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Behavior Archive 2011

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Dru Saren, Ph.D
Behavioral and Education Specialist

I have taught pre-school through graduate school; general and special education; in public, private and psychiatric hospital schools; in New York City, New Mexico, and California. I received my doctorate in education, with a specialization in working with students with behavioral and emotional disorders, from the University of New Mexico in 1986.

Much of my success and failure in implementing behavior strategies, as well as maintaining some sense of humor about it all, can be credited to a 27-year post graduate course offered by my daughter, who has Down Syndrome, and her younger brother and sister, who have substituted when things were going too smoothly.

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  • What do you do for a kid who wants to be restrained?

Question:

I am a teacher in a moderate to severe class for students with autism grade 3-5. We recently received a new student. (He has multiple disabilities). He is verbal, does mostly grade level academics. His behaviors have increased since he has entered the program. The main predictor of the behavior is denied assess; denied access to a toy he is using in an aggressive manor, denied access to a peer he is being unsafe with etc. His physical aggression includes grabbing throats, pulling hair, hitting, kicking throwing things.( We have tried everything to prevent behaviors from escalating this far, cool down charts, sensory breaks, social skills training, incentive charts, etc) Originally (trained) teachers were able to block however recently it got the the point of restraint (as decided by school psychologist and trained teacher-me). 

The problem came when the whole next day he was being unsafe, asking to be restrained again. We do ton's of sensory within his day, squeeze matching being one of those things. The O.T. doesn't see his issue as being sensory related. What do you do for a kid who wants to be restrained?

Thanks,
Alanna


Answer:

Alanna, thanks so much for this question. It happens more frequently than you might think. The short answer is that if restraint becomes the reinforcer, STOP! Of course, that’s easy for me to say! I’m sitting at my computer and you’re in a classroom with a violently acting out student, trying to keep your students, your staff, yourself, and Bryce (as I’ll call him) safe. 

I am curious about Bryce’s placement. If he is on grade level and verbal, why is he Multiply Handicapped and why is a placement that focuses on interventions for students with Autism the best place for him? I am not suggesting that this is the sole cause, or even the proper intervention, but I have seen students whose behavior was purely horrid in their Special Day Classes, but when they went to their general education class, they could keep it together because they knew that their peers would not accept that kind of behavior. Just saying…

It sounds like you and the team are aware of all the procedural and legal issues (I have cited some resources in the Resource section below, just in case or for other readers). You mention interventions you have tried unsuccessfully, although it’s hard to know how well they were developed and implemented.  I don’t say that to be insulting!  Years of experience has taught me that naming the interventions used really gives me no idea of how they were used and if they were suitable for this particular student.

But I am guessing that you feel you have tried these, though often I find that data keeping can be improved. What you would like are some concrete ideas to consider. 

  1. Bryce’s only goal right now is to diminish the use of the aggressive behaviors you delineated above.
  1. He has learned that aggression is effective in getting him what he wants, and it’s become automatic. In fact, it may be reinforcing in itself. Thus, interventions that rely on his inhibiting for any reason, like a chart, are not apt to work.
  1. Avoid using restraints by any and all means. If necessary, remove everyone from the room so there is no one for him to hurt. 
  1. Are you sure that the function of the behavior is not attention? Can you check this out by ignoring low levels, such as allowing him to keep a toy until he satiates and then seeing what happens? Most often, attention is the function when a person likes to be restrained.  However, the next suggestions assume access is the function.
  1. Choose one circumstance when aggression is highly likely to occur and focus on that circumstance alone. Note and record the precursor behaviors. Next time intervene with a highly desirable, usually unavailable reinforcer, accompanied with praise for “Good safe behavior” immediately when you see the precursors. For example, if Bryce narrows his eyes and tenses his fists while interacting with a peer, approach at once and offer access to something you control (for example, computer time with his favorite game). 
  1. What is the replacement behavior? Is it something like saying “I want that toy”? Allow him to have the toy, with praise for using the replacement behavior (even though it is not the correct behavior from other perspectives). Remember, the goal is decreasing aggressive behavior, not more time on academics or even compliance.

There are so many other possible scenarios and situations to cover with this amount of information that I can just graze the surface. For example, just last week I saw a student with severely aggressive behavior who received a diagnosis of AD/HD and with the proper dose of the right stimulant medication, underwent a behavioral change just short of miraculous. 

According to treatment using Functional Analysis, there are three ways to reduce problem behavior using reinforcement based approaches. If the behavior is aggression (and not attaining restraint) those are:

  1. Let him have what he wants all the time. That is not practical or desirable in a school setting, although including some time of noncontingent reinforcement in your plan is very instructive.
  1. Never let aggression work to get him what he wants. This is hard to do at school, but should be a kind of philosophy for the overall plan.
  1. Teach a replacement behavior to get what he wants. This is the form school based plans usually take.  But in extreme cases the behavior itself (hurting others) is severe and causes harm and cannot be tolerated with any frequency.

