Reducing Seclusion Timeout and Restraint Procedures with At-Risk Youth.

Abstract

The purpose of this pilot study was to review the effects of professional staff training in crisis management and de-escalation techniques on the use of seclusion timeout and restraint procedures with at-risk students in a K-12 special day school. An exploratory pre-post study was conducted over a twoyear period, comparing the use of these behavior management interventions when all staff members were provided crisis intervention training. In addition, a brief survey was administered to all staff members concerning their training in and use of behavioral interventions. Results indicated professional staff training was effective in reducing (a) seclusion timeout procedures by more than one-third (39.4%) and (b) physical restraints (17.6%). This study also found staff members were not initiating seclusion timeout procedures primarily for the reasons they were trained (e.g., physical aggression) but rather for nonviolent behaviors such as leaving an assigned area and disrupting the classroom environment. Seclusion timeouts and physical restraint are two of the most restrictive behavioral interventions schools rely on to manage the inappropriate and aggressive behavior frequently displayed by at-risk youth. recently, however, public awareness has been raised regarding the inherent dangers associated with the use of these aversive procedures. An investigative series in the Hartford Courant, a Connecticut newspaper, reported there were 142 restraint-related deaths across the united States over a 10-year period (Weiss, 1998). Similar findings regarding the hazards of restraint and seclusion have been issued by the Government Accounting office (uSGAo, 1999) and the Child Welfare league of America (CWlA, 2002). Timeout Procedures Used in Schools Timeout is a behavior management procedure that has long been used in the field of education to address a broad range of maladaptive behaviors across educational placement settings (Costenbader & reading-brown, 1995). It is actually a form of punishment implemented to reduce inappropriate behaviors by denying a student access to any type of reinforcement (Alberto & Troutman, 1999; ryan, Sanders, Katsiyannis & Yell, In Press). There are three variants of this procedure, differing in respect to the degree they separate students from their peers and academic instruction. Timeout procedures ranging from the least to most restrictive interventions include (a) inclusion, (b) exclusion, and (c) seclusion. Inclusion (e.g., contingent observation, timeout ribbon), the least aversive of the three procedures, entails placing the student in a classroom area in which the student can observe the class but denies the him/her the opportunity to participate in activities and receive reinforcement for a given period of time (Yell, 1990). exclusion (e.g., think time), the second and most frequently used timeout procedure (Costenbader & reading-brown, 1995; Gast & nelson, 1977), denies the student the opportunity to either observe or participate in any classroom activities. The third and most restrictive form of timeout, seclusion (e.g., isolation room, cool down room), removes students from the classroom environment, placing them in an involuntary confinement in a room or area where they are physically prevented from leaving (busch & Shore, 2000). Restraint Procedures Used in Schools There are two common forms of restraints used in schools today: (a) mechanical, and (b) ambulatory. mechanical restraint entails the use of any device or object (e.g., tape, tie downs, calming blanket, body carrier) to limit an individual’s body movement to prevent or manage out-of-control behavior. The second and more common form of physical restraint is often referred to as ambulatory restraint, manual restraint, or “therapeutic holding” (American Academy of Pediatrics Committee on Pediatric emergency medicine, 1997). This type of restraint involves one or more people using their bodies to restrict another’s body movement as a means of reconstituting behavioral control, and establishing and maintaining safety for the out-of-control student, other students, and staff (American Academy of Child and Adolescent Psychiatry, 2000). The use of physical restraint in schools, discussed since the 1950s, was included in a list of “techniques for the antiseptic manipulation of surface behavior” by redl and Wineman (1952)

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