- Got it.
Okay.
You can advance to the next slide, Sherry.
So today's training will focus on the purpose of Rule 4500.
We'll go over some of the most basic definitions and sort
of really try to pick those definitions apart
so that you know exactly what we're talking about in terms
of what is permissible and what is prohibited
in the use of restraints and seclusions.
We'll talk a little bit
about when and how to terminate interventions,
and then we will end with talking about some considerations
in the context of COVID.
And in order to fit in the COVID discussions,
I have eliminated some pieces of the training
that I normally do.
So at the end of the slide deck,
you will see the extra slides,
and they're more straightforward parts of the rule,
just about how and when and whom to report to
and debriefings and things like that.
Okay.
So you can advance the slide, please.
So, oops!
Wait, was there one?
There you go.
The purposes of Rule 4500 are to create and maintain
a positive and safe environment,
to promote positive behavioral interventions and supports,
and to ensure that students are not subjected
to inappropriate use of restraint or seclusion.
That is why the State of Vermont developed these rules.
Next slide, please.
All right.
On second.
All right.
So we're gonna talk first about seclusions.
So seclusion means the confinement of a student alone
in a room or an area, with the key word there being alone,
and the student is prevented or reasonably believes
that he or she will be prevented from leaving.
It does not include timeout or private processing
in which the student is not left alone
and is under adult supervision.
Next slide, please.
We're gonna jump right into a poll, and Sherry,
they're just answering in the chat, is that right?
- Yes.
- Okay.
So I will let you, I will provide a few minutes for you
to read this scenario about Zuri,
and then we will ask you to identify whether you think
this is define, whether you could define this scenario
as a seclusion.
So go ahead and read that little scenario.
All right.
- It's so resounding no.
- Yes.
Okay.
So that is correct.
This is not a seclusion because Zuri
and her behavior interventionist were together,
in that enclosed space,
and so she wasn't alone and was able to interact
with her interventionist.
All right, next slide.
Same situation with Zuri,
but read this
and then answer whether this would represent a seclusion.
- No, no, no, no, no, no, no, no, no, no.
- Yeah.
Okay.
Nice job.
Next slide.
So, no, that's not a seclusion
either because in this situation,
Zuri chose to enter the room on her own accord.
She was told and she had every reason to believe
that she could exit at will
and wasn't prevented from leaving,
and Zuri chose a good coping skill
which could be acknowledged and then shaped
into a proactive skill
before she got to the point of acting out aggressively.
Let's do one more scenario with Zuri.
Go ahead and read that and tell me
whether you think this is a seclusion.
- BI stands for behavioral-
- Behavior interventionist.
- We got a lot of yes, yes, yes, yes, yes, yes and yes.
- Yup, okay.
Good job, everybody.
Yes, this is a seclusion because she was confined alone
in the room and she told she had to remain there
until she was given permission to leave.
- There's a question in the chat box,
"What if the student is monitored the entire time?"
- Well, we will get into the actual rules
around what is permitted and what is prohibited,
and one of the rules around seclusion is that the student
has to be monitored the entire time.
So monitoring is part of seclusion, and the difference
between it being a seclusion
and not would be, A, was the student alone in the room?
And B, were they allowed to leave?
- And another question from Abby,
"What if the BI remained in the room and said to Zuri,
"that she couldn't leave till she calmed down?"
- In that case,
that would not be a seclusion
because Zuri wasn't in the room alone.
Even though she would be prohibited from leaving,
it's not a seclusion because she's accompanied by an adult.
- So, and this is technical, so that's technically the case,
it's what's best practice is another conversation, right?
And we don't have a lot of information about Zuri.
- Yeah.
- Yeah, okay.
- Absolutely.
- Yup.
- So I lied that wasn't the last Zurich scenario,
but here you go, here's one more.
One, one.
- Resounding yeses.
- Yeah, coming in a little bit slower this time, but yes.
Good job, everybody, this too is a seclusion.
Zuri is, A, alone, B, not permitted to leave,
and seclusions, they don't even need to occur
in a room at all.
You can tell a student to remain in an alcove
or even behind a divider,
and as long as the student is alone in that space
and not allowed to leave, that would be a seclusion.
Okay, next slide.
Going forward, we're gonna talk
about physical restraints now, and for the time being,
we're going to assume that COVID is not a factor,
and this is just for instructional purposes
so that we can just go over the rule as it is written
and as hopefully we will return before too long.
Okay.
Next slide.
- I was so busy imagining what no COVID would be like.
- I know.
I can't even quite imagine that.
Okay.
Physical escort as opposed to physical restraint.
A physical escort is defined
as momentary touching or holding
of a hand or wrist and arm or a bat
without the use of force.
The student would be exhibiting minimal resistance,
and the purpose of the escort is to direct the movement
of the students from one place to another.
An escort is not considered a restraint and it doesn't need
to follow Rule 45 Protocol,
not considered a restraint when it doesn't involve force
or a student resistance.
Okay.
Now, let's talk about a transport
or what I'm going to call a moving restraint.
