Revisiting the School Seclusion and Restraint Epidemic: The Federal Government Says It's Worse than Thought

While the Numbers are Important, We Need to Focus on the Reasons and Solutions

Dear Colleagues,

Introduction

   Back in March, we wrote a two-part Blog Series on the issues related to the number of seclusions and restraints in our nation’s schools.  Critically, while seclusions and restraints involve both general education students and students with disabilities, the latter group is disproportionately represented in these events.

   The two Blogs in this Series were:

Congress Take Note: How to Really Address the School Seclusion and Restraint Epidemic. The U.S. Department of Education Keeps Pushing PBIS, but PBIS Ain’t Got Nothing to Give (Part I, March 2, 2019)

CLICK HERE for ORIGINAL

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States Take Note: How to Really Address the School Seclusion and Restraint Epidemic. What State Departments of Education Need to Learn If Using PBIS to “Solve” This Problem (Part II, March 16, 2019)

CLICK HERE for ORIGINAL

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   In this Blog Series, we cited the federal definitions in this area, and reported some of the most-recent national seclusion and restraint incident data.

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The Definition and Current Incident Levels of Seclusion and Restraint

   The Civil Rights Data Collection (CRDC) is an ongoing U.S. Office of Civil Rights survey involving all public schools and school districts in the United States.  Initiated in 1968, the CRDC measures student access to courses, programs, staff, and other resources and issues that impact education equity and opportunity for students across the country.

   In the May, 2012 U.S. Department of Education’s Restraint and Seclusion: Resource Document, the following CRDC definitions were documented:

The CRDC defines seclusion as:

The involuntary confinement of a student alone in a room or area from which the student is physically prevented from leaving. It does not include a timeout, which is a behavior man­agement technique that is part of an approved program, involves the monitored separation of the student in a non-locked setting, and is implemented for the purpose of calming.

The CRDC defines physical restraint as:

A personal restriction that immobilizes or reduces the ability of a student to move his or her torso, arms, legs, or head freely. The term physical restraint does not include a physical escort.
Physical escort means a temporary touching or holding of the hand, wrist, arm, shoulder, or back for the purpose of inducing a student who is acting out to walk to a safe location.

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   The most-currently published CRDC school report is for the 2015-2016 school year. This Report summarized the experiences of more than 50.6 million students at over 96,000 public schools across the country, and it included the following seclusion and restraint data.

   During the 2015-2016 school year:

  • Over 84,000 students covered under the Individuals with Disabilities Education Act were restrained or secluded in 2015-16 (69% of the more than 122,000 students restrained or secluded nationally). 
  • 23,760 students with disabilities were secluded (66% of the 36,000+ seclusions for all students across the country).
  • 61,060 students with disabilities were restrained (71% of the 86,000+ restraints for all students across the country).
  • 1.3 of every 100 students with disabilities nationally was restrained or secluded.

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   In the early part of 2019, these data prompted a fair amount of Congressional attention. . . which resulted in a formal hearing and talk of national legislation.  But any real resolution to this issue 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.

   In Part II of this Blog Series, I stated:

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.

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A Recent Federal Government Report StatesSchools Under-Reported their Seclusion and Restraint Data

   On June 18, 2019, Jacqueline M. Nowicki, the Director of the Education, Workforce, and Income Security Office within the U.S. Government Accountability Office (GAO) sent a letter to the respective leaders of the Senate and House of Representatives Subcommittees on Labor, Health and Human Services, Education, and Related Agencies Committee on Appropriations

   This letter was headlined:  K-12 Education: Education Should Take Immediate Action to Address Inaccuracies in Federal Restraint and Seclusion Data.

