Restraint and Exclusion

I. Purpose

To provide guidance and procedures for Maryland School for the Deaf (MSD) which assure compliance with regulations pertaining to student behavior interventions and promotes a safe and orderly academic environment.

II. Definitions

II. Definitions

A. Behavior Intervention Plan (BIP) — A proactive, data-based, structured plan that is developed as a result of a functional behavioral assessment which is consistently applied by trained staff to reduce or eliminate a student's challenging behaviors and to support the development of appropriate behaviors and responses.

B. Functional Behavior Assessment (FBA) — The systematic process of gathering information to guide the development of an effective and efficient behavior intervention plan for the problem behavior. It includes:

1. Identification of the functions of the problem behavior for the student;

2. Description of the problem behavior exhibited in the educational setting; and

3. Identification of environmental and other factors and settings that contribute to or predict the occurrence, nonoccurence, and maintenance of the behavior over time.

C. Exclusion — The removal of a student to a supervised area for a limited period of time (not to exceed 30 minutes) during which the student has an opportunity to regain self-control and is not receiving instruction including special education, related services, or support.

D. Restraint — A personal restriction that immobilizes or reduces the ability of a student to move the student's torso, arms, legs, or head freely.

Physical restraint does not include:

1. Briefly holding a student to calm or comfort the student;

2. A physical escort, which is the temporary touching or holding of the hand, wrist, arm shoulder, or back for the purpose of inducing a student who is acting out to walk to a safe location;

3. Moving a disruptive student who is unwilling to leave the area if other methods such as counseling have been unsuccessful; or

4. Intervening in a fight in accordance with Education Article §7-307, Annotated Code of Maryland.

E. Mechanical Restraint — The use of any device or equipment to restrict a student's freedom of movement.

1. Mechanical restraint does not include devices implemented by trained school personnel, or used by a student, that have been prescribed by an appropriate medical or related services professional and are used for the specific and approved purposes for which such devices were designed, including:

a. Adaptive devices or mechanical supports used to achieve proper body position, balance, or alignment to allow greater freedom of mobility than would be possible without the use of such devices or mechanical supports;

b. Vehicle safety restraints when used as intended during the transport of a student in a moving vehicle;

c. Restraints for medical immobilization; or

d. Orthopedically prescribed devices that permit a student to participate in activities without risk of harm.

2. MECHANICAL RESTRAINT IS PROHIBITED AT MSD.

3. Seclusion — The involuntary confinement of a student alone in a room or area from which the student is physically prevented from leaving.

a. Seclusion does not include a timeout, which is a behavior management technique that is part of an approved program, involves the monitored separation of the student in a non-locked setting, and is implemented for the purpose of calming.

b. SECLUSION IS PROHIBITED AT MSD.

4. Time Out — A circumstance in which a student independently requests to go to an alternate work location to continue instruction, access a cool-off room, or take a break outside the classroom.

III. General Procedures

A. MSD shall use an array of positive behavior supports and strategies to increase or decrease targeted student behaviors.

B. School personnel shall only use exclusion or restraint.

C. After less restrictive or alternative approaches have been considered, and;

a. Attempted; or

b. Determined to be inappropriate;

c. In a humane, safe, and effective manner;

d. Without intent to harm or create undue discomfort; and

e. Consistent with known medical or psychological limitations and the student's behavioral intervention plan.

D. Restraint or exclusion should never be used as a punishment or discipline, as a means of coercion or retaliation, or as a convenience.

E. The use of corporal punishment is prohibited by Maryland law under any circumstances.

F. School personnel may initiate appropriate student disciplinary actions in accordance with MSD's Student Code of Conduct.

G. Law enforcement, judicial authorities, or school security personnel may exercise responsibilities, including the physical detainment of a student or other person alleged to have committed a crime or posing a security risk.

IV. Exclusion

A. School personnel may use exclusion to address a student's behavior:

1. If the student's behavior unreasonably interferes with the student's learning or the learning of others;

2. If the student's behavior constitutes an emergency and exclusion is necessary to protect a student or other person from imminent, serious, physical harm after other less intrusive, nonphysical interventions have failed or been determined inappropriate;

3. If exclusion is requested by the student; or

4. If supported by the student's behavior intervention plan.

B. A setting used for exclusion shall:

1. Provide school personnel with the ability to see the student at all times;

2. Provide adequate lighting, ventilation, and furnishings; and

3. Be unlocked and free of barriers to prevent egress.

C. School personnel shall monitor a student placed in exclusion:

1. Provide a student in exclusion with an explanation of the behavior that resulted in the removal and instructions on the behavior required to return to the learning environment.