A moving restraint would involve the use
of more than just the minimal amount of force
from the adult.
It would be a momentary period of physical contact,
again, more than the minimal level of force,
you are restricting the student's movement and the student
is actively resisting.
That would be considered a restraint or a moving restraint.
It would be governed by Rule 4500,
and it would also be governed by the protocols
of the restraint training program
that you used to be trained,
and different training protocols have different ideas
of what can and cannot be used for a moving transport.
Next slide is just a chart that sort of talks
about the difference between the two.
Once again, an escort is not a restraint
because it doesn't involve force,
it doesn't involve the student resisting.
The student is moving of their own accord.
They may be verbally resisting, but not physically,
so that is not a restraint and it doesn't need
to follow 4500 Protocol.
A moving restraint, again, is more than the minimal level
of support, of force from a staff member.
You are restricting the student's movement in some way,
A CPI, for example, a CPI high-level transport
would fit this description
whereas a lower or a medium transport for CPI
would be considered an escort.
Once again, in the moving restraint,
the student is physically resisting
and is not moving of their own accord,
they're actively trying to stop the movement.
All right, next slide is another poll.
Read this scenario about Ben and then tell me
whether you think it involves an escort
or a moving restraint.
All right.
I'm seeing lots of escorts, and that is the correct answer.
This intervention was an escort.
The assistant used direct person-to-person contact
while putting her arm around Ben's shoulders,
but she has minimal force to guide him toward the door,
and Ben moved his own body forward
with verbal resistance, but not physical resistance.
Once again, this type of escort is allowable
and doesn't need to follow or be reported as a restraint.
Next slide, please.
Now we're gonna talk about physical restraints,
which would be a stationary holding of a student.
So a physical restraint is defined as the use
of physical force to prevent an imminent
and substantial risk of bodily harm to the student
or to others.
We'll get more into exactly what is prohibited
or permissible, but when we're talking about restraints,
we're only talking about an emergency intervention
in which there is an imminent risk
of substantial bodily harm.
When we talk about prone restraints,
we're talking about holding a student face down
on their stomach, and a supine is lying down on their back.
Next slide is a poll.
Oh, sorry, I forgot.
A note about prone and supine restraints.
They are considered to be prohibited
unless the student's size or the severity
of their behavior required it
because a less restrictive restraint has failed
or would be ineffective.
These are the most restrictive types of restraint,
and they're the ones that cause the most risk
of positional asphyxiation.
So they should only be used as a last resort.
All right.
Next slide.
Oh, I think I got ahead of myself here.
Let me catch up.
Sorry.
One question.
Okay.
These are the things that are not considered
to be restraint.
Again, momentary periods of physical restriction
accomplished by minimal force, in other words, an escort.
Another way of describing an escort
is the minimum contact necessary to physically escort
a student from one place to another.
A restraint doesn't include things
like hand-over hand assistance for completing a task
or any types of prescribed techniques
or therapeutic or medical techniques
that have been prescribed
by a qualified medical professional.
For example, a seatbelt holding a student into a wheelchair,
that would not be considered a physical restraint.
- Oh, there's a question from Abby in the chat box.
- Sure.
There's a lot of confusion on the momentary periods,
can you describe what you believe momentary means?
- Yeah.
So momentary is a subjective term,
and the intent there is to talk
about just getting the student into a safer
or more private place.
It's not meant to, it's only to prevent,
and a significant disruption to the classroom,
to the classroom environment
or to interrupt what might turn into a physical altercation.
It's not meant to be transporting the kid long distances.
It's just to move them quickly to another space
where they can be either more private
in their interactions or safer.
- Yeah.
CPI does a really good job
of like level, high, medium
and low types of restraints,
and the low
really is a momentary touch short, brief conversation,
and again, Abby, I can't give you
like two minutes, one minute.
- Yeah.
- That's really, really hard,
but enough period of time
so that you're not really putting pressure on someone
that you wouldn't, a friend.
But that's where the hard stuff comes in
is what does that all mean?
- Yeah.
- Oh, great.
Okay.
Moving along.
- Okay, yeah.
- Okay.
Let's go into this scenario with Ben.
And the question is, is this a restraint or not?
You guys are right on.
- It's the clarity of your presentation, Tracy.
(Tracy laughs) - I don't know about that,
but so the answer is that this is a moving restraint,
and the reason that we are calling this a moving restraint
is that the assistant needed
to use more than just the minimal amount of force
to get Ben to move.
Ben was actively resisting,
and so remember that moving restraints are restraints,
they must be reported as such and they're governed by all
of the conditions outlined in the Rule 4500 series.
Just a little note,
depending on Ben's level of resistance or his size
and strength or their bodily positioning,
this may or may not have been a safe maneuver,
and the assistant very well might have had to move
to a stationary hold to maintain safety.
I don't want to sit here and promote the use
of moving restraints when they're not safe by any means,
and those sort
of restraints do pose quite a significant risk of harm.
So only use them by the guidelines by which you were trained
to do so.
- There's a question from Cassandra,
"Is moving restraint and option
"to select on the Rule 4500 paperwork?"
