School Restraint and Recommendations from the US Department of Education

In recent years, there has been growing attention paid to cases of misuses of physical restraint in schools and adverse incidents that have been caused by them. Although there have been rare cases of willful abuse by a few individuals, the majority of these incidents have been related to well-meaning teachers who had not been given proper training in crisis prevention and management but were then in situations where they felt they had to act immediately to keep students safe. Poor training, improper training or lack of training are among the primary reasons why inappropriate physical restraint is used, or is used at the wrong time or in the wrong way.

In order to protect students and educators, PCMA maintains the highest training and certification standards of any nationally (or internationally) known crisis management system. PCMA also applauds the many organizations that have recently advocated for higher training standards and more accountability with respect to crisis prevention, de-escalation and physical restraint, including the American Association of School Administrators and the US Department of Education.

Toward these efforts, the US Department of Education recently released an important paper called “Restraint and Seclusion: Resource Document, which lists important recommendations for all schools in the United States. The report features 15 principles for the safe and effective use of restraint. PCM fully supports these principles and most of them are specifically included in the core values and ethics upon which the PCM system is built. To download a copy of the full report you may go to http://www2.ed.gov/policy/seclusion/restraints-and-seclusion-resources.pdf. The principles are listed below, along with comments on the ways that PCM system supports them and is compatible with those actions that must be taken by the individual school and district.

1. Every effort should be made to prevent the need for the use of restraint and for the use of seclusion.

PCMA supports this principle by emphasizing prevention, even more so than de-escalation. A very large portion of the PCM course involves extensive preventive measures that are used before individuals become agitated and engage in pre-crisis behavior.

2. Schools should never use mechanical restraints to restrict a child’s freedom of movement, and schools should never use a drug or medication to control behavior or restrict freedom of movement (except as authorized by a licensed physician or other qualified health professional).

PCMA does not teach mechanical restraint and, of course, is not involved in the use of drugs or medications. PCM is intended to minimize the need for these more restrictive interventions that do not respond instantly to a child’s behavior and can continue to affect a student’s ability to participate in normal school activities long after the crisis is over.


3. Physical restraint or seclusion should not be used except in situations where the child’s behavior poses imminent danger of serious physical harm to self or others and other interventions are ineffective and should be discontinued as soon as imminent danger of serious physical harm to self or others has dissipated.

The PCM utilization criteria are designed to prevent over use and under use, which can also be dangerous. Although the PCMA believes that the PCM criteria are more objectively stated than the criteria set by the DOE (which is important for reliable implementation), schools and other organizations are free to adopt any criteria that are equally or more rigorous.

4. Policies restricting the use of restraint and seclusion should apply to all children, not just children with disabilities.

PCMA fully supports the use of positive behavior support strategies for all children regardless of their developmental status or other exceptionalities and, when necessary, the appropriate and correct use of a dignified, safe and effective system of crisis intervention to keep them safe. PCMA believes that all protective measures that are needed and appropriate (positive behavior support measures, parental informed consent and notification, etc…) should be applied to every child regardless of his or her educational status.PCM strategies are safe to use with all children and all adults.

5. Any behavioral intervention must be consistent with the child’s rights to be treated with dignity and to be free from
abuse.


PCM is built upon the PCMA guiding principles which were established in 1981. The guiding principles include (but are not limited to) the right to be treated with dignity and respect and the right to freedom from pain or abusive treatment. Every PCM procedure was developed with these principles taking paramount priority.

6. Restraint or seclusion should never be used as punishment or discipline (e.g., placing in seclusion for outof-seat behavior), as a means of coercion or retaliation, or as a convenience.

The PCM utilization criteria are designed to prevent it from being used in a punitive or coercive way or for retaliation or convenience. The criteria emphasize that PCM may not be used except for the immediate physical protection of individuals under very specific circumstances. The prevention component of PCM includes positive, pro-active behavioral strategies which are intended to prevent the temptation to use punitive strategies.

