It is essential schools support positive, proactive environments rather than reactive and punitive atmospheres. Training in positive behavioral interventions and de-escalation techniques are crucial prior to the use of any crisis management technique. Therefore, all staff who may implement any crisis management techniques must complete regular de-escalation training. A list of staff members who completed the training and a description of the training must be on file at each school. Additionally, each incident of seclusion and/or physical restraint must be carefully documented and steps be taken to prevent the re-occurrence of future incidences.

Training for Positive Behavioral Interventions and De-escalation Techniques:

• Ongoing professional development opportunities are made available throughout the school year. Please refer to the Professional Development Portal for a complete list.


• Comprehensive Crisis Prevention Institute (CPI) training is provided to site-based CPI teams. For more information contact your Special Education Specialist or Behavior Specialist.


• Additional site-based trainings are available in the areas of de-escalation strategies, positive behavior practices, active supervision, behavior change techniques, and effective classroom management.

In addition to training in de-escalation strategies, each incident involving the use of crisis management techniques must be carefully documented and steps taken to prevent the re-occurrence of future incidences. The following are guidelines and procedures to assist staff in documenting incidents involving the use of crisis management techniques.

Defining Crisis Management Techniques

Crisis Management Techniques are techniques considered to be physical interventions used in a behavioral crisis. These techniques are used as a last resort when there is imminent risk of a student harming themselves or someone else. These techniques require physical intervention in order to keep students and staff safe.

Defining Last Resort

The phrase “last resort” is not defined by law but infers all responses are exhausted and attempts made to defuse the situation. Efforts are made to implement any reasonable options of responding to the crisis that may prevent or de-escalate the situation.

Defining Imminent Risk of Danger

Imminent risk of danger is when a student is likely to engage in physical aggression immediately as indicated by overt signs of aggression or agitation. The CPI Decision Making Matrix* should be used as a reference to help determine likelihood and severity of risk. Imminent Risk of danger does not refer to implementing physical intervention techniques when a student is speaking in loud tones or demonstrates verbal aggression. Behavior “might” happen because it has occurred in the past, or because a student makes threats but does not have the ability to carry out the physical threat.

Crisis Management Techniques

Crisis management techniques include stills taught in CPI trainings such as personal safety techniques like blocking and disengaging from a grab. They also include holding skills or physical restraints taught and reviewed in CPI such as the Children’s Control Position and other holding techniques.

Crisis management techniques also include the use of Seclusion Timeout. Although, South Carolina law does not currently ban the use of seclusion in public schools, GCSD strongly discourages the use of this practice. These guidelines and procedures are provided with the intent to restrict the use of Seclusion Timeout to extraordinary circumstances.

Crisis Management Techniques should NEVER

• be used as a punishment, to force compliance, or to manage a student’s behavior


• be used to substitute for appropriate educational supports


• be used in response to the use of profanity, verbal threats/outbursts, minor property destruction or displays of disrespect


• be performed alone or by someone not currently certified in the holding techniques approved for use in Greenville County Schools (CPI).


• involve pain or dehumanize/disrespect the student


• involve restraints to or on the floor due to the risk of restraint-related positional asphyxia, injury or death


• be used in response to a student running away unless there is imminent risk of injury related to that flight

School Crisis Response Teams

What is a School Crisis Response Team

A school crisis response team is a team of five (5) or more individuals at each school that are trained in de-escalation strategies as well as trained in the use of crisis management techniques. GCSD utilizes CPI as their training program for crisis management techniques. Depending on the needs of individual schools, team size and members will vary. A behavior crisis could occur in any school at any time; therefore, every school should have an established team regardless of their enrollment size or number of specialized classes.