- No, it's not,
but so you would mark it as a restraint,
and then in your description,
you could say that it was a moving restraint.
Thank you.
Ready?
- Yes.
Next slide, please.
So now we are gonna talk
about what substantial risk means.
You'll remember that in order to use a restraint
or a seclusion,
the student needs to be showing a substantial risk
of bodily harm.
That means the student
is imminently about to an act bodily harm,
it's happening right now.
It also means that they have the ability to enact that sort
of form, that sort of harm,
and it also means in order to be permissible,
it means that less restrictive alternatives
have already been tried and been exhausted
because the student kept on posing a risk
and, or just the level
of risk prohibits exhausting other means.
So substantial risk in order
to be a permissible use of restraint or seclusion needs
to be imminent, there needs to be significant bodily harm
at risk there, and the student needs to have the ability
to enact that harm.
- So it's not or, it's and.
- Yes.
- Right, because that third bullet
really does make you wonder, well,
I've tried talking to him, I tried this,
I tried that,
it's and, thank you. - Yes.
It is.
- Okay.
Okay, next slide, please, is a poll about Chloe.
So right here,
we're talking about whether Chloe
is presenting a substantial risk of physical harm.
- No, no, no, no, no.
- Yep.
Okay?
That is correct.
This is not a substantial risk.
The teacher made several attempts
to deescalate her students, but Chloe persisted.
The thing is that Chloe didn't pose an imminent risk
of harm given that she remained seated at her desk
and even with her arms crossed.
She didn't have a knife,
she didn't have her boyfriend's car right there
in the classroom.
I'm going to assume that the teacher's baby
was safely at childcare or somewhere else,
so Chloe didn't have the means by which to carry out
the threats that she was talking about,
at least not in that moment.
All right, next slide.
A little different twist on the Chloe situation.
- Got some nos.
- Okay.
That's correct.
This does not present a substantial risk
because although it's not acceptable, getting hit
with a paper ball doesn't pose the risk of a serious injury.
It wouldn't warrant a restraint or seclusion.
Next slide again is still Chloe.
- Yes, yes, yes, yes, yes, yes, yes.
- Okay.
Good job.
Yep.
This is a substantial risk.
Chloe has access to those objects and she is using them
at that time.
Being hit by heavy objects like tables,
chairs, globes, staplers
could indeed cause significant physical injuries.
Chloe's behavior is no longer a threat,
she's carrying through with her threats.
She's posing an imminent risk of substantial physical injury
to her teacher.
Okay.
Moving along.
We're going to talk now
about what is allowable in terms of seclusion.
So we're back to talking about seclusions now
and we're talking about what is allowable.
Next slide.
Permissible use of seclusion
is allowed only when the student's behavior poses
an imminent risk of substantial physical injury.
You're gonna hear me repeat that all over the place.
Only when less restrictive interventions have failed
or would be ineffective
in stopping such an imminent risk of harm,
there to be used only by staff who've been trained
to do so,
and of course that involves the use of all kinds
of deescalation techniques
before you are putting a student in seclusion.
It is used only as a temporary intervention,
only when the student is monitored at all times by an adult,
only in a space that's large enough to permit safe movement,
the space is adequately lit, heated, ventilated,
free of sharp or otherwise dangerous objects,
and in compliance with fire and safety codes.
Only when there are no known developmental medical,
psychological or other contraindications to the use
of seclusion, and only
when physical restraint is contraindicated.
Next slide.
What?
You may say.
All of these things are the only places, only circumstances
under which you may use a seclusion.
And at the bottom,
they slipped in this one in the rules,
only when physical restraint is contraindicated.
Next slide, please.
(Tracy clears throat)
The developers of the rules stated that restraint
is considered the least restrictive
and preferable intervention.
In other words,
seclusion must not be used except when physical restraint
has been deemed inadvisable.
Now, there may be some very valid reasons a student's team
would meet to determine when or if a restraint
is contraindicated, and later we'll talk about the impact
that COVID would have upon this section of the rules.
But please know, oh, I keep messing up here, sorry.
But please know that if you send in a report
to the Agency of Education where you have gone immediately
to a seclusion, and there's no evidence
that the team has determined that seclusion,
that restraint is contraindicated
and you haven't already tried to restrain the kid,
then that is going to be a violation
of the law, of the rules.
All right.
So let's look at this poll involving D'Andre.
And in this case,
I want you to tell me
whether or not seclusion is permissible.
Seeing a lot of nos.
Kara.
Kara, I'm going to hold on COVID questions until later,
but we will come into that.
Okay.
So lots of nos here.
Seclusion would not be permissible in this instance.
With no other students in the room
and with two trained staff members,
oh, you can advance to the next slide.
- Yeah, there's also a question, so.
- Oh, okay.
- What if the student has a knife.
- With D'Andre here?
- Yeah.
So that would be a very dangerous circumstance.
Whew!
I think that then you would say
that that a seclusion would be permissible,
but only if you had the means
by which to safely get the student to the seclusion room.
You wouldn't want to just open the door with a kid
who has a knife and let them run around the school.
