Student Handbook - Appendix G

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APPENDIX G 

PHYSICAL RESTRAINT POLICY

• (a) To administer a physical restraint only when needed to protect a student and/or a member of the AWRSD school community from assault or imminent, serious, physical harm; and
• (b) To prevent or minimize any harm to the student as a result of the use of physical restraint.
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Definitions:

The following terms shall have the following meanings as regards this policy:

Physical escort: temporary touching or holding, without the use of force, of the hand, wrist, arm, shoulder, or back for the purpose of inducing a student who is agitated to walk to a safe location.

Physical restraint: direct physical contact that prevents or significantly restricts a student's freedom of movement. Physical restraint does not include: brief physical contact to promote student safety, providing physical guidance or prompting when teaching a skill, redirecting attention, providing comfort, or a physical escort.

Mechanical Restraint: the use of any physical device or equipment to restrict a student's freedom of movement. Mechanical restraint does not include devices implemented by trained school personnel, or utilized by a student that have been prescribed by an appropriate medical or related services professional, and are used for the specific and approved positioning or protective purposes for which such devices were designed. Examples of such devices include: adaptive devices or mechanical supports used to achieve proper body position, balance, or alignment to allow greater freedom of mobility than would be possible without the use of such devices or mechanical supports; vehicle safety restraints when used as intended during the transport of a student in a moving vehicle; restraints for medical immobilization; or orthopedically prescribed devices that permit a student to participate in activities without risk of harm. Mechanical restraint is prohibited in the Ashburnham-Westminster Regional School District.

Medication Restraint: the administration of medication for the purpose of temporarily controlling behavior. Medication restraint is prohibited in the Ashburnham-Westminster Regional School District. Medication prescribed by a licensed physician and authorized by the parent for administration in the school setting is not medication restraint.

Prone Restraint: a physical restraint in which a student is placed face down on the floor or another surface, and physical pressure is applied to the student's body to keep the student in the face-down position. Prone restraint shall be prohibited in public education programs except on an individual student basis, and only under the following circumstances: 

• • The student has a documented history of repeatedly causing serious self-injuries and/or injuries to other students or staff;
  • All other forms of physical restraints have failed to ensure the safety of the student and/or the safety of others;
  • There are no medical contraindications as documented by a licensed physician;
  • There is psychological or behavioral justification for the use of prone restraint and there are no psychological or behavioral contraindications, as documented by a licensed mental health professional;
  • The program has obtained consent to use prone restraint in an emergency as set out in 603 CMR 46.03(1)(b), and such use has been approved in writing by the principal; and,
  • The program has documented 603 CMR 46.03(1)(b) 1 through 5 in advance of the use of prone restraint and maintains the documentation.

Seclusion: the involuntary confinement of a student alone in a room or area from which the student is physically prevented from leaving. Seclusion is prohibited in the Ashburnham-Westminster Regional School District. Seclusion does not include a time-out as defined in 603 CMR 46.02. 

Time-out: a behavioral support strategy developed pursuant to 603 CMR 46.04(1) in which a student temporarily separates from the learning activity or the classroom, either by choice or by direction from staff, for the purpose of calming. During time-out, a student must be continuously observed by a staff member. Staff shall be with the student or immediately available to the student at all times. The space used for time-out must be clean, safe, sanitary, and appropriate for the purpose of calming. Time-out shall cease as soon as the student has calmed.

School Working Day: Any day or partial day that students are in attendance at the public education program for instructional purposes.

Preventing Restraints:

Students, families, and school staff each play a role in preventing restraint and ensuring the safety of our school community. Prevention includes using positive steps taken before a behavioral crisis occurs. The Ashburnham-Westminster Regional School District implements the following for preventing student violence, self-injurious behavior, and suicide, including individual crisis planning and de-escalation of potentially dangerous behavior occurring among groups of students or with an individual student:

Staff should consider a variety of behavioral interventions that may be effective in preventing, de-escalating the student, and that may be considered alternatives to physical restraint in emergency situations such as:

Positive behavioral interventions: AWRSD employs a variety of services and strategies to address the social, emotional and behavioral well-being of all our students.

