § The Office of Compliance and Monitoring will work with the administrators at the school to submit the CAP to the State.

If you have any questions, please call The Office of Compliance and Monitoring at 799 -1020