So that's a really tricky one.
- It's, yeah, it's hard to answer this
in the black and white,
but you leave them in the room, but there's a knife?
You know what?
That's something I think we should probably take offline
and do some problem-solving around
because, just it prompts me to ask questions,
like there is a knife, where is it?
What do we know about him?
And all those things.
So there's what the rule would say,
and the biggest rule we have is don't do nothing, and yeah.
(Sherry laughs)
- And use your professional judgment.
In a situation like that,
In a situation like that, there are times,
as teachers, as educators,
you make 1,000,001 decisions in a split second,
and I guess we are in the business
of questioning those decisions, but I think in a situation
like that, no one is going to really question
in a way that would jeopardize your standing
in a situation like that.
Okay, so let's...
Okay.
So if your training program has advised not to restrain
if there's a weapon and to call police
and secure the environment, then absolutely, yeah,
that makes the most sense.
Okay.
So the reason that seclusion would not be permissible
in the instance of D'Andre with no weapon
would be that with no other students in the room
and two trained staff members,
the adults could have been able
to employ additional strategies to deescalate him,
they would have the time and space to do that.
The adults may have been able to coax him off
of the bookshelf and then corral him to a safer part
of the room.
And then if those strategies failed and D'Andre continued
to put himself at risk of serious injury,
given no other information
about the restraint being contraindicated,
then the staff members should have restrained him there
in the evacuated classroom.
All right.
Next slide, still talking about D'Andre, but with a twist.
Seeing a lot of yeses here,
and that's correct.
That is a permissible use of seclusion.
This time, the classroom assistant was alone in the room.
She had already attempted restraint
after having tried several deescalation strategies,
and even after the restraint,
D'Andre remained highly aggressive.
Now, given that he had willingly walked with her
to the quiet room,
I think the staff member had a good reason to believe
that the walk or the change in environment
may have calmed him down,
and because this may have afforded them an opportunity
to process, I think the staff member made a sound decision
to go into the room with Andre and with her in there,
it wouldn't be considered a seclusion,
but then when he realized escalated and was aggressive
towards the assistant, again, inside that quiet room,
it was a reasonable professional judgment to exit the room
and seclude him.
At that time, the assistant was probably really fatigued
from all the physical exertion.
Maybe she was injured or in pain
from having been punched and kicked.
She had a valid reason not to feel confident in her ability
to safely restrain him again,
and because she had attempted restraint and it had failed
to keep him safe, this seclusion is allowable.
Now, it may be that D'Andre's team will take this
into account and gather additional data,
consult with other team members,
and maybe they will meet as a team
and decide whether or not restraint
is in his best interest.
- We have a question from Michelle, and I'm not sure
I totally understand it.
Just to clarify, does the restraint
and seclusion have to occur on the same day
during the same incident in order for it to follow the rule?
- Yeah, I think I know what you're saying,
and that sort of gets at my last point there.
If you...
So if D'Andre's team is feeling
like restraint only escalates him further,
then you would want to meet as a team to talk about that.
You would wanna look at the data and see,
out of X number of times that he was restrained,
did he continue to escalate?
For how long?
With what intensity?
And then you might wanna test and see
if he calms quicker or more safely in a seclusion.
And in that case,
then you would, on a different day,
meet as a team and determine that, yeah,
we're gonna say that restraint is contraindicated
for D'Andre, because that's what our data tells us.
Does that answer your rule?
There's blah!
Does that answer your question, Michelle?
Good.
All right.
Okay.
Next slide.
Once again, a D'Andre twist,
go ahead and read this one and tell me
whether you think this is permissible.
- We got a mix.
- Yes, we do.
And I'm not surprised at the mix because, I apologize,
this is a little bit of a trick question.
So let's dissect one.
So in this situation,
the assistant was right to use seclusion
rather than restraint because the team
had determined restraint to be contraindicated.
But remember, seclusion is a temporary intervention,
meaning that it should be terminated
as soon as D'Andre no longer poses an imminent risk
of substantial harm,
or as soon as less restrictive interventions
may have proven successful.
So the assistant should have told D'Andre
that she would watch for signs that he was calming
and/or he could tell her when he was ready to talk,
and then the seclusion could end.
But you are not permitted to put a student in seclusion
for a designated or arbitrary period of time.
Okay.
Next slide.
Now we're gonna talk about what's allowable
in terms of restraints.
Next slide.
Restraint is permissible, again, the tape recorder,
only when a student's behavior poses an imminent
and substantial risk of physical injury to himself
or to others,
only when less restrictive interventions have failed
or would be ineffective
in stopping such imminent danger or injury,
only in accordance with school ride safety plan
that's consistent with the rules,
only when the student is monitored face-to-face
by a staff member that is only observing,
only when it's used in a manner that's safe,
proportionate to sensitive to the student's severity
of behavior, their chronological or developmental age,
their size, their gender,
their ability to communicate, cognitive ability,
and any known (clears throat) physical,
medical, psychiatric or personal history.
Only by school personnel or contracted staff
who've been trained and certified to use these techniques.