Interrupting: Distracting the individual to another topic or something in the environment.

Ignoring: Ignoring is used during the early stages of negative behavior to which the behavior is not visibly responded to, in order to avoid inadvertently reinforcing it.  It does not mean that early danger signs are truly ignored and does not mean that dangerous behaviors are ever ignored.

Redirecting: Redirecting is used to manage a potentially dangerous behavior by deflecting or redirecting the behavior, and then reinforcing a more appropriate behavior by rewarding the individual for displaying the more appropriate behavior. 

Other interventions: offering choices of activities, opportunity for a break, reducing the demands/amount of work expected (without removing the expectations entirely), reminding student of reinforcers available for engaging in appropriate behaviors (e.g. first work, then you can read), prompting the student to use functional language to communicate their feelings or needs (e.g. if you are frustrated you can tell me “I need a break”), offering opportunities to speak with professionals e.g. teacher, administrator, nurse, or school counselor. 

Please note: Whenever there is a behavior support plan in place for a student, staff should defer to the specific individualized interventions outlined in the behavior plan for that student. 

Prevention also involves ensuring that staff has training; appropriate staffing; policies/procedures in place including behavioral support plans; appropriate programming; ability to recognize individuals strengths, weaknesses and triggers. 

De-escalation of Potentially Dangerous Behavior: The goal of de-escalation is to reduce the intensity of a volatile or potentially dangerous situation. Guidelines for de-escalating potentially dangerous behavior include but are not limited to:

Remain Calm: use a neutral and level tone of voice, do not raise your voice or talk to the other person in a way that could come across as angry, demanding, or condescending, control one's facial expressions and use a supportive non-threatening body language.

Obtain Assistance: Whenever possible, school personnel should immediately take steps to notify school administrators, school counselors, BCBA and/or other school personnel of a potentially dangerous situation and to obtain additional assistance.

One Person Speaks: If there is more than one adult involved, having one person providing overall direction to the response and the follow up procedures is advisable. This often may be either the first trained staff person on the scene or the staff person with the most information about the particular situation.

Remove Student If Possible and/or Necessary: The feasibility of having a student experiencing distress leave an area with other students and move to another more private and safe area in order to de-escalate should be considered. 

Remove Other Students: If it is not feasible to have a student experiencing distress move to a more private and safe area in order to de-escalate, consider the feasibility of having other staff assist and monitor the removal of other students to another area within the school until the student de-escalates.

Crisis Planning and Response: 

Methods for Preventing Student Violence, Self-Injurious Behavior, and Suicide: 

The Ashburnham-Westminster Regional School District has Emotional/Mental Health Advisory Teams (EMHAT) established in each building. The EMHAT is a predefined group of staff who are familiar with response guidelines for students in crisis. EMHAT may include: Principal, Assistant Principal, School Psychologist, School Nurse, School Adjustment Counselor, School Counselor, and School Resource Officers and other District staff as appropriate. 

Follow-up Response to Threats of Violence Or Suicide: Threats of violence or self-injury, made by a student or group of student(s) should be reported to the school principal and reviewed with the school Emotional/Mental Health Advisory Team (EMHAT), regardless of whether a student's behavior resulted in the use of physical restraint. Based on the situation, the school treatment team may recommend or require that the student(s) undergo a Risk Assessment or a screening. The Student Incident Reporting Form will be completed.

Protocol for Reporting Student Suicidality: When a teacher or staff member becomes aware of any student experiencing at-risk behavior (verbal statements, writing, report from peers, family etc.) or at risk for self-injury/suicide (a student who indicates through actions speech or writings that they may be at risk of harming themself physically) they will report immediately to the school administration and/or school counseling staff.