Required Team Members

Each team should consists of at least five (5) team members but many schools will have more. School administrators determine staff in their building that are on their crisis response teams. Team members could consist of teachers, paraprofessionals, instructional support staff, or counselors. Support staff such as custodians, cafeteria staff, or office staff should not be included as team members. Team members should be physically and mentally able to respond to a crisis involving a student physically acting out. Apart from the previous suggested team members, the following school staff are required team members:

• at least one school administrator


• all EDSC and ID Moderate teachers and paraprofessionals


• other special education teachers from your school including multicategorical, resource, and/or educational support teachers that the school administration believes should be trained.

*Staff in a position required to be a team member but not physically able to participate in actual physical restraints (i.e. pregnancy, injury, etc.) will provide help with all other aspects of managing the crisis (i.e., de-escalation, documentation, etc.).*

Guidelines and Procedures for the Use of Physical Restraint

Professionals working in the field of education, at times, may find themselves in a situation involving a student displaying disruptive, challenging, or potentially dangerous behaviors. In Greenville County Schools, we believe most aggressive incidents can be prevented or de-escalated through the use of appropriate adult interactions and positive behavioral supports. However, incidents may arise in which physical restraint may be needed in order to protect the student from harming themselves or others. The following are guidelines and procedures to assist staff in preparing should such incidents occur.

Physical Restraint is the application of physical force by one or more individuals that immobilizes or reduces the ability of an individual to move his/her arms, legs or head freely. This includes the physical holding of a student for any purpose other than providing safety and support. The duration of the physical restraint is limited to the amount of time it takes the student to regain composure.

For use in this document, the term “physical restraints” only refers to the holding skills and techniques taught in CPI trainings. (Child’s Control Position, Standing Holding Position, etc.) These are the only physical restraints supported by GCSD.

Nonviolent Physical Crisis Intervention (CPI) is the physical restraint practice supported by Greenville County Schools. It is a set of techniques utilized in an emergency by a “certified staff person” to control or suppress the movement of a student to ensure the safety of that student and any other people in the immediate area. CPI is used as a last resort and is not to be used as punishment. It is an emergency procedure comparable to first aid. A “certified staff person” refers to an individual on the school crisis response team who has completed an initial CPI training session and has maintained the certificate through ongoing recertification training. CPI training should be included as part of a school’s emergency planning.

CPI training for the school’s crisis response team should be included as part of a school’s emergency planning. A list of CPI trained staff should be maintained by the school and a copy of their certification kept on file.

CPI trained staff should review and practice the restraint skills and review all de-escalation models at least monthly (i.e., Verbal Escalation Continuum, Decision Making Matrix*, etc.). These practices should be documented.

Risks of Restraint

• Any use of restraint poses a significant amount of risk for both the student and staff members implementing the restraint.


• Risks to the student may include: cuts/scrapes, bruises, broken bones, hyperthermia (overheating), psychological trauma, breathing problems/asphyxia, and death.


• Restraints should always be conducted in a team approach! This increases the likelihood emergency procedure are implemented properly and safely thus reducing the potential for injury or for future litigation.

Remember, the best way to eliminate the dangers of restraint, is to eliminate the need for restraint.

Requirements for the Use of Physical Restraint and Crucial Considerations:

• Only staff members certified in CPI are authorized to use physical restraint. However, this does not preclude an uncertified staff member from responding to protect students, other persons or themselves from assault or imminent, serious physical harm.


• Restraint should be used only as a last resort when an individual is a danger to self or others and when less restrictive interventions (i.e., positive intervention strategies, de-escalation strategies, etc.) have been tried with fidelity and are unsuccessful.


• A team approach is to be used when responding to a crisis requiring the use of restraint. Although some restraint or holding techniques can be done by one person, there should always be more than one person there to help monitor the student.


• The degree of force applied may not exceed what is necessary to protect the student or other persons from bodily injury. The intent of the restraint is the calm and protect the student and should not involve pain.


• An administrator or designee should be notified immediately of an emergency requiring the use of restraint.


• The intent of the restraint is to maintain the safety of students and staff.

Inappropriate Uses of Physical Restraint:

• Restraint should never be used to manage a student’s behavior, as a punishment or to address non-compliance.