And then remember what we said about prone
and supine restraints.
You would only use the student in a face-down
or face-up lying-on-the-floor position when the size
or the severity
of their behavior requires such restraint
because a less restrictive intervention has failed
or would be ineffective.
Next slide is another poll.
We're gonna talk about Abigail now,
a little kindergartener.
In this situation, we're asking,
is the restraint permissible?
- Got a no, no, no, no, no.
- Yep.
Okay.
Good job, guys.
So next slide.
Although it's against school rules to elope
and to access the playground without permission,
swinging on a swing
doesn't pose an imminent risk of substantial physical harm.
It might take some time,
but eventually a student like Abigail might get tired
of that activity and returned to the school building.
Maybe even the swinging meets some sensory need
that soothed her resulting
in her being more willing to comply.
If not, it's likely that other staff members would come
to the paraprofessional's aid,
and sometimes, just a change of face is enough
to get a student to become more agreeable.
So main thing here is that swinging on a swing
doesn't pose a significant risk of physical harm.
Let's go to the next slide and look
at a different take on Abigail
Seeing lots of yeses.
Okay.
Yes.
The restraint with Chloe is permissible
in this circumstance.
Given her age and her impulsivity,
Chloe absolutely placed herself at imminent risk
of physical, substantial physical injury.
In situations like this, staff members have little time
to implement less restrictive interventions
because the danger is so imminently there.
Actually, in this situation,
even if no one in the immediate vicinity was trained
to administer a restraint,
it would have been permissible given that it was so imminent
and such significant risk involved.
So it would be okay due to a clause in the rules
that an untrained staff member could intervene
in this situation while others then summoned a trained staff
to take over.
Okay, next slide.
Oh, sorry.
Next slide.
Now we're going to talk about what is prohibited
in terms of restraints and seclusions.
Next slide.
We are not in the business
of restraining students mechanically
or by offering them medications,
unless that's a prescribed thing.
Any intervention that restricts or limits breathing
or communication, any intervention that causes pain
or that's imposed without maintaining direct physical
or visual contact,
you're not allowed to restrain or seclude
for the convenience of a staff or as a substitute
for an educational programming,
not as a substitute for inadequate staffing or training,
not as a form of discipline or punishment,
not in response to a student's use of disrespect
or disruption, not in response to a verbal threat
that's not accompanied by the means or the intent
to carry out that threat.
So next slide is another poll.
Here we're gonna look at Frankie's behavior,
and tell me whether or not the following intervention
is permissible or not.
- I think the slide needs to be changed.
- Okay.
Tell me why.
- I'm not seeing it anything about Frankie.
It's the last page of prohibitive interventions continued.
- Oh, I'm sorry.
Can you advance the slide, Sherry?
- Thank you. - I'm so sorry.
I'm so sorry.
- There you go, sorry.
- I was reading Micah's question in the chat box.
Sorry about that.
- Micah, I'll come back to your question.
- Okay, everybody is on it now.
No, no, no, no, no, no, no, no, no.
- Okay.
I have to say you guys are really on point, just saying.
So, yeah, the answer is no,
restraints and seclusions are emergency interventions
and should not be used planfully as a consequence
for unacceptable behavior.
Timeout procedures, as, which was written
into his behavior plan,
they typically involve moving a child to a different part
of the classroom.
Any procedure that places a student alone in a room
or a space and doesn't permit them to leave,
we know is a seclusion.
Frankie's behavior was offensive, it was hurtful.
It represents harassment if it was continued multiple times,
but his behavior did not place himself or anyone else
at risk of imminent substantial injury.
Also remember the case we talked about previously,
restraints and seclusions have to be terminated
as soon as the risk of harm is no longer present
or could be managed by less restrictive measures.
So predetermined periods of restraint or seclusion
are not permitted.
Next slide.
- Do you wanna address Micah's question?
- Oh, yeah.
Micah is saying that if you pull a student's shirt sleeve
over their hand, does that represent a mechanical restraint?
And I would say no, but anyone who's trained
in a protocol that says otherwise,
go ahead and...
So Lori is saying "Yes,
that does represent mechanical hold."
I've seen this being done just to prevent the student
from scratching themselves or others.
I can look into that,
but I wouldn't consider that really a mechanical restraint,
but I could be wrong.
Yeah.
So I'm seeing a few people saying yes.
- Yeah.
- So I will stand corrected
and I will absolutely research that and get back to you.
- Yeah.
So the CPI does not reference mechanical dos and don'ts, so.
- Yeah, okay.
- Okay.
- All right.
Thanks for bringing that up.
We're gonna talk about, oh,
we're doing well in terms of time here.
We're gonna talk about termination of interventions.
Next slide, please.
So you are required to stop a restraint or a seclusion
as soon as you see that the student is in unnecessary pain
or significant distress.
Now, we know that these sort of interventions
are absolutely distressing,
but if you see that the student is significantly struggling,
you should stop.
You should absolutely stop
anytime breathing or communication is compromised,
as soon as behavior no longer poses
an imminent or substantial danger of physical injury,
as soon as less restrictive interventions
would be effective.