Protocol for Responding to Student Suicidality: EMHAT will assess level of risk according to pre-established guidelines as outlined in the Ashburnham-Westminster Critical Incident Management Plan. Guidelines include but are not limited to the identified child being directly supervised by a member of the EMHAT throughout the process. If the student requires medical attention, the school nurse will be contacted immediately. Staff should remain calm; remember the student is overwhelmed and confused as well as ambivalent. Don’t minimize the student’s concerns or make light of the threat. Don’t worry about silences; both you and the student need time to think. Don’t promise confidentiality - promise help and privacy.

Family Engagement: 

The Ashburnham-Westminster Regional School District will engage families in discussions about restraint prevention and the use of restraint solely as an emergency procedure. The restraint policy and procedures will be posted on the district’s website. The Ashburnham-Westminster Regional School District may conduct an annual workshop, open to the entire school community, concerning restraint prevention and the use of restraint solely as an emergency procedure. This workshop may be coordinated with the special education parent advisory council (SEPAC), the parent-teacher organization (PTO), and other relevant community groups.

Any parent/guardian with concerns about the use of physical restraint at any school within the Ashburnham-Westminster Regional School District  may request a meeting with the building Principal or the Superintendent to discuss such concerns. Any individual who believes that a physical restraint of a student may have been unwarranted or conducted inappropriately may also make use of the Restraint Grievance Procedure.  

Training:

This policy outlines appropriate responses to student behavior that may require immediate intervention. These procedures shall be reviewed annually and made available to school staff and parents of enrolled students.

Each building Principal shall be responsible for arranging for the provision of training, as approved by the Massachusetts Department of Education, regarding the school district’s restraint policy. This training will occur within the first month of school or, for new hires, within one month of employment.  

Training will include information on the following:

1. The role of the student, family, and staff in preventing restraint
2. The AWRSD restraint prevention and behavior support policy and procedures, including use of time-out as a behavior support strategy distinct from seclusion
3. Interventions that may preclude the need for restraint, including de-escalation of problematic behaviors and other alternatives to restraint in emergency circumstances
4. When behavior presents an emergency that requires physical restraint, the types of permitted physical restraints and related safety considerations, including information regarding the increased risk of injury to a student when any restraint is used, in particular a restraint of extended duration
5. Administering physical restraint in accordance with medical or psychological limitations, known or suspected trauma history, and/or behavioral intervention plans applicable to an individual student
6. Identification of school staff who have received in-depth training pursuant to 603 CMR 46.03(3) in the use of physical restraint

At the beginning of each school year, each building Principal shall also be responsible for identifying staff who are authorized to serve as a school-wide resource to assist in ensuring proper administration of physical restraint. This would include individuals who have received in-depth training in the use of physical restraint. This in-depth training will be at least sixteen (16) hours in length with at least one refresher training occurring annually thereafter.  

In-depth training will include information on the following:

1. Appropriate procedures for preventing the use of physical restraint, including the de-escalation of problematic behavior, relationship building and the use of alternatives to restraint
2. A description and identification of specific dangerous behaviors on the part of students that may lead to the use of physical restraint and methods for evaluating the risk of harm in individual situations in order to determine whether the use of restraint is warranted
3. The simulated experience of administering and receiving physical restraint, instruction regarding the effect(s) on the person restrained, including instruction on monitoring physical signs of distress and obtaining medical assistance
4. Instruction regarding documentation and reporting requirements and investigation of injuries and complaints
5. Demonstration by participants of proficiency in administering physical restraint
6. Instruction regarding the impact of physical restraint on the student and family, recognizing the act of restraint has impact, including but not limited to psychological, physiological, and social-emotional effects.

Determining When Physical Restraint May Be Used:

Physical restraint shall be considered an emergency procedure of last resort and shall be prohibited in public education programs except when a student's behavior poses a threat of assault, or imminent, serious, physical harm to self or others and the student is not responsive to verbal directives or other lawful and less intrusive behavior interventions, or such interventions are deemed to be inappropriate under the circumstances.

