When Physical Management Becomes Necessary
Despite our best efforts to prevent behavioral crises, there may be situations where physical intervention becomes necessary to ensure the safety of the student, their peers, or staff members. It’s important to approach these situations with caution, adhering to legal and ethical guidelines while prioritizing the well-being of all involved.
Legal and Ethical Considerations
Before implementing any physical management procedures, educators and administrators must be aware of the legal and ethical framework surrounding these actions:
Federal Guidelines: The U.S. Department of Education has issued guidance on the use of restraint and seclusion in schools. Key points include:
- Physical restraint should only be used in emergency situations where there is an imminent danger of serious physical harm to the student or others.
- Restraint should never be used as a form of punishment or discipline.
- Schools should work to eliminate the use of restraint through positive behavioral interventions and supports (PBIS).
Least Restrictive Interventions: School personnel should always use the least restrictive intervention possible to manage the situation safely.
Proportional Response: The level of intervention should be proportional to the level of risk presented by the behavior.
Duration: Physical management should be used for the shortest time necessary to ensure safety.
Documentation: All instances of physical management must be thoroughly documented and reported according to your school district and state policies.
Parent/Guardian Notification: Parents or guardians should be promptly informed of any use of physical management involving their child.
Deciding When to Use Physical Management
The decision to use physical management procedures should follow a clear, predetermined process:
Assess Immediate Risk: Quickly determine if there is an imminent risk of serious physical harm to someone.
Confirm There Are No Less Restrictive Options: Ensure all other de-escalation strategies and less restrictive approaches to intervention have been attempted or considered and the only way to prevent harm is through physical management.
Ensure Physical Management Will Not Increase Risk: The use of physical management should not increase risk of harm to staff or students. If there is a possibility of increased risk, do not use physical interventions.
Consider Individual Factors: Take into account the student’s age and size, medical or psychological conditions, and any history of trauma when deciding if physical management is appropriate and necessary.
Team Approach: When possible, involve multiple trained staff members in the decision-making process.
Communicate Intent: In some cases, it may be appropriate to communicate to the student that physical management will be used if the dangerous behavior continues.
Prepare for Intervention: Ensure that all staff members who are intervening have been trained in proper physical management procedures.
Continuously Reassess: Throughout the intervention, continue to evaluate if restraint procedures are still necessary. As soon as it is safe to do so, staff should release from physical management and continue with de-escalation strategies.
Safety Considerations
When implementing any physical management procedures ensure that all involved staff are properly trained to use the procedure and monitor the student’s physical and emotional well-being (and each other’s). The student should be assessed for breathing and any complaints of pain and discomfort or any indication the use of physical management may be traumatizing. Avoid putting pressure on the student’s head, neck or torso. If physical management becomes unsafe (i.e. the student becomes unconscious, complains about breathing, etc) immediately release and seek medical attention.
Post-Intervention Procedures
After any use of physical management, everyone involved should be provided medical care and emotional support as needed, complete debriefing procedures, and staff should determine if any changes need to be made to the student’s behavior plan to reduce the likelihood of behavioral crisis situations occurring in the future.
Immediate Safety Check: Assess for any injuries or medical needs of the student and staff involved. If necessary, administer first aid or seek medical attention. Emotional well-being should also be assessed and support provided as needed for staff and students.
Notification and Documentation: Inform school administrators about the incident as soon as possible. Notify the student’s parents or guardians promptly, providing a clear, factual account of what occurred. Complete a detailed incident report while the events are fresh in memory. Include the following in your report:
- Date, time, and location of the incident
- Names of all individuals involved
- Description of events leading up to the intervention
- De-escalation strategies attempted
- Type and duration of physical management used
- Any injuries or property damage
- Post-intervention actions taken
Have a designated administrator review the incident report for completeness and accuracy and ensure the incident is properly recorded in the school’s data management system for tracking purposes. Verify that all necessary reporting requirements (district, state, federal) have been met.
Debrief with the Student: As soon as the student is calm and receptive, it is important to debrief with them to understand what happened and how we can better support them in the future to prevent similar incidents. Choose a quiet, private location for the conversation and allow the student to share their perspective on what happened.
Work with the student to identify triggers and discuss more appropriate behaviors they can engage in next time. If applicable, discuss how to repair any harm caused to relationships or property.
Staff Debriefing and Support: Gather all staff involved and any administrators responsible for decision-making for a thorough debriefing session. Discuss the sequence of events, focusing on what led to the use of physical management and the effectiveness of the intervention, and collaborate on identifying what could be done differently in future situations. Ensure staff are aware of available support services, including counseling if needed.
Review & Modify Behavior Support Plans: Assess the effectiveness of the current behavior support plan in light of the incident. Determine if there are more effective methods for preventing or minimizing similar incidents in the future and make modifications to the student’s plan accordingly.
Follow-up Actions: If modifications have been made to the student’s plan, communicate those to all staff working with the student and their legal guardians. Provide additional training as necessary to address new interventions or skill gaps identified in debriefing. Make any necessary changes to the physical environment to support appropriate, desirable behavior.
Long-term Monitoring and Evaluation: Closely monitor the student’s behavior in the weeks following the incident. Schedule follow-up meetings with the student, parents/guardians, and relevant staff as needed. Continue collecting data on behavioral incidents and analyze data to identify patterns and refine and improve overall behavior management approaches.
Conclusion
There are several considerations that should inform interventions involving physical management with students. Physical management should always be considered an emergency intervention and restraints should be as brief as possible to reduce the likelihood of harm to everyone involved. Any use of physical management should be followed by debriefing procedures with the student and all staff involved to identify modifications that can be made to prevent similar incidents from happening in the future.
In our next blog we will discuss the importance of ongoing training and education and overall best practices for the use of physical management.
Read part one of the blog series at: https://qbs.com/best-practices-for-physical-management-in-classrooms-understanding-challenging-behavior-and-how-to-prevent-it/
References
Center on PBIS. What is PBIS? Retrieved from: https://www.pbis.org/pbis/what-is-pbis
U.S. Department of Education. Restraint & Seclusion. Retrieved from: https://www2.ed.gov/policy/seclusion/index.html