Considerations for Seclusion and Restraint Use in School‐wide Positive Behavior Supports
Robert Horner and George Sugai
Co‐directors OSEP Technical Assistance Center on
Positive Behavioral Interventions and Support
Concern
Seclusion and restraint refer to safety
procedures in which a student is isolated from others (seclusion) or physically
held (restraint) in response to serious problem behavior that places the
student or others at risk of injury or harm. Concern exists that these
procedures are prone to misapplication and abuse placing students at equal or
more risk than their problem behavior. Concerns include the following:
- Seclusion and restraint procedures are
inappropriately selected and implemented as “treatment” or “behavioral intervention,” rather
than as a safety procedure.
- Seclusion and restraint are inappropriately
used for behaviors that do not place the student or others at risk of harm or injury (e.g.,
noncompliance, threats, disruption).
- Students, peers, and/or staff may be
physically hurt or injured during attempts to conduct seclusion and restraint procedures.
- Risk of injury and harm is increased because
seclusion and restraint are implemented by staff who are not adequately trained.
- Use of seclusion and restraint may
inadvertently result in reinforcement or strengthening of the problem behavior.
- Seclusion and restraint are implemented
independent of comprehensive, function‐based behavioral intervention plans.
Toward Effective Policy
- The majority of problem behaviors that are
used to justify seclusion and restraint could be prevented with early identification and intensive
early intervention. The need for seclusion and restraint procedures is in part a result of
insufficient investment in prevention efforts.
- Seclusion and restraint can be included as a
safety response, but should not be included in a behavior support plan without a formal functional
behavioral assessment (a process used to identify why the problem behavior continues to
occur).
- Seclusion and restraint should only be
implemented (a) as safety measures (b) within a comprehensive behavior support plan, (c) by
highly trained personnel, and (d) with public, accurate, and continuous data related to (1)
fidelity of implementation and (2) impact on behavioral outcomes (both increasing desired
and decreasing problem behaviors).
School‐wide Positive Behavior Support
School‐wide Positive Behavior Support
(SWPBS) is a systems approach to establishing the whole‐school social culture
and intensive individual behavior supports needed for schools to achieve social
and academic gains while minimizing problem behavior for all students. SWPBS is
NOT a specific curriculum, intervention, or practice, but a decision making
framework that guides selection, integration, and implementation of
scientifically‐based academic and behavioral practices for improving academic
and behavior outcomes for all students. A central feature of SWPBS is
implementation of behavioral practices throughout the entire school. SWPBS
defines practices that all students experience in all parts of the school and
at all times of day.
SWPBS emphasizes four integrated elements:
(a) socially valued and measurable outcomes, (b) empirically validated and
practical practices, (c) systems that efficiently and effective support implementation
of these practices, and (d) continuous collection and use of data for decision‐making.
These four elements are operationalized by
five guiding principles:
- Invest first in prevention to establish a
foundation intervention that is empirically validated to be effective, efficient and sustainable.
- Teach and acknowledge appropriate behavior
before relying on negative consequences.
- Use regular “universal screening” to
identify students who need more intense support and provide that support as early as possible,
and with the intensity needed to meet the student’s need.
- Establish a continuum of behavioral and
academic interventions for use when students are identified as needing more intense support.
- Use progress monitoring to assess (a) the
fidelity with which support is provided and (b) the impact of support on student academic and
social outcomes. Use data for continuous improvement of support.
Research Supporting Implementation of School‐wide
Positive Behavior Support
- Schools are able to implement SWPBS as
evidenced by more than 9000 schools using SWPBS across the nation.
- Schools that implement SWPBS demonstrate
reductions in problem behavior and improved academic outcomes.
- Preliminary evaluation data indicate that
more intensive individual student behavior support is perceived as more
effective (and less likely to be needed) when SWPBS is implemented.
- Evaluation (but not experimental) data
indicate that implementation of SWPBS is associated with reduction in the number of instances in
which intensive interventions (including seclusion and/or restraint) are perceived as needed,
increases the effectiveness of comprehensive interventions, and improvement in the
maintenance of behavior support gains.
The development of this paper was
supported in part by a grant from the Office of Special Education
Programs, U.S. Department of Education (H029D40055). Opinions expressed
herein are the author’s and do not reflect necessarily the position of
the US Department of Education, and such endorsements should not be
inferred. Contact: Rob Horner (Robh@uoregon.edu), OSEP Center on
Positive Behavioral Interventions and Supports (www.pbis.org),
University of Oregon, Eugene.