Physical restraint is prohibited:  As a means of discipline or punishment, when the student cannot be safely restrained because it is medically contraindicated for reasons including, but not limited to, asthma, seizures, a cardiac condition, obesity, bronchitis, communication-related disabilities, or risk of vomiting, as a response to property destruction, disruption of school order, a student's refusal to comply with a public education program rule or staff directive, or verbal threats when those actions do not constitute a threat of assault, or imminent, serious, physical harm; or as a standard response for any individual student. 

No written individual behavior plan or individualized education program (IEP) may include use of physical restraint as a standard response to any behavior. 

Physical restraint is an emergency procedure of last resort.

The Ashburnham-Westminster Regional School District does not allow the use of medical restraint, mechanical restraint and/or seclusion. 

Proper Administration of Physical Restraint:

Only school personnel who have received training pursuant to 603 CMR 46.03(2) or 603 CMR 46.03(3) shall administer physical restraint on students. Whenever possible, the administration of a restraint shall be witnessed by at least one adult who does not participate in the restraint. The training requirements contained in 603 CMR 46.00 shall not preclude a teacher, employee or agent of a public education program from using reasonable force to protect students, other persons or themselves from assault or imminent, serious, physical harm.

A person administering physical restraint shall use only the amount of force necessary to protect the student or others from physical injury or harm.

A person administering physical restraint shall use the safest method available and appropriate to the situation subject to the safety requirements set forth in 603 CMR 46.05(5).  Floor restraints, including prone restraints otherwise permitted under 603 CMR 46.03(1)(b), shall be prohibited unless the staff members administering the restraint have received in-depth training according to the requirements of 603 CMR 46.04(3) and, in the judgment of the trained staff members, such method is required to provide safety for the student or others present.

A person administering physical restraint shall discontinue such restraint as soon as possible. All physical restraint must be terminated as soon as the student is no longer an immediate danger to himself or others, or the student indicates that he or she cannot breathe, or if the student is observed to be in severe distress, such as having difficulty breathing, or sustained or prolonged crying or coughing.

Additional requirements for the use of physical restraint are as follows:

1. No restraint shall be administered in such a way that the student is prevented from breathing or speaking. During the administration of a restraint, a staff member shall continuously monitor the physical status of the student, including skin temperature and color, and respiration.
2. Restraint shall be administered in such a way so as to prevent or minimize physical harm. If, at any time during a physical restraint, the student expresses or demonstrates significant physical distress including, but not limited to, difficulty breathing, the student shall be released from the restraint immediately, and school staff shall take steps to seek medical assistance.
3. If a student is restrained for a period longer than 20 minutes, staff shall obtain the approval of the principal. The approval shall be based upon the student's continued agitation during the restraint justifying the need for continued restraint.
4. Staff shall review and consider any known medical or psychological limitations, known or suspected trauma history, and/or behavioral intervention plans regarding the use of physical restraint on an individual student.
5. Following the release of a student from a restraint, AWRSD will implement follow-up procedures. These procedures shall include reviewing the incident with the student to address the behavior that precipitated the restraint, reviewing the incident with the staff person(s) who administered the restraint to discuss whether proper restraint procedures were followed, and consideration of whether any follow-up is appropriate for students who witnessed the incident

Reporting Requirements:

Staff shall report the use of any physical restraint as specified in 603 CMR 46.06(2).

The school staff member who administered the restraint shall verbally inform the Building Principal or his/her designee of the restraint immediately, or as soon as possible, upon the conclusion of the restraint and the safe transfer of the student’s supervision to another staff member. In addition, The school staff member who administered the restraint shall provide a written report to the principal for review of the use of the restraint no later than the next school working day. 

If the principal has administered the restraint, the principal shall prepare the report and submit it to an individual or team designated by the superintendent for review. 

The principal shall maintain an on-going record of all reported instances of physical restraint, which shall be made available for review by the parent or the Department upon request.