• Restraint should never be used in response to property destruction, verbal outbursts or displays of disrespect.


• Restraint should never be used in response to students running away unless there is imminent risk of injury related to that flight.


• The student is never to be restrained to/on the floor (face up or face down). Such actions increase the risks of restraint-related positional asphyxia, injury or death.

Procedures:

• Use the principles taught in the Decision Making Matrix* to guide the team as they are determining if restraint is needed.


• Ensure there is clear understanding of what signs to look for in the individual student to know when to stop the restraint or when to opt out of the restraint as taught in CPI training.


• A team approach must be used.


• When restraining a student, only district approved techniques outlined in CPI training are to be used.


• Clear the environment of people, materials or furniture as needed


Contact:


• An administrator or designee and inform them of the emergency crisis. The designee should be a member of the school leadership team.


• Other crisis response team members that are needed. A plan for how to contact other team members should be established prior to an incident.


• Team members should provide ongoing feedback to everyone involved as to the needs of the student and the staff responding


Observe:


• Team members will continually assess the student for signs of tension reduction or signs of distress. They will also use de-escalation strategies as appropriate and identify opportunities to re-establish therapeutic rapport with the student.


• Team members will continually assess other team members for distress or other needs during the incident.


Documentation:


• Documentation of the restraint should occur before, during and after the incident of restraint.


• Documentation should include: times, staff present, types of restraints used, and behaviors leading to the restraint, during the restraint and following the restraint. This documentation will be used during the debriefing with staff and notification to parents. Please see the section on documentation for more details.

Following the Use of Restraint:

1. Re-establish rapport with the student. Use the Coping Model* as outlined in our CPI trainings.


2. After the use of restraint, a member of the school’s nursing staff will conduct a well-body check of the student to assess for any possible injuries.


3. A member of the administration team or designee must notify the student’s parent(s)/guardian(s) on the day restraint occurred. Attempts to contact the parent(s)/guardian(s) should be documented. This contact is separate from sending home a copy of the Crisis Management Techniques Documentation form.


4. Staff-debriefing with appropriate team members should occur the day of the restraint incident, but no more than 24 hours or one school day after the use of restraint. This meeting is documented in the bottom portion of the Crisis Management Techniques Documentation form (see Appendix). More guidance on debriefing and documentation can be found under the Guidelines for the Documentation of Seclusion and/or Physical Restraint section of this document.


5. The Crisis Management Techniques Documentation form must be completed by staff members and copies sent within 24-hours or one school day to the following:
   
   
   1. Parent(s)/guardian(s)
   2. Administration
   3. Special Education Specialist (SES)


6. Keep a copy of the completed Crisis Management Techniques Documentation form in a secure location at the school. Upon request, parent(s)/guardian(s) must have access to and an opportunity to review this report.

Guidelines for the Use of Seclusion Time Out

Time out is a behavior management technique in which a student is placed in an environment where access to positive reinforcement is unavailable. Time out occurs on a continuum from least to most restrictive. The following guidelines are in place to address seclusion time out, the most intrusive and restrictive form of time out.

Although, South Carolina law does not currently ban the use of seclusion in public schools, GCSD strongly discourages the use of this practice. These guidelines and procedures are provided with the intent to restrict the use of seclusion time out to extraordinary circumstances.

There is no evidence to support that seclusion is effective as an intervention. The practice of seclusion may increase the likelihood of escalation of behavior, resulting in increased possibility of physical restraint.

Defining Seclusion Time Out

Seclusion time out or seclusion refers to the involuntary confinement of a student alone in a secured room or other space from which the student is physically prevented from leaving. Seclusion is not the same as removing a student to a private location during a physical restraint.

Requirements for the Use of Seclusion:

• The school administrator or designee has sole authority to permit the use of any seclusion.


• A teacher or paraprofessional may implement the use of seclusion with the administrator or designee’s authorization.