So Alanna, unless you have sufficient trained staff to work on a behavior plan individually all day, it may be too difficult to implement with fidelity in a program such as yours. Bryce may require a program designed for students with behavioral problems.

Thanks for your question. I’d be interested in learning what happened.

Best, Dru

 

Resources:

Helpful PowerPoint delineating all legal issues and acceptable practices:

http://www.pent.ca.gov/beh/rst/restraint08_DK.pdf

CA Procedural Paper:  http://www.cde.ca.gov/sp/se/lr/om110707.asp

“Best practices” for avoiding the need for restraints

  1. Teach appropriate behavior - show the student what behavior is expected and teach how to do it.
  2. Provide necessary related services to the child and others - examples of related services include speech-language and audiology assessments and services, interpreter services, psychological services, physical and occupational therapy, recreation, counseling, social work services, and parent counseling and training.
  3. Provide needed supplementary supports and services - provide what a student needs to stay in the least restrictive setting so the student can be educated with students who do not have disabilities.
  4. Provide specially designed instruction/goals to improve behavior - change the content, method, or delivery of services to improve behavior.
  5. Assess communication deficits and provide appropriate services or assistive technology - help students develop better skills in communicating instead of resorting to negative behavior to 'communicate' their needs. Assistive technology devices and services include assessments, and training for staff and parents.
  6. Assess function of behavior and develop a positive behavior intervention plan (PBIP) - figure out when and why behaviors occur and develop a plan to teach the student how to meet needs in a desirable way.
  7. Take appropriate data on behavior and behavior goals and revise as necessary - figure out the functions of behavior (for example, to avoid work, seek attention), take detailed data to measure the effects of interventions, and change if they are not working.
  8. Provide appropriate and ongoing training to staff, parents and the student about the disability and plan - make sure everyone involved understands how to help the student and how to assess progress.

http://www.olrs.ohio.gov/faq-prevent-restraint-seclusion



  • Some of my students are being called “Retard,” and etc. Is that bullying and what can I do?

Question:

Dear Dru,

I teach Special Education in a middle school.  When I am walking in the halls, I overhear kids saying things like, “Oh, that’s so gay!” or, in teasing each other, “You’re such a retard!” and I don’t know what to do.  These are not students who know me.  I think that if I said something, they would say ok, and then smirk at each other.

Similarly, there are some students who come to my Resource Room who are reluctant to do so because of their standings with their peers.  When I ask them what the kids say to them, they say it’s not so much that as looks, or acting like my kids are getting away with something. 

Are these things bullying?  What should I be doing?
Thanks.
Lettie


Answer:

Dear Lettie,

Thanks for your timely letter.  Bullying is being acknowledged as a national (world-wide, actually) problem that is pervasive in schools and there are numerous resources that have been developed to address this situation.  From President Obama remembering the pain of being ridiculed for his big ears and odd name to the suicides in the past few months of seven teens who were harassed for being seen as gay, educators and parents are taking a stand against a practice that was considered “just kids being kids” a short time ago.

Some newer things are being recognized.  The first is understanding that children who bully are often those with their own set of problems and that we may get somewhere by not just punishing them but at getting to know what is motivating them. They often have their own risk factors such as depression, self-esteem issues, and difficult family lives.

A second newer way at looking at bullying is to teach bullied children effective techniques to overcome the fear and shame they experience.

The third angle is somewhat pertinent to your dilemma – that of “bystander behavior”.  What does a person do when she hears hate speech, even when it’s not spoken to her?  How do groups of children learn not to stand by when bullies are at it?

My answer to your first question is that you need to be the adult, modeling prosocial behavior whether or not you feel it will be effective.  “I statements” still work best: “It really makes me sad to hear you use the word “retard” as a put-down.  You probably didn’t think about how hurtful that word is before you said it.   I know you would have made a better choice.  Maybe your friends can help us come up with a better word to kid your friend.  Dork?  Goofball?”

They may not be participating enthusiastically but you have the authority, so make it a teachable moment.  It isn’t really bullying, but it is hate speech and it contributes to the school climate in a negative way.

To your second question, my response is not so forthright!  Nonverbal behavior is so hard to characterize.  Your student may even be incorrect in his interpretation. What you can do is continue to do those things that Special Ed teachers do in helping their students recognize their strengths and understanding that everyone encounters difficulties.  You can talk to the general education teachers about your perceptions and see if they can’t do a little “public relations” too. 

And all schools should be implementing bullying awareness and anti-bullying programs and practices.  If that’s not being done at your school, see if any of the resources below can help you get it going.

Thank you so much for bringing up this very important issue.