And once again,
think about that behavior plan involving Frankie.
Any questions about when to terminate
or restrain a seclusion?
Okay.
Let's move on.
And now we're gonna talk about a subject so near and dear
to everyone's heart.
So in the context of COVID, last fall,
the Agency of Education in collaboration
with the Department of Health gave an exception
to Rule 4500, stating that during the global pandemic,
seclusion could be used instead of restraint as a means
to mitigate the risk of viral transmission.
So last fall,
we said, we gave you the choice
to either use restraint or to go ahead and use a seclusion.
Thinking about the Abigail scenario,
when she ran into traffic,
that would be, even during the height of COVID,
which may be now, you would still want to intervene.
You may be at risk of transmission of the virus,
but you would weigh that
against the potential real catastrophic harm to Abigail
if she were to run into traffic.
So what are we doing now?
What we're doing now is that we are saying that schools
that are serving students who are not yet eligible
for a COVID vaccine, in other words,
kids right now age five to 12,
are able to use the exception above,
and, who are eligible for the vaccine,
ages 12 and up, should return
to the use of seclusion
only when restraint is contraindicated.
Next slide.
But remember, you can meet
on a case-by-case basis anytime
to determine whether restraint is contraindicated.
You would want to include parents and guardians
in those in those meetings,
you would want to include your COVID coordinator,
school nurse or other medical professionals,
you would wanna consider physical, medical,
psychological factors, personal history.
You would think about what the data tells you.
You would talk about whether the student
is eligible for, but not vaccinated,
and you would talk about factors such as spitting
or biting that may pose greater risk of viral transmission.
So the rule of thumb
is that for students age five through 11, you can go ahead
and use seclusion as an option rather than restraint.
For students older, you would return
to the usual 4500 Rules,
but remember that you have the ability to meet and determine
whether or not restraint is contraindicated in that case.
- We have a question from Pierre,
and I'm not sure when it came about,
but how does the last bullet apply to K-8 schools?
Less than about 20% of my student population is eligible.
So I'm assuming that comes from the previous slide.
- Yeah.
- So Pierre, you're talking about a K-8 school,
and we do have several of those.
So in those situations, I would say,
go ahead and use seclusion
if you feel like that is the most reasonable intervention,
but if you know that a student has been vaccinated,
then you might want to not use the seclusion.
Just know that you have the ability to meet
and determine whether or not a restraint is contraindicated.
- And then there's a link in the chat box that Cassandra
is asking about, is it the correct link
for last year's guidance?
I don't know if you can tell.
- Yeah.
I would say that we're are in the midst
of having a new piece
of guidance going through the vetting process.
So what you posted here, Cassandra, is last year's guidance,
and that's what you can apply to students
who are not yet eligible.
But we will be providing updated guidance
that is reflective of what I just told you
and we'll take down the one that you've just posted.
- Okay.
Next.
- Okay.
Additional considerations in the COVID environment,
remember personal protective equipment.
We would suggest that you remove the student's mask
if you're going to seclude or restrain,
as long as you're able to safely do so.
Staff members should keep their facial covering
unless doing so interferes with their ability
to safely, properly administer the restraint.
If you have a student who is triggered
by staff members wearing facial masks,
you could consider having the observer wear, I think
I put a typo in there,
you could consider having the observer wear a face shield
instead of a mask,
but it all comes down to consulting your COVID coordinator
or the school nurse for additional guidance around PPE.
Next slide.
Following a restraint or seclusion,
you would want to complete all of the guidelines mandated
by the rule,
and those are the things we haven't covered yet
but are listed further on in the slide show,
but you would need to complete all the guidelines
such as a health assessment
as soon as the restraint or seclusion is over,
monitoring the student for the rest of the school day,
following all the reporting guidelines,
debriefing, documenting, including any information
that you need to document related to contact tracing.
And then you wanna make sure that you sanitize all
of the areas that were used,
remove and sanitize and replaced the PPE and wash your hands
and offer the student the ability to wash their hands
or sanitize their hands.
Next slide.
I just put these in here to consider when you have students
who have trouble following the health
and safety expectations.
Here you're going
to use universal interventions and supports.
You can treat these expected behaviors around health
and safety the same way you treat your other expectations.
So we all know that because we're all PBIS wizards,
so you're going to, you're gonna post and teach
and model and practice and acknowledge all
of your expected behaviors,
discuss the rationale about why these safety
and health expectations are there,
you're going to offer social and emotional supports
for all students who may be coping with trauma,
anxiety, loss, fear, confusion,
acknowledge students and groups of students who adhere
to the expectations.
It's reasonable to schedule in mask breaks,
provide a variety of different types of masking for students
with sensory issues, and if you have a student
with exceptional needs
you could consider using shields or barriers
if they are not able to wear a facial mask.
Next slide.
- Oh, sorry. I was writing in the chat box.
- Oh.
- Can I just, I was just-
- Yeah, go ahead.
- That there are so many environmental supports
to be considering too that we've done with COVID and people
are reflecting on as being really positive.