CLICK HERE for the ORIGINAL

   Here are the essential “take-aways” from this letter in direct quotes from this document:

  • Every 2 years, the Department of Education (Education) collects and publicly reports data from nearly all public school districts and schools as part of its Civil Rights Data Collection (CRDC).  Districts self-report and certify the data. Education’s Office for Civil Rights (OCR) uses CRDC data in its enforcement of various federal civil rights laws prohibiting discrimination on the basis of race, color, national origin, sex, and disability.
  • As we reported in February 2019, Education data suggest that the restraint and seclusion of K-12 public school students is rare nationwide, though it disproportionately affects students with disabilities and boys in general.  In broad terms, Education defines restraint as restricting a student’s ability to freely move his or her torso, arms, legs, or head, and defines seclusion as involuntarily confining a student alone in a room or area from which the student is physically prevented from leaving.
  • We have work under way on districts’ reporting practices for restraint and seclusion data in response to a provision in the explanatory statement from the House Committee on Appropriations accompanying the Consolidated Appropriations Act of 2018. As part of our data reliability testing for that work, we analyzed the number of districts that left fields pertaining to restraint and seclusion blank, or that reported all zeros for those fields, to determine the prevalence of blanks or zeros in the CRDC at the national, state, and district levels.

Our data reliability testing raised questions about the completeness and accuracy of the CRDC restraint and seclusion data (my emphasis added).

  • We are therefore issuing this separate report on the issues we have identified to date regarding potentially incomplete data. Because Education is currently collecting and validating restraint and seclusion data for the 2017-18 school year, it is important it take immediate steps to address underreporting before it publishes these data.
  • For the most recent CRDC—school year 2015-16—70 percent of the more than 17,000 school districts in the U.S. reported zero incidents of restraint and zero incidents of seclusion. In 39 states and the District of Columbia, more than half of the school districts reported zero incidents; and in 12 states, 80 percent or more of the districts reported zero incidents. However, our analyses of 2015-16 CRDC data and review of Education documents indicate that CRDC data do not accurately capture all incidents of restraint and seclusion in schools.
  • While according to Education’s business rule districts with more than 100,000 enrolled students are likely to have at least one incident of restraint or seclusion, one-third (10 of 30) of such districts in the country reported zero incidents of restraint and zero incidents of seclusion in the 2015-16 school year.
  • Documents from Education that we reviewed indicated that the misreporting of zeros occurred in smaller districts as well. These erroneous reports were detected either by the media or in the course of larger investigations by Education into restraint and seclusion, rather than by any systemic review of the CRDC data.
  • Collecting accurate civil rights data is key to OCR’s mission to ensure equal access to education and to promote educational excellence throughout the nation through vigorous enforcement of civil rights laws that protect students from discrimination on the basis of race, color, national origin, sex, or disability. Federal Standards for Internal Control state that agency management should use quality information to achieve the entity’s objectives. These standards also note that such data should be reasonably free from error and bias and faithfully represent what they purport to represent, and that agency management should evaluate sources of data for reliability. Absent reliable and accurate data, neither Education nor the public can know the prevalence of restraint and seclusion in public schools.
  • Conclusion:  Our analyses raise questions about whether the confirmed instances of misreported zeros to the CRDC are indicative of a more pervasive pattern of underreporting of restraint and seclusion in U.S. public schools.

Although districts, not Education officials, are required to certify their data as “true and correct,” the Department of Education has repeatedly published restraint and seclusion data in its CRDC without always correcting known reporting errors. Data left uncorrected could further undermine the public’s confidence in these data and limit the utility of a dataset intended to assist with federal civil rights monitoring, enforcement, and oversight.

We believe the 2017-18 data collection is at risk for similar reporting issues.

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Commentary.  Clearly, the seclusion and restraint numbers above are an underestimate of what actually occurred in our nation’s schools during the 2015-2016 school year.  But until we have accurate data, we do not know just how “bad” the problem is.

   In order to get accurate data, however, four things are needed:

  • Clear and objective seclusion and restraint definitions that are indisputable, and that result in reliable and valid reporting;
  • A powerful balance of incentives, consequences, oversight, and accountability that motivate and ensure that schools accurately report their incidence data;
  • Data management or student information systems that are user-friendly and time-efficient, and that collect and analyze seclusion or restraint incident reports in meaningful ways; and
  • A reporting protocol that differentiates different student groups, and that helps to determine the root causes of the behavioral situations that result in a student seclusion or restraint.

   The latter two points in the last bullet above will frame the remainder of this Blog.