Informing Parents and Guardians. The Building Principal shall attempt to verbally inform the student’s parents or guardians of the use of physical restraint immediately, or as soon as possible within 24 hours, following notification by the school staff member who administered the restraint. The Building Principal shall also notify the parent by written report sent either within three (3) school working days of the restraint to an email address provided by the parent for communications about the student, or by regular mail postmarked no later than three (3) school working days of the restraint. If the school customarily provides a parent or guardian of a student with report cards and other necessary school-related information in a language other than English, the written report shall be provided to the parent or guardian in that language.

The written report will follow the requirements of 603 CMR 46.06(2) and 603 CMR 46.06(3) and shall include:

1. The name of the student; the names and job titles of the AWRSD staff who administered the restraint, and observers, if any; the date of the restraint; the time the restraint began and ended; and the name of the principal or designee who was verbally informed following the restraint; and, as applicable, the name of the principal or designee who approved continuation of the restraint beyond 20 minutes pursuant to 603 CMR 46.05(5)(c). 
2. A description of the activity in which the restrained student and other students and staff in the same room or vicinity were engaged immediately preceding the use of physical restraint; the behavior that prompted the restraint; the efforts made to prevent escalation of behavior, including the specific de-escalation strategies used; alternatives to restraint that were attempted; and the justification for initiating physical restraint.
3. A description of the administration of the restraint including the holds used and reasons such holds were necessary; the student's behavior and reactions during the restraint; how the restraint ended; and documentation of injury to the student and/or staff, if any, during the restraint and any medical care provided.
4. Information regarding any further action(s) that the school has taken or may take, including any consequences that may be imposed on the student.
5. Information regarding opportunities for the student's parents to discuss with school officials the administration of the restraint, any consequences that may be imposed on the student, and any other related matter. 

Individual student review. The principal will conduct a weekly review of restraint data to identify students who have been restrained multiple times during the week. If such students are identified, the principal shall convene one or more review teams as the principal deems appropriate to assess each student's progress and needs. The assessment shall include at least the following:

• • review and discussion of the written reports submitted in accordance with 603 CMR 46.06 and any comments provided by the student and parent about such reports and the use of the restraints;
  • an analysis of the circumstances leading up to each restraint, including factors such as time of day, day of the week, antecedent events, and individuals involved;
  • consideration of factors that may have contributed to escalation of behaviors, consideration of alternatives to restraint, including de-escalation techniques and possible interventions, and such other strategies and decisions as appropriate, with the goal of reducing or eliminating the use of restraint in the future;
  • agreement on a written plan of action by the program.

If the principal directly participated in the restraint, a duly qualified individual designated by the superintendent shall lead the review team's discussion. The principal shall ensure that a record of each individual student review is maintained and made available for review by the Department or the parent, upon request.

Administrative review. The principal will conduct a monthly review of school-wide restraint data. This review shall consider patterns of use of restraints by similarities in the time of day, day of the week, or individuals involved; the number and duration of physical restraints school-wide and for individual students; the duration of restraints; and the number and type of injuries, if any, resulting from the use of restraint. The principal shall determine whether it is necessary or appropriate to modify the school's restraint prevention and management policy, conduct additional staff training on restraint reduction/prevention strategies, such as training on positive behavioral interventions and supports, or take such other action as necessary or appropriate to reduce or eliminate restraints.

Department Reporting. The Ashburnham-Westminster Regional School District will collect and annually report data to the Department regarding the use of physical restraints. Such data shall be reported in a manner and form directed by the Department.

When a physical restraint has resulted in an injury to a student or AWRSD staff member, AWRSD shall send a copy of the written report required by 603 CMR 46.06(4) to the Department postmarked no later than three (3) school working days of the administration of the restraint. The Ashburnham-Westminster Regional School District shall also send the Department a copy of the record of physical restraints maintained by the principal pursuant to 603 CMR 46.06(2) for the 30-day period prior to the date of the reported restraint. The Department shall determine if additional action by AWRSD is warranted and, if so, shall notify AWRSD of any required actions within 30 calendar days of receipt of the required written report(s).