- Yeah.
- So how the space is organized,
where the items are located,
minimizing distractive material,
things like that,
that really, really can be a very strong universal approach.
- Absolutely.
The other thing is last year when students
were going through health checks
before they entered the school building,
there's something to be said for being greeted
by a familiar face first thing
before you even walk in the building.
There's something to be said for walking
into the school building one by one or two by two
instead of mass chaos when a bell rings,
something to be said for going directly to your classroom,
you can still consider those sort of things
even though you aren't necessarily providing all
of the mitigating strategies that were used last year.
So remember targeted and intensive interventions
and supports for those who might willfully violate health
and safety expectations.
Look at the student's FBI-driven behavior support plans.
If they don't have one, create one.
Consider the level of risk involved.
Provide safety escalations spaces.
When you're talking about students
who are willfully violating health and safety expectations,
talking about using their own bodily secretions as a weapon,
let's say, in spreading the risk of a viral transmission,
whatever you do for a consequence needs to be done
in the context of an EST meeting.
If the student's on a 504 plan
or has been referred for one,
you would want to work through those processes,
and the same for IEPs for students who are eligible
for special ed.
Students that are suspected or who have a disability,
you're gonna have to be really careful and work
with your administrators to adhere to all
of the due process considerations that are in place
for students with disabilities.
You would have to look at manifestation determinations.
you'd have to look at change in placement
in the context of FAPE,
you would have to meet as an IEP meeting,
and if the IEP team in accordance
with all due process considerations determine
that a student was too dangerous to remain
in-person in school, then you would implement a change
in placement, but that change in placement would need
to include a reintegration plan so that you would have
the goal of getting the student back in class
as soon as possible.
- There's a question from Rhonda about eminent,
"Is it considered imminent danger during COVID if a child
"is spitting at peers or staff?"
- Yeah.
So under normal non-COVID situations,
all other things being equal
assuming the student doesn't have another type
of medical condition that is transmissible,
you have to look at spitting are biting differently
in this context.
And all that I can say then is you've gotta pull in
your COVID coordinator and make decisions
on a case-by-case basis.
But yeah, in this context,
you would look at spitting and biting in a different way
than you might otherwise.
So bring in the COVID coordinator,
bring in the school nurse,
bring in any medical professionals you have,
and absolutely, if the student is a student
with a disability or suspected of having a disability,
then you need to involve the IEP team.
Any other questions, comments?
Does 4,500 applied to in pre-K settings
or for our early ed partners?
If not, what is the guidance for this age group?
Well, 4,500 applies to any learning environment
in the State of Vermont
that is federally funded
and/or is under the guidance,
under the command of the Agency of Education.
So if a student is in a pre-K situation
that receives federal funds
or that is overseen by the Agency of Education, then yes,
Rule 4500 does apply.
And I believe that our Early Childhood Team
at the Agency of Ed is drawing up some specific guidance
for this age group,
but know that the guidance that they come up with is in line
with Rule 4500.
The thing that you have to consider there
are also licensing restrictions, and I may be mistaken,
but I'm pretty sure that licensing
for early childcare situations prohibits the use
of a seclusion of any type.
So I'm 95% sure that seclusion is contraindicated
for students in pre-K.
Can I put your contact information in the chat box so people
with additional questions? - Absolutely.
Yeah.
All right.
I'm seeing lots of questions here.
Let me see.
Beth says, "Elopement is considered imminent danger for some
"and not for others based on developmental age and co yes."
Yes.
Thinking about the situation with Abigail,
she was a young, impulsive,
developmentally young little girl
who doesn't have maybe the developmental cognition
to understand the consequences of their behavior.
So yeah, elopement could be considered imminent danger
for some but not for others.
What about a really small school with a very small staff?
Often, multiple roles are held by single staff members
without dedicated staff for interventions.
Could you tell me more about this, Meg?
You can unmute yourself.
- [Meg] Hi.
So we have two full-time staff members
and two part-time staff members,
and we have at least a couple of kids who are in the process
of determining whether they'll get on a 504 plan,
but in the meantime have behaviors
that I think meet some of the criteria
that you've discussed today.
- Mm-hmm.
That-
- [Meg] We don't have a trained interventionist.
- Okay.
So you would not be allowed to implement a restraint
or seclusion if you don't have trained staff.
That is for everyone's safety.
Restraints and seclusions
can be both physically and psychologically traumatic
for students and for staff,
so it's very important
that you have a trained person on staff.
And so I don't know if you want to or have the ability
to send one or more of your staff members to a training
or if you want to consider contracted staff
or just consider other interventions.
- Can you say a little bit more, Tracy,
about the expectations
that schools have trained personnel
in one of the approved programs?
I'm not sure if there's any more to that.
Can you maybe elaborate a little bit?
- Yeah, there really isn't more to that,
it's just the Agency of Education maintains a list
of approved training programs,
and it is a hard-and-fast rule
that except for that one clause in the rules,
but let's forget that one for now,
it is a hard-and-fast rule that these interventions
can only be administered by people are trained and certified
to do so,
that one expectation to the rule
is that if the danger presented is so imminent
and so substantial that no trained personnel
is immediately available,
then an untrained person can step in
and administer an intervention,
but only temporarily until a trained person is able
to be there.