• Staff members trained in the appropriate procedures for the use of seclusion must observe and supervise the student at all times. There are never circumstances under which a student may be left in seclusion without a trained staff member’s supervision/observation.


• Students should always be treated with respect. Allow access to the restroom or to a drink of water if requested during seclusion.

Precautions and Crucial Considerations when Considering Seclusion:

Seclusion should only be used for the management of behavior when the student poses a threat of imminent, serious, physical harm to self and/or others, and the student has the ability to cause such harm.

AND

Seclusion should be used only as a last resort when an individual is a danger to self or others and when less restrictive interventions have been tried with fidelity and are unsuccessful.

• Students engaging in self-injurious behaviors should not be placed in seclusion.


• If possible, a student’s shoes, belt, glasses, hair accessories (e.g., scarf, hair band, etc.) and items in pockets should be removed prior to placing a student in seclusion. These items may present as choking hazards or could be used to harm oneself.


• Students should always be treated with respect. Allow access to the restroom or to a drink of water if requested during seclusion.


• Seclusion should never be used as punishment, to force compliance, as a substitute for appropriate educational supports, or as a response to property destruction.


• Seclusion should never be used as a response to verbal threats and profanity that do not rise to the level of physical harm unless that student demonstrates a means of carrying out the threats.


• Seclusion should never be used in a room that has a locking door.


• Seclusion should not be used in response to a student running away unless there is imminent risk of injury related to that flight


• Staff must be prepared to act immediately should the student exhibit any signs of distress.


• The intent of seclusion time out is to protect the student and others.

Procedures for the Use of Seclusion:

• A team approach must be used.


• Use the principles taught in the CPI Decision Making Matrix* to guide the team as they are determining risks


• Ensure there is clear understanding of what signs to look for in the individual student to know when to end the seclusion. These signs should help indicate when a student is regaining composure.


Contact:


• Administrator or designee and inform them of the emergency crisis.


• Other crisis response team members that are needed


• Provide ongoing feedback to everyone involved as to the needs of the student and the staff responding


Observe:


• Staff members trained in the appropriate procedures for the use of seclusion must observe and supervise the student at all times. There are never circumstances under which a student may be left in seclusion without a trained staff member’s supervision/observation.


• Continually assess for signs of tension reduction and identify opportunities to re-establish therapeutic rapport with the student.


Securing Location:


• Locking a door during the use of seclusion is prohibited.


• If using a seclusion time out room, the door handle must be held by the supervising staff member while the student is in the time out room. Tampering with the door handle to enable it to lock is not permitted.


Documentation:


• Documentation of the seclusion should occur before, during and after the seclusion.


• Documentation should include: times, staff present and actively involved in implementation and or observation during the incident, behaviors leading to the use of seclusion, behaviors during the seclusion and behaviors following the seclusion. This documentation will be used during the debriefing.


Duration:


• Time spent in seclusion should be limited to the amount of time it takes the student to regain composure.


• Seclusion should not exceed twenty consecutive minutes. If staff determines it is necessary to keep a student in seclusion longer than twenty consecutive minutes, the administrator should be consulted to determine if extending the seclusion is appropriate.

Following the Use of Seclusion:

1. Re-establish rapport with the student. Closely monitor the student during the first few minutes after the student is out of seclusion


2. After using seclusion, a member of the school’s nursing staff will conduct a well-body check of the student to assess for any possible injuries.


3. A member of the administration team or designee must notify the student’s parent(s)/guardian(s) of the incident involving seclusion as soon as reasonably possible on the day the seclusion occurred. All attempts to contact the parent(s)/guardian(s) are documented on the Crisis Management Techniques Documentation form. The form is provided to the parent(s)/guardian(s) after the debriefing meeting is held.