Best,
Dru

RESOURCES:

BULLY POLICE USA: A Watch-dog Organization - Advocating for Bullied Children & Reporting on State Anti Bullying Laws. 
Includes an extensive list of links and sells a book for parents to read with their children.
http://www.bullypolice.org/links.html

THE IT GETS BETTER PROJECT
It is estimated that at least one third of all teens who commit suicide were dealing with being, or perceived as being, gay or lesbian and have been bullied and tormented daily.  The It Gets Better Project was created to show young lesbian gay, bisexual and transgendered people the levels of happiness and potential their lives will reach if they can just get through their teen years. It Gets Better: the Book was released on March 22nd.
http://www.itgetsbetter.org/pages/about-it-gets-better-project/

ABILITY PATH REPORT: Walk a Mile in Their Shoes: Bullying and Special Needs.  AbilityPath is a resource that supports and provides resources for parents of children with special needs.  AbilityPath.org interviewed experts, educators and parents regarding a silent epidemic facing children with special needs - bullying. The result was the report and guide, Walk a Mile in Their Shoes: Bullying and Special Needs:
http://www.abilitypath.org/areas-of-development/learning--schools/bullying/articles/walk-a-mile-in-their-shoes.pdf

UNITED STATES DEPARTMENT OF EDUCATION-DEPARTMENT OF HEALTH AND HUMAN SERVICES-DEPARTMENT OF JUSTICE:  Provides information from various government agencies on how kids, teens, young adults, parents, educators and others in the community can prevent or stop bullying: www.StopBullying.gov

POSITIVE BEHAVIORAL INTERVENTIONS AND SUPPORTS, OFFICE OF SPECIAL EDUCATION PROGRAMS, US DEPARTMENT OF EDUCATION: Gives schools capacity-building information and technical assistance for identifying, adapting, and sustaining effective school-wide positive behavioral supports for Bully Prevention: www.pbis.org

CALIFORNIA DEPARTMENT OF EDUCATION:  Bullying Publications and Resources: http://www.cde.ca.gov/ls/ss/se/bullyres.asp



  • The use of Restraints and Seclusion

Question:

Honestly, there were no questions this month!  Has everyone achieved true behavioral nirvana?  If that’s the case, I will use this opportunity to share some information on a hot topic in the field: the use of Restraints and Seclusion.


Answer:

Here is a short update on the restraint and seclusion bills in the Senate and House of Representatives:

The House passed a restraint bill in March (H.R. 4247) 2010 and there has been a pending measure (S. 3895 Keeping All Students Safe Act) before the Senate Health, Education, Labor and Pensions Committee.  The Senate bill allows officials to put restraint or seclusion in an IEP or other student plan.  This is controversial and resulted in loss of support from some disability rights groups.

Senator Chris Dodd was the chief sponsor of the Senate bill.  He retired.  He stated that he hopes to find another Democratic Senator to champion the bill in the next Congress.
At this point, it is unclear what will happen to the Keeping All Students Safe Act in the 112th Congress.  Some disability rights groups are working on alternative wording and coming up with strategies for getting a restraint and seclusion bill passed.

Some states and individual districts are writing their own laws and policies on restraint and seclusion. In some cases, new laws and policies will apply to other agencies as well as schools. Regardless of the status of a Federal law, the trend is to put more restrictions on how and when restraint and seclusion can be legally used. 

Websites that may have additional information:

Attention to this matter is long overdue!  Let’s hope humane voices prevail.
I’d love some questions, friends.


Best,
Dru Saren


  • What can we do to prevent threats of violence in schools?

Question:

“Mark” is in special ed in the middle school where I work and carries numerous diagnoses such as ADHD, ODD, OCD, and he has some serious learning disabilities.  Most staff and students here basically like Mark, but sometimes he can be hostile and aggressive, particularly when he sees a situation as “unfair”.

He made a verbal threat to “mash your brains” to one of his teachers.  The teacher didn’t report this until the end of the day and nothing was done at that point.  The next day a hammer was discovered in his backpack and he was suspended.

My question is, in light of the shootings in Arizona and similar horrible incidents elsewhere, including schools, what are we supposed to do to prevent one from happening here?

Thank you.
Melissa, Resource Teacher


Answer:

Dear Melissa,

Unfortunately, your question is oh too timely. All over the country, people are grappling over what should be done to change the culture of violence that has become so prevalent. But you don’t want that discussion here. You want a blueprint of actions to follow, and I can send you in just the right direction.

Please follow these links:
http://www.pent.ca.gov/thr/threat.html  and
http://youthviolence.edschool.virginia.edu/

There you will find the most up to date thinking and procedures on what is termed “Threat Assessment”, a problem-solving approach to violence prevention. Threat assessment evaluates whether the threat was substantive or transient and guides you in determining what issues to address. Did you know that the four vital activities that are necessary when a student like Mark makes a threat are Assess, Refer, Monitor and Support? And was your school response a team process? This is some of the information that is spelled out at these websites.

Resources on the first website include the eleven questions that are recommended by the US Department of Education in coordination with the Secret Service; a threat assessment protocol from the Virginia Youth Violence Project; a staff training and “cue cards”; links to related topics such as bullying, suicide, abuse, and psychosis.

Thanks for your question. I hope that Mark gets the help he needs to keep everyone safe.

Best,
Dru Saren