I'm gonna go out on a limb and say
that maybe because you're such a small school,
you may be also rural and may not have access
to police officers or state troopers
that could be an intervention.
It's not one that we like to go to,
but if that's the last resort.
Right.
- Are we are done with the formal presentation
so that I can just have us all see each other
a little bit better.
Thank you.
- Yeah, yeah, yeah, yeah.
- Yeah, yeah.
Okay.
Now we're all here.
I'll also let you know
that there is an upcoming CPI training
that the Best Project is offering,
and I'm (laughs) gonna try to find it in the chat box,
it's on our professional development calendar,
and I think it's October 19th.
Little challenging to offer, it's October 19th
at the Hampton, and I'll put the link in the chat box
after I stop talking,
but it's best if you attend with someone
who you are comfortable
practicing with physical intervention,
someone who you know has also been vaccinated or part
of your pod at school.
We will require people to wear masks,
and it's a pretty full day, eight to 4:30 at the Hampton Inn
on the 19th, if you're looking for a training,
an upcoming training,
and I'm going to look for that and put it in the chat box
for those who might be interested.
- Sherry, do you know if any of the other trained trainers
are available to offer trainings outside
of that one CPI that you just mentioned?
- Yeah, there are, that I know of, and it's CPI
is Ken, and, @gmail.com,
and we just supported our new trainer, Jeremy Tretiak,
and anybody can contact me
and I can be your little agent and help you find trainers
that could come to your school perhaps.
Ideally, your district or supervisor
or union has its own team
that's been certified to provide training to your staff,
that's what we always encourage,
but we also have trainings as well.
And I'm gonna find that link and put in the box here.
- I'm going to answer Robin's question.
Robin is asking about when you are required to report
to the Secretary of the Agency of Education.
There are three circumstances under which you'd report
to the AOE.
One would be if the intervention lasted
for more than 30 minutes,
another would be if it was a violation of the rules,
and the last would be that either the student
or a staff member were injured in such a way
that required outside medical intervention.
Robin is asking whether that's more than 30 minutes
would be in a single situation or more than 30 minutes
in a day.
Robin, the answer would be in a situation,
and a situation could involve holding the student
for say 15 minutes, letting go,
but then within a few minutes,
they reescalate and need to be held again.
So one situation would be close proximity
involving the same escalation, if that makes sense.
- [Robin] Yep, that makes perfect sense.
That's what we thought,
but we've had some scenarios this year where over the course
of the day, the combined total was more than 30,
so we just wanted to ensure that we were following
the reporting if that's what it indicated.
So I guess that does lead me to one other question.
We are really good about having the school nurse check,
especially when students are involved.
We've had a couple of situations in the last couple of years
where a parent has maybe chosen to take their child
to the emergency room or a doctor after the incident
is, but yet when the school nurse checked
and we did our reporting on the sheet,
there was nothing indicated on the sheet.
So I guess my question there
is is that something that we should send
if there is hospital or doctor access following the incident
at a later time.
- That you're aware of, I would just go ahead
and send that in just to cover all bases and just make sure
that you indicate on the form that that was the case.
I think it's best to be safe.
- [Robin] Yeah, okay, thank you.
- Any other questions?
This was a really good group.
You guys, I think this is the best group we've had in terms
of really understanding the rules.
And we are way ahead of schedule, aren't we, guys?
- And don't tell anybody, go outside
and play for a little while.
(Tracy laughs)
Thank you, Tracy.
I think it was a great group and that you were great
in being very, very clear in your presentation,
and you'll see the PowerPoint is on the website,
so you can review it with your staff.
The recording will be up within a few days,
and we'll send you an email asking you to let us know
how it went for you, and within that survey,
you can click on your certificate of attendance.
And we have a training coming up October 19th.
It's a full day at the Hampton Inn in Colchester,
and it is in-person
and it will be our only in-person that we're doing this year
so far anyway.
A lot of people are needing that physical practice,
so we're doing that.
- But you don't have one scheduled for the spring time?
- Oh, we may, but I'll be retired by then,
so I haven't looked at it.
(Participants laughing)
Just a second, I'll let you know.
Let's see.
CPI.
CPI is also Lake Morey on March 22nd.
I'll put that
in the chat box as well. - Okay.
(Sherry laughs)
Feel free to contact me
if you have any questions or are looking for training
a little bit more in your area or at your school,
we can try to connect you with someone who can do that.
The Best Project has promoted the use of CPI.
There are a lot of good ones out there,
and the one that we do.
Thanks, Rhonda.
(Sherry laughs)
- I think Beth is feeling that it's a little unfair
that you're retiring.
- Yeah.
It's like leaving my comfortable, wonderful family
after so many years and finally moving away
from home, and I'm excited and scared and nervous
and looking forward to it at the same time,
so it's been terrific.
Yes, please stop recording (laughing) and thank you.