2. Provide an opportunity for the student to share their perspective on the incident that led to the exclusion.

School personnel shall ensure that each period of exclusion:

1. Is appropriate to the developmental level of the student and the severity of the behavior; and

2. Shall not exceed 30 minutes.

D. Prior to the student leaving the exclusion setting, school personnel should evaluate the student's readiness to return to the instructional environment.

If the student is not ready to return to their instructional environment, school personnel shall determine the next intervention and notify parents.

E. Parents and school personnel may at any time request a meeting to address the use of exclusion to:

1. Conduct a functional behavioral assessment; and

2. Develop, review, or revise the student's behavioral intervention plan.

F. School personnel shall refer a student with a disability to the IEP team if he or she has experienced an excessive period of exclusion that may result in a change of placement.

V. Restraint

A. The use of physical restraint is prohibited at MSD unless:

1. There is an emergency situation and physical restraint is necessary to protect a student or other person from imminent, serious, physical harm after other less intrusive, nonphysical interventions have failed or been determined inappropriate;

2. The student's behavioral intervention plan or IEP includes physical restraint to address the student's behavior in an emergency situation, provided that school personnel:

a. Review available data to identify and contraindications to the use of physical restraint based on medical history or past trauma, including consultation with medical or mental health professionals as appropriate;

b. Identify less intrusive, nonphysical interventions that will be used to respond to the student's behavior until physical restraint is used in an emergency situation; and

c. Obtain written consent from the student's parent.

B. Physical restraint shall be applied only by school personnel who are trained in the appropriate use of physical restraint.

C. In applying physical restraint, school personnel shall only use reasonable force as is necessary to protect a student or other person from imminent, serious, physical harm, and:

1. Shall be removed as soon as the student is calm; and

2. Shall not exceed 30 minutes, prior to school personnel evaluating the student's readiness to return to the instructional environment.

D. In applying physical restraint, school personnel may not:

1. Place a student in a face-down position;

2. Place a student in any other position that will obstruct a student's airway or otherwise impair a student's ability to breathe, obstruct a staff member's view of a student's face, restrict a student's ability to communicate distress, or place pressure on a student's head, neck, or torso; or

3. Straddle a student's torso.

E. Following a physical restraint, the student will be assessed by a nurse to determine if there are any physical injuries or distress as a result of the restraint.

VI. Documentation of the Use of Restraint

A. Each time a student is in a restraint, school personnel involved in the restraint shall debrief and document:

1. Other less intrusive interventions that have failed or been determined inappropriate;

2. The precipitating event immediately preceding the behavior that prompted the use of restraint;

3. The behavior that prompted the use of a restraint;

4. The names of the school personnel who observed the behavior that prompted the use of restraint; and

5. The names and signatures of the staff members implementing and monitoring the use of restraint.

B. Documentation required by this procedure shall include a description of the restraint event, including:

1. The type of restraint;

2. The length of time in restraint;

3. The student's behavior and reaction during the restraint;

4. The name and signature of the administrator informed of the use of restraint;

5. The name and signature of the nurse who conducted an assessment following the restraint; and

6. The date and time the parent was contacted by the administrator.

C. The documentation of the use of restraints shall be maintained in the student's cumulative educational record and available for inspection by the student's parent or legal guardian.

D. Each time restraint is used, every effort shall be made to notify the parent/guardian by the end of the school day (i.e. orally, video phone, etc.) and written notification shall be provided to the parent within 24 hours; unless otherwise provided for in a student's behavior intervention plan or IEP.

E. Complaints regarding the use of exclusion or restraint shall be referred to the Director of Student Support Services/designee, as appropriate, for investigation.

>> Restraint Single Incident Report Form

VII. Mechanical Restraint

A. The use of mechanical restraint is prohibited at MSD. Mechanical Restraint is also prohibited in public agencies and nonpublic schools unless a public agency or nonpublic school is certified by and meets the requirements of the Joint Commission for the Accreditation of HealthCare Organizations.

B. School personnel may use a protective or stabilizing device

1. as prescribed by a health professional; or

2. for a student with a disability, in accordance with the student's IEP or behavior intervention plan.