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Disaggregating Seclusion and Restraint Data by Disability

   In order to fully understand any of the seclusion and restraints data for students with disabilities, they need to be disaggregated across the thirteen disability areas identified in the Individuals with Disabilities Education Act (IDEA, 2004).  The primary reason for this is that seclusion and restraints vary across these disability areas, and this variation is important to analyze and understand. . . especially if we are going to decrease the need for these actions.

   Without getting heavily into the specific data, our comprehensive analysis of the seclusion and restraints data—from selected states during the 2012-13 through 2016-17 school years—indicated that:

  • The total number of students in following disability areas either decreased or remained statistically constant during these five consecutive school years: 

Specific Learning Disability

Speech or Language Impairment

Multiple Disabilities

Hearing Impairment

Orthopedic/Physical Impairment

Visual Impairment

Deaf-Blindness

Traumatic Brain Injury

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  • During these same school years, the following disability areas increased their total statewide numbers from 4.7% to 17.6%):

Other Health Impairment

Intellectual Disability

Developmental Delay

Emotional Disturbance

Autism

  • Critically—if the states’ data are accurate—while the total number of seclusions and restraints decreased over the five school years studied, the number of seclusions and restraints for students with autism, emotional disturbances, other health impairments, and developmental disabilities significantly increased.
  • Indeed, in some states, students with autism and emotional disturbances comprised fully half of these states’ total seclusion and restraint incidents during the 2016-17 year.

   Thus, the students with the most significant social, emotional, or behavioral challenges were the students with disabilities who were most frequently secluded or restrained.

   If this state’s data are similar to other states across the country, this would reflect a significant multi-tiered service, support, intervention, and training issue.

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Analyzing the Root Causes of the Behaviors Triggering Seclusions and Restraints

   Even if a state’s near-majority of seclusion and restraint incidents involved students with autism and/or emotional disturbances, it is critical to not assume that there are similar root causes for the behaviors “triggering” the need for such drastic actions.

   Indeed, every student with a disability is different, and if we are going to choose and implement the best services, supports, strategies, and interventions with these individual students, we need to know the specific root causes for their challenges.

   Thus, in the spirit of an individualized education program, there is a need for an individualized functional assessment to determine what that “program” needs to be.

   From a state perspective, all of these individual assessments need to be collated to determine the patterns of behavior that result in districts and schools using seclusions and restraints for students with autism and emotional disturbances.

   Conversely, the states also should identify the patterns of multi-tiered services, supports, strategies, and interventions that are preventing the need for seclusions and restraints—that is, that are successfully preventing or helping staff to respond to these students’ social, emotional, or behavioral upsets.

   With these results, State Departments of Education (SDoEs) and Districts can determine whether they have the “right” services, supports, strategies, and interventions available, and whether there are training needs or gaps that need to be addressed.

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The “High-Hit” Root Causes for Students’ Challenging Behavior

Relative to assessing the root causes of students’ challenging behavior, three initial principles are crucial:

  • Principle 1. The assessment and intervention focus for all students is on their specific social, emotional, and behavioral self-management skills.

Even though some students need interventions that decrease or eliminate inappropriate or maladaptive social-emotional behaviors, a comprehensive intervention program concurrently plans for prosocial, emotional control, and replacement behaviors.

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  • Principle 2. Given #1, assessments should not result simply in diagnostically labeling a student. Even if this occurs, the correlation between a label and the needed interventions is limited.

By way of example:  If a school was developing individual intervention plans for five autistic students, they would need to know (a) what specific social, emotional, and behavioral deficits the five students exhibit; (b) what replacement behaviors are warranted; (c) the root causes of the self-management gaps; and (d) which individual interventions—in the context of the root causes and from a science-to-practice perspective—will help the students close their gaps and develop or reinforce their needed replacement behaviors.

These will differ for each of the students (regardless of the “common” label). . . hence, the reason for the individual root cause analyses and intervention plans.

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  • Principle 3. A formal Functional Behavioral Assessment (FBA) is not always appropriate as the “root” of the root cause analysis.

FBAs should be conducted only when they can validly answer the specific diagnostic questions that are present for a case. FBAs typically answer questions that relate to a student’s motivation in choosing to demonstrate an inappropriate behavior. That is why FBAs ask, “What is the function of the behavior for this student?”

