Transcript 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
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
necessary under the circumstances.
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  to provide proper body
of the student;
 to protect a student who
is known to be at risk of
injury to self because of
lack of coordination or
frequent loss of
consciousness;
alignment to a student; or
 to position a student who
has physical disabilities in a
manner prescribed in the
student’s IEP.
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