VIII. Seclusion

The use of Seclusion is prohibited at MSD. No student should be confined alone in an area from which the student is physically prevented from leaving.

IX. Referral to IEP Team

A. If restraint is used for a student who has not been identified as a student with a disability, the student shall immediately be referred to the school's IEP team.

NOTE: Maryland School for the Deaf serves students who are deaf and hard of hearing.

B. If restraint is used for a student with a disability, and the student's IEP or behavior intervention plan does not include the use of restraint, the IEP team shall meet, in accordance with COMAR 13A.08.03, within 10 business days of the incident to consider:

1. The need for functional behavior assessment;

2. Developing appropriate behavioral interventions; and

3. Implementing a behavioral intervention plan.

C. If restraint is used for a student with a disability, and the IEP or behavior intervention plan includes the use of restraint, the student's IEP or behavior intervention plan shall specify how often the IEP team shall meet to review or revise, as appropriate, the student's IEP or behavior intervention plan, in accordance with COMAR 13A.05.01 and 13A.08.03.

D. When an IEP team meets to review or revise a student's IEP or behavior intervention plan, as specified in §C(3) of this regulation, the IEP team shall consider:

1. Existing health, physical, psychological, and psychosocial information, including any contraindications to the use of restraint based on medical history or past trauma;

2. Information provided by the parent;

3. Observations by teachers and related service providers;

4. The student's current placement; and

5. The frequency and duration of restraints events that occurred since the IEP team last met.

E. The local school system or nonpublic school shall provide the parent of the student with written notice in accordance with COMAR 13A.05.01.12A when an IEP team proposes or refuses to initiate or change the student's IEP or behavior intervention plan that includes the use of restraint.

F. Parental Consent

1. The IEP team shall contain the written consent of the parent if the team proposes to include restraint in the behavior intervention plan or IEP to address the student's behavior.

2. If the parent does not provide written consent, the IEP team shall send the parent written notice within 5 business days of the IEP team meeting that states:

a. The parent has the right to either consent or refuse to consent to the use of restraint; and

b. If the parent does not provide written consent or a written refusal within 15 business days of the IEP team meeting, the IEP team may implement the proposed use of restraint.

3. If the parent provides written refusal, the IEP team may use the dispute resolution options listed in Md. Education Code Ann. 8-413 to resolve the matter.

X. Training and Technical Assistance

A. At the beginning of each school year, the Chief Educational Programs Officer (CEPO) or designee(s) shall identify personnel to serve as school-wide resources to assist in ensuring the proper administration of exclusion and restraint.

B. The school personnel designated by the CEPO or designee(s) to use exclusion and restraint shall receive training in current professionally accepted practices and standards regarding:

1. Positive behavior interventions strategies and supports, including methods for identifying and defusing potentially dangerous behavior;

2. Trauma-informed intervention;

3. Functional behavior assessment and behavior intervention planning;

4. Exclusion;

5. Restraint and alternatives to restraint;

6. Symptoms of physical distress and positional;

7. First aid and cardiopulmonary resuscitation (CPR); and

8. Individualizing behavior interventions based on student characteristics, including disability, medical history, and past trauma.

C. The professional development shall include a written examination and physical demonstration of proficiency in the described skills and competencies.

XI. Monitoring and Compliance

A. The Director of Mental Health/designee shall review each incident of restraint, including the Restraint Single Incident Report. The requirements described in Section V of these procedures shall be followed if a student is restrained at a school.

B. The Director of Mental Health/designee will monitor and review reported cases of restraint to ensure compliance with the requirements described in Section V of these procedures.

C. The Director of Mental Health/designee will monitor and re view Functional Behavior Assessments (FBA) and Behavior Intervention Plans (BIP). The monitoring and review process will include random audits of FBA and BIP documents to ensure compliance with the procedures and best practices detailed in the professional development described in above Section X.B.

XII. Attachments

Restraint Single Incident Report Form

Parent Notification Letter

XIII. Legal References

COMAR Regulations 13A.08.04.05

COMAR Regulations 13A.08.04.06

ADMINISTRATIVE PROCEDURE HISTORY

Revised: August 2023 (titles/positions)
Revised: March 21, 2023
Revised: January 9, 2023
Adopted: July 1, 2022
Reviewed: April 12, 2022