In order for a behavior to have “function” (e.g., to satisfy a student’s need for attention, control, power, or escape), the student needs to be motivated to attain this goal.

If the student does not have the skills to demonstrate the desired, appropriate behavior, an FBA will not be accurate.

Moreover, if the student’s behavior is biologically-based (e.g., the student cannot control his or her emotions, attention, impulsivity, or motor behavior), the FBA also will not accurately identify this.

I see far too many FBAs conducted with autistic students when some (sometimes, most) of their behavior is biologically-based. When behavior is biologically-based, there typically is no motivational function to the behavior. Thus, once again, most FBA “results” here are often inaccurate, and there has been no productive “return” on the time invested in completing the FBA.

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   Beyond these Principles, some of the primary reasons why students demonstrate social, emotional, or behavioral problems in the classroom include:

  • There are (known or undiagnosed) biological, physiological, biochemical, neurological, or other physically- or medically-related conditions or factors that are unknown, undiagnosed, untreated, or unaccounted for.
  • They do not have positive relationships with teachers and/or peers in the school, and/or the school or classroom climate is so negative (or negative for them) that it is toxic.
  • They are either academically frustrated (thus, they emotionally act out) or academically unsuccessful (thus, they are behaviorally motivated to escape further failure and frustration).
  • Their teachers do not have effective classroom management skills, and/or the teachers at their grade or instructional levels do not have consistent classroom management approaches.
  • They have not learned how to demonstrate and apply effective interpersonal, social problem-solving, conflict prevention and resolution, and/or emotional coping skills to specific (school-based or home-based) situations in their lives.
  • They do not have the skills or motivation to work with peers—for example, in the cooperative or project-based learning groups that are more prevalent in today’s classrooms.
  • Meaningful incentives (to motivate appropriate behavior) or consequences (to discourage future inappropriate behavior) are not (consistently) present.
  • They are not held accountable for appropriate behavior by, for example, requiring them (a) to apologize for and correct the results of their inappropriate behavior; and (b) role play, practice, or demonstrate the appropriate behavior that they should have done originally.
  • Their behavior is due to past inconsistency-- across people, settings, situations, or other circumstances. For example, when teachers’ classroom management is inconsistent, some students will manipulate different situations to see how much they can "get away with." Or, when peers reinforce inappropriate student behavior while the adults are reinforcing appropriate behavior, students will often behave inappropriately because they value their peers more than the adults in the school.
  • They are experiencing extenuating, traumatic, or crisis-related circumstances outside of school, and they need emotional support (sometimes including mental health) to cope with these situations and be more successful at school.

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   Critically, if we do not know and understand these root causes, we will likely never identify and implement the right interventions or solutions.

   For students whose behavior escalates to the point that schools use seclusions and restraints, a big part of the root cause analysis should also focus on their emotional control and coping skills, and the situations that trigger the behavioral escalation. These assessments must be ecological in nature. They need to look not just at the student, but at how other people, task and situational demands, settings, and interactions are related to problem at-hand.

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What Strategic or Intensive Interventions Can Replace the Need for Seclusions and Restraints

   From my perspective—and given my continuous consulting with schools across the country—I believe that one of the major reasons for schools’ need to resort to (unnecessary) seclusions and restraints is the lack of “Tier II and Tier III” intervention training and expertise.

   In addition, there also is not enough real, continuous, and collaborative coordination between districts’ related services and intervention professionals, and the community-based clinicians (e.g., psychologists, psychiatrists, clinical social workers) who are available or are working with specific students.