7. Restraint or seclusion should never be used in a manner that restricts a child’s breathing or harms the child.

No PCM procedure restricts breathing or involves any touch to the torso, neck, head, joints or other sensitive or risky areas. The PCM system includes a customizable continuum of procedures with alternatives for training at any level of restrictiveness that is appropriate for the setting and population. There is an effective PCM training option for every program, regardless of any limitations there may be on specific procedures or classes of procedures. A detailed medical review of PCM procedures is available on request from PCMA.

8. The use of restraint or seclusion, particularly when there is repeated use for an individual child, multiple uses within the same classroom, or multiple uses by the same individual, should trigger a review and, if appropriate, revision of strategies currently in place to address dangerous behavior; if positive behavioral strategies are not in place, staff should consider developing them.

PCMA encourages organizations to adopt this internal policy and supports them in proactive behavioral programming in many ways. PCM emphasizes prevention in many forms, including positive behavioral programming for individuals as well as setting-wide. In addition to the extensive positive, proactive strategies covered in the PCM and BehaviorTools courses, PCMA behavioral experts frequently present on topics related to these strategies at conferences and via free webinars. Programmatic consultation is available to all PCM users from PCMA’s experienced staff of board certified behavior analysts.

9. Behavioral strategies to address dangerous behavior that results in the use of restraint or seclusion should
address the underlying cause or purpose of the dangerous behavior.


Both the PCM courses and the BehaviorTools courses cover ways to assess and understand the reasons why individuals engage in crisis behaviors (behavioral function) and how this understanding translates into effective individualized prevention and intervention strategies.

10. Teachers and other personnel should be trained regularly on the appropriate use of effective alternatives to physical restraint and seclusion, such as positive behavioral interventions and supports and, only for cases involving imminent danger of serious physical harm, on the safe use of physical restraint and seclusion.

PCM courses include extensive information on the appropriate use of effective alternatives to physical restraint. These include positive behavioral interventions and supports and other proactive strategies that include manipulating various aspects of the program, physical environment and staff-to-student interactions. A large section of the PCM course and the entire BehaviorTools course falls into this category.

11. Every instance in which restraint or seclusion is used should be carefully and continuously and visually monitored to ensure the appropriateness of its use and safety of the child, other children, teachers, and other personnel.

PCMA supports this internal school policy by encouraging supervisors and personnel at all levels and in various roles to be trained and certified so that they may be able to accurately assess when a procedure is being used correctly and immediately correct any inappropriate or imprecise applications of procedures.

12. Parents should be informed of the policies on restraint and seclusion at their child’s school or other educational setting, as well as applicable Federal, State, or local laws.

PCMA supports this internal school policy by periodically offering a free webinar and newsletter article on the topic of gaining informed consent from caregivers and notifying them of the use of procedures when they do occur. PCMA staff frequently field related questions from users and provide advice and support as needed.

13. Parents should be notified as soon as possible following each instance in which restraint or seclusion is used with their child.

PCMA supports this internal school policy by including this recommendation in the free webinars and newsletter articles that PCMA periodically distributes to users.

14. Policies regarding the use of restraint and seclusion should be reviewed regularly and updated as appropriate.

PCMA supports this internal school policy by offering free telephone consultation to user schools on request. Many schools have consulted with PCMA experts in the process of updating their restraint and seclusion policies. Additionally, PCMA experts provide the educational and behavioral communities with information that is useful in setting policies via numerous free publications and speaking engagements at professional conferences.

15. Policies regarding the use of restraint and seclusion should provide that each incident involving the use of restraint or seclusion should be documented in writing and provide for the collection of specific data that would enable teachers, staff, and other personnel to understand and implement the preceding principles.

PCMA supports this internal school policy by providing a restraint usage data sheet template in the PCM course materials and emphasizing the importance of collecting data. PCMA encourages all user organizations to collect and share restraint related data and offers incentives for those that provide PCMA with data that can be published or shared in a public format.