4. Staff-debriefing with appropriate team members should occur the day of the seclusion incident, but no more than 24 hours or one school day after the use of restraint. This meeting is documented in the bottom portion of the Crisis Management Techniques Documentation form (see Appendix). More guidance on debriefing and documentation can be found under the Guidelines for the Documentation of Seclusion and/or Physical Restraint section of this document.


5. The Crisis Management Techniques Documentation form must be completed by staff members and copies sent within 24-hours or one school day to the following:
   
   
   1. Parent(s)/guardian(s)
   2. Administration
   3. Special Education Specialist (SES)


6. Keep a copy of the completed Crisis Management Techniques Documentation form in a secure location at the school. Upon request, parent(s)/guardian(s) must have access to and an opportunity to review this report.

Guidelines for the Documentation of Seclusion & Physical Restraint

Debriefing After an Incident of Seclusion or Restraint

Staff involved in managing or responding to a crisis, especially those involving seclusion or restraint, should meet after the crisis event has occurred. During this debriefing, staff members discuss the interventions used during the crisis event. Debriefing is a constructive dialog between staff members focusing on the student’s needs and developing a plan to reduce the use of seclusion or restraint in the future. Crises are more likely to reoccur if the team does not analyze the situation and brainstorm alternative responses. In addition to debriefing with the team, there may be a need to communicate with others directly or indirectly involved in the crisis, including IEP team members, bystanders, other peers, or family members.

The Crisis Management Techniques Documentation form is used to document the incident and the debriefing meeting. The form should be completed during the debriefing meeting by the case manager, administration or other appropriate certified SPED service provider involved in the incident.

The following are procedures to help the team with the debriefing process and documentation.

Debriefing Procedures:

Who is involved in the debriefing meeting?

• Debriefing meetings are to include all staff members involved in the incident; an administrator; and at least one other staff member who is highly knowledgeable in the use of behavioral techniques, but was not involved in the incident. This may be a School Psychologist, Behavior Specialist, Special Education Specialist, Special Education Teacher, etc.

What is discussed during the debriefing meeting?

• A discussion of the behaviors that preceded the behavior or conduct causing the use of crisis management procedures.


• Use the Coping Model* taught in CPI as a means to help the team summarize and discuss the situation. A copy of the Coping Model* can be found in your CPI Student Workbook.


• Discuss interventions used during the crisis and why they were unsuccessful. This should include interventions attempted prior to the use of seclusion or restraint, as well as, a discussion on the use of seclusion and/or restraint as a last option.


• The team should discuss if and how the situation could have been handled in a way to prevent the need for crisis management procedures. Include a discussion of how similar events, if any, may be avoided in the future.

Additional questions to consider during the debriefing meeting:

• Are there additional district support staff that should be contacted for support (Special Education Specialists, Behavior Specialists, Academic Specialists, etc.)?


• What less restrictive strategies should be used to address the emergency crisis behavior?


• Should an On Track referral be made to further support students who have not been identified as a student with a disability?

Debriefing meetings can include discussion of BIPs, FBAs, and IEPs but an IEP Special Review meeting should be held ASAP to discuss any potential changes to services, goals, or supports delineated in an IEP.

When should the debriefing meeting be held?

• Staff-debriefing should occur the day of the incident but no more than 24 hours or one school day after the incident.
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How will the debriefing meeting be documented?

• Record the events of the incident as they occurred using times and locations and people present. The record of the event should include enough details so that anyone not familiar with the incident can clearly understand the events.
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• The team should use the debriefing section located on the bottom portion of the Crisis Management Techniques Documentation form (see Appendix) to lead a discussion in developing a plan to address the needs of the student and prevent any future crisis. The form is completed by the student’s Case Manager or other appropriate certified staff.
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• Within one day of the use of Crisis Management Techniques, send a copy of the Crisis Management Techniques Documentation formto the parent/guardians, the administration and the Special Education Specialists (SES)
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• Keep a copy of the Crisis Management Techniques Documentation form in a secure location. Upon request, parent(s)/guardian(s) must have access to and an opportunity to review this report.
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