In the former areas, many students with significant social, emotional, behavioral, and/or mental health needs (again, based on accurate functional assessments) often need one or more of the following clinical interventions:

Emotional Control and Coping Interventions/Therapies

Progressive Muscle Relaxation Therapy and Stress Management

Emotional Self-Management (Self-awareness, Self-instruction, Self-monitoring, Self-evaluation, and Self-reinforcement) Training

Emotional/Anger Control and Management Therapy

Self-Talk and Attribution (Re)Training

Thought Stopping approaches

Systematic Desensitization

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)

Cognitive-Behavioral Intervention for Trauma in Schools (CBITS)

Structured Psychotherapy for Adolescents Responding to Chronic Stress (SPARCS)

Trauma Systems Therapy (TST)

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Motivational Interventions

Positive Reinforcement, Schedules of Reinforcement, and Fading Techniques

Differential Reinforcement of Alternative, Other, Low Rates, and Incompatible Behaviors

Extinction/Planned Ignoring

Response Cost/Bonus Response Cost

Positive Practice and Restitutional Overcorrection

Group Contingency (Independent, Dependent, Interdependent) Interventions

Behavioral Contracting

Educative Time-Out

The Good Behavior Game

Check-In/Check-Out

Check and Connect

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Skill Instruction Interventions

Intensive Social Skills Training (Interpersonal, Social Problem-Solving, Conflict Prevention and Resolution, and Emotional Control and Coping skills)

Cueing, Prompting, and Stimulus Control

Attention-Control Training

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   At the same time, in the latter area, many of these students need additional interventions that include medication, intensity community-based individual and family therapy, and specialized school settings—so that the right interventions can be implemented in the right ways.

   This is, once again, why an ecological approach is necessary, and why the integration of school, family, and community services is essential.

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   At the same time, because of my ongoing work in schools with high-needs students, I know that some students present with such significant, diverse, and historical needs that there are no silver bullets. However, in the absence of schools having the skills, resources, and capacity to select and implement many of the interventions above, we really do not know the levels of success that we might have with these students.

   So. . . let’s put the “horse before the cart.” Let’s get these interventions into the hands of the right school professionals, and let’s see what happens. We need to empower our colleagues with the tools to get the job done.

   In the final analysis, I have never met anyone working in the schools who wants to seclude or restrain a student. This is not to excuse these incidents. . . it is to embark on a systematic plan—as outlined above—to diminish their need.

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Summary

   During the past four weeks, I have worked intensively with a number of school districts—helping them each to write a federal grant.  While the “core” of the grant proposals focus on improving school climate and safety, the more “subtle” parts of the grant are directed to training administrators, general and special education teachers, and related services and clinical professionals in how to implement strategic and intensive services, supports, strategies, and interventions to behaviorally challenging students.

   Critically, in many schools, their classroom climates are often dictated by the students with the most significant social, emotional, and behavioral challenges.  Given the presence of these students in every school, the multi-tiered process must address the Tier I, Tier II, and Tier III needs of all students—but especially the challenging students—simultaneously

   This is where the current PBIS and SEL frameworks fail. 

   The PBIS framework fails, because it is most often implemented in a sequential Tier I to Tier II to Tier III approach—and most schools never get to the Tier III services, supports, and interventions needed by the most challenging students.

   The SEL framework fails, because it does not even discuss the need for multi-tiered student services and supports.

   What is needed is an evidence-based science-to-practice model—one that we have described in previous Blog messages.

CLICK HERE for the Best Past Blog Message

   Unless we change course relative to school discipline, classroom management, and student self-management, very little is likely to change in the districts and schools with large numbers of (disproportionate) behavioral problems related to trauma, disability, bullying, emotional- and self-control gaps, and mental illnesses.

   And thus, concurrently, very little is likely to change in the districts and schools that are responding to students’ upsets with large numbers of seclusions and restraints—whether they were counted during the 2015-2016 school year or not.

   And so, once again, the needed federal, state, and local agenda must include the following:

  • Clear and objective seclusion and restraint definitions that are indisputable, and that result in reliable and valid reporting;
  • A powerful balance of incentives, consequences, oversight, and accountability that motivate and ensure that schools accurately report their incidence data;
  • Data management or student information systems that are user-friendly and time-efficient, and that collect and analyze seclusion or restraint incident reports in meaningful ways; and
  • A reporting protocol that differentiates different student groups, and that helps to determine the root causes of the behavioral situations that result in a student seclusion or restraint.

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   As always, I appreciate your dedication in reading and thinking deeply about these issues.  These are issues related not only to the quality of our educational process, but also to the necessity to advocate for our most-needy students.

   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, I hope that you are enjoying your summer time off. . . it is well-deserved.

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

Best,

Howie