Grievance Procedure. The Ashburnham-Westminster Regional School District has established an internal procedure in order to provide for prompt and equitable resolutions of complaints regarding the administration of physical restraints.

Definitions:

A "Grievance" is a complaint made pursuant to, and arising out of, the Ashburnham-Westminster Regional School District obligations to comply with state regulations regarding the use of physical restraints.

An "Aggrieved Party" is a person or persons making the complaint.

Purpose: The purpose of this grievance procedure is to secure prompt and equitable solutions to grievances which may, from time to time, arise pursuant to 603 CMR 46.00.

General:

No aggrieved party will be subject to coercion, intimidation, interference or discrimination for registering a complaint or for assisting in the investigation of' any alleged complaint within the context of this grievance procedure.

All documents, communications, and records dealing with the filing of a grievance will be kept confidential to the full extent provided by law.

Forms for filing grievances will be provided upon request by building principals or the Superintendent of Schools, Ashburnham-Westminster Regional School District, 11 Oakmont Drive, Ashburnham, MA 01430

Procedure:

1. The aggrieved party should complete the Grievance Form and return it to the building principal or their designee at the school building in which the alleged grievance occurred. The complaint should be filed within fifteen (15) days after the complainant becomes aware of the alleged violation. Assistance will be provided, upon request, to enable an individual to complete the Grievance Form and pursue the grievance process. 
2. Within ten (10) school days after receiving the grievance, the building principal or their designee shall meet with the aggrieved party in an effort to resolve the grievance. This investigation into the complaint is contemplated to be thorough, but informal, in nature. All interested persons and their representatives, if any, shall be afforded an opportunity to be heard and to submit evidence relevant to the complaint. If the grievance is not resolved, it will be forwarded to the Director of Pupil Services and/or Superintendent.
3. Within thirty (30) school days of receipt of an unresolved grievance, the Director of Pupil Services and/or Superintendent will conduct a hearing to determine what, if any, action shall be taken in response to the grievance. The hearing shall be held at a time and place mutually convenient to all parties. The hearing procedure will follow appropriate due process procedures, including:
   a. the opportunity for the aggrieved party to present the grievance in any suitable manner;
   b. the right of the aggrieved party to an impartial hearing officer;
   c. the right of the aggrieved party to be represented by counsel or an advocate at the aggrieved party’s expense;
   d. he right of the aggrieved party to a prompt decision.
   Parents/legal guardians should provide advance notice to the Director of Pupil Services and/or Superintendent that they will be represented by counsel or an advocate at the grievance hearing. Failure to provide such notice will likely result in a postponement of the hearing.
4. A written determination of the validity of the complaint and a description of the resolution, if any, shall be issued by the Director of Special Education and forwarded to the complainant no later than fifteen (15) working days after the hearing. The determination of the validity of the complaint and the description of the resolution will be provided in an alternate format, upon request, if needed for effective communication. 
5. The complainant can request a reconsideration of the case in instances where he or she is dissatisfied with the resolution. The request for reconsideration should be made within fifteen (15) working days following receipt of the written determination to the Superintendent of the Ashburnham-Westminster Regional School District.
6. The right of a person to a prompt and equitable resolution for the complaint file hereunder shall not be impaired by the person’s pursuit of other remedies such as the filing of an ADA, Section 504 or other complaint with the responsible federal department or agency. Use of this grievance procedure is not a prerequisite to the pursuit of other remedies.
7. These rules shall be construed to protect the substantive rights of the interested persons to meet appropriate due process standards and to assure that the Ashburnham-Westminster Regional School District comply with 603 CMR 46.00.

Copies of all resolutions and findings made under this procedure shall be filed with the Superintendent’s Office of the Ashburnham-Westminster Regional School District.