Extracted from Restraint and Seclusion: Hear Our Stories (2013) film, free to the public through StopHurtingKids.com for training, professional development and public awareness

Recommended Practices for Reducing Physical Restraint in Schools

Sarah Davidon, Ed.D.

CANDO

June 9, 2017

Definition

Physical restraint is defined by the Colorado Department of Education (Rules for the Administration of the Protection of Persons from Restraint Act, 1 CCR 301-45, 2009) as the use of bodily, physical force to involuntarily limit an individual’s freedom of movement

Statement of the Problems• Lack of Tools to Understand Recommended Practices

– There is no systemic approach to assess and reduce schools’ use of physical restraint, nor is there a primary source for standards in training, reporting, or data use to guide schools that ensures consistency across schools and districts

• Deficiencies and Variance in Data

– Data is lacking and inconsistent. Improvement of circumstances can only happen within a system that has a continuous quality improvement orientation, and measurement and feedback processes that can link data to outcomes

• Disproportionality of Restraint of Students with IEPs

– As physical restraint practices are implemented, specific groups have become disproportionately impacted, with one of the primary groups of children those with disabilities.

U.S. Department of Education Office for Civil Rights. (2014). Civil rights data collection: data snapshot: school discipline. Washington, DC: U.S. Department of Education, Office for Civil Rights.

Contemporary and Relevant Issues

• Legislation • Literature and News

March 27, 2017

April 4, 2017

Review of the Literature

• National Perspective on Restraint Data and Policy– Butler (2015)

– Freeman & Sugai (2013)

– Health, Education, Labor, and Pensions Committee, Majority Committee Staff Report (2014)

– U.S. Department of Education (2012)

– Wale, Belkin, & Moon (2011)

• Restraint Use and Students with Disabilities– GAO (2009)

– Wagner, Kutash, Duchnowski, Epstein, & Sumi (2005)

– Garrison (1984)

• Aversive and Exclusionary Intervention Impact– Kentucky Protection & Advocacy (2012)

– GAO (2009)

– Amos (2004)

• Importance of Teacher Knowledge and Resources– Partin, Robertson, Maggin, Oliver, & Wehb

(2009)

– Vinh, Strain, Davidon, & Smith (2016)

– Dunlap, Ostryn, & Fox (2011)

• Impact of Restraint on Children– Howes (2000)

– Sullivan, Bezmen, Barron, Rivera, Curley-Casey, & Marino (2005)

• Policies and Position Statements– Every Student Succeeds Act (2015)

– National Association of School Nurses (2015)

– Council for Exceptional Children (2009)

Conceptual Framework

Meaningful use of data

Data collection

Data use

Professional development

Reporting

Who cares about data?

We need to better help, guide, and support all of these

stakeholders!

Key Focus Areas

• Follow recommended practices on data collection components, processes, review, and use

• Ensure adequate and appropriate professional development

• Ensure meaningful reporting practices

How to Determine Recommendations?

Development of matrix of

recommended practices through grounded theory

Policy collection and review

Verification of policies

Policy review through content

analysis

Development of recommendations

How Were Recommended Practices Determined?

117 original documents reviewed

• Framed around 6 areas of lit review

53

restraint documents

• Found through literature review

• US Department of Education Resource Document “gold standard”

• Reviewed for themes: data, reporting, and training

19 filtered for inclusion criteria

• Seven criteria for inclusion in matrix – must meet all criteria

• Re-reviewed for specific recommendations in themes: data collection, data use, professional development, and reporting/documentation emerged

79 metrics

9 categories

• Expanded themes to 9 categories

• Categorized 79 specific recommendations

District and School Policies

Policy collection and review

Verification of policies

4 districts4 schools

Policy Comparison to Recommended Practices

Policy review through content

analysis

• 4 district policies• Content analysis to

determine if elements are present

Framework Development

Development of recommendations

Framework• Recommended incident report elements for documentation• Recommended practices in the 9 categories• Suggested policy and practice use of the framework for

states, districts, and schools

What are recommended practices for mitigation of physical restraint use?

Data elements Review of incidents

Documentation process

Parent notification process

Reporting requirement

Staff training requirements

Use of data• student• classroom/school• state

How do four Colorado districts map to recommended practices?

Category District percentage match with recommended practices

Data Elements 53%

Documentation Process 92%

Parent Notification Process 59%

Reporting Requirement 31%

Review of Incidents 48%

Staff Training Requirements 49%

Use of Data: Student 19%

Use of Data: Classroom/School 37%

What policy and practice changes can best ensure implementation of recommended

practices?

What policy and practice changes can best ensure implementation of recommended

practices? (continued)

Implications for Practice and Policy• Better data collection and accountability

• Meaningful use of data and documentation

• Mitigation of use

• More specific information on whether there are disproportionate percentages of young children restrained

• Specificity in prevention strategies in policies

• Use of recommended practices

Recommendations for Further Work

• Age and grade level prevalence of restraint

• Availability of information

• Data-informed practice/policy research

• Increased accountability, consistency, and clarity in reporting

25

The true measure of any society can be

found in how it treats its most vulnerable

members

-attributed to Mahatma Gandhi