Continuum of Interventions

1. Introduction

PPRA, or the Protection of Individuals from Restraint and Seclusion act, allows for a continuum of prevention, or preventative techniques.  In building a continuum of prevention we want to consider the following:

• Environmental management- How can we arrange, shift, or adjust the environment?
• A continuum of de-escalation techniques including verbal and non-verbal de-escalation.

The use of restraints can be an indication that the use of less restrictive alternatives has failed or was not followed.

The continuum needs to include:

• Prevention
• Early intervention
• Targeted interventions
• Individualized interventions that are specific to the individual

When emphasizing the use of prevention and early intervention, educators can make use of positive behavior, intervention, and supports (PBIS) for the purpose of creating a positive learning environment for each student.  Additionally, school personnel can make use of social emotional learning (SEL) which can promote a positive school climate and culture.

When considering targeted and individualized interventions, educators often choose to conduct a Functional Behavior Assessment (FBA) before developing a Behavior Intervention Plan (BIP).

Additional information on the continuum of interventions is highlighted throughout this course.  

2. National and Local Data

National Lens

Data from the national lens. 80% of all students who are restrained are students with disabilities and only 20% of the students are general education students. A total of 70,833 students were restrained of those 56,905, were students with disabilities.

Colorado Lens 

Moving from the national data to Colorado’s data, 10% of students in Colorado have an IEP (Individual Education Plan). This 10% of students accounts for 78% of students who have been restrained.

3. Positive Behavior Intervention Supports

PBIS: 

In the area of prevention and early intervention schools can make use of positive behavior, intervention, and supports (PBIS) for the purpose of creating that positive school environment.

Research: 

Researchers found that PBIS (positive behavior intervention supports) when used effectively, can reduce problematic behaviors.  The research includes different case studies where PBIS has been implemented. Positive Behavior Intervention is considered to be an evidence-based alternative and can reduce the usage of  restraints.

Positive School Culture and Climate: 

When we talk about PBIS, there is what is called "little" PBIS which focuses on establishing a positive school climate and culture.  There are many different types of programs that can assist in developing a positive climate and culture.  Some examples include Capturing kids Hearts, Boys Town, Second Step, Restorative Practices, Trauma Informed Practices, etc. The Colorado Department of Education does not endorse or recommend any specific program to create a positive school climate and culture.

PBIS as a Framework: 

Schoolwide positive behavior intervention and supports (SWPBIS), George Suigy and Rob Horner’s Official Framework.  School-Wide Positive Behavior Interventions and Supports is a comprehensive, school-wide research-based system that is “based on the assumption that actively teaching and acknowledging expected behavior can change the extent to which students expect appropriate behavior from themselves and each other.” SWPBIS provides a framework for creating predictable, positive environments for all students to achieve academically, behaviorally, and social/emotionally.

Serious behavior problems and overall school climate improve because faculty and staff actively teach positive behavior, through modeling expected behavior and rewarding positive behaviors, such as academic achievement, following adult requests, and engaging in safe behavior. SWPBIS focuses on data-based analysis and decision-making and also includes a tiered intervention approach, that focuses on primary or universal positive behavior instruction and support for all students and increasing levels of interventions and supports for students with higher level behavior, emotional, and mental health needs.

Prevention: 

Prevention is key to a safe respectful productive learning environment. Students at risk for developing, or who have a history of challenging behavior benefit from environments that are organized and predictable, interventions that are provided by skilled caregivers and addressing behavior errors after a crisis promoting success.

4. Environmental Modifications

Part of the PPRA prevention continuum needs to be environmental modifications. Environmental modifications can include how we set up the classroom examining traffic patterns. Assessing classroom traffic patterns includes looking at where materials for assignments are located within the classroom, looking at the location for turning in assignments. Does a student who struggles with staying on task have to walk past 5 or 6 students, to get to the materials, or to turn in their work, assignment? We want to really make sure we have an efficient traffic pattern to and from materials that allow the students to get there quickly and efficiently. You might also think about the location of the doors and windows, is a student that is easily distracted sitting by the doors or windows where the activity outside the door and windows is preoccupying their attention.

Desk Arrangements: 

Environmental modifications include desk arrangements. Are the desks in rows?  In pods?   Are they single by themselves? How you arrange the desks will determine different traffic patterns, and how students interact with each other.

Decorations: 

You will want to examine the decorations within the classroom.  Sometimes teachers have great information, and they have huge volume of information that is up on the classroom walls in the classroom.  Sometimes all that information can be very visually overstimulating.  This can result in students spending all their time trying to take in and absorb all that information.  They are processing what's going on in the environment instead of paying attention to their teachers, peers, or what's going on around them. You want to make sure that the walls and the materials are not overwhelming and distracting.

Clutter: 

You need to scan the environment for items that could be used as a weapon and clear those items from the environment. Sometimes classrooms have lots of clutter providing quick and easy access to items that can be used as weapons such as, pencils, scissors, etc.  When a student escalates, they reach for whatever items are closest for throwing.

Blocking: 

Another environmental modification or another environmental strategy which you can put in place is blocking. Blocking is placing yourself between the student and the object(s) that the student is trying to access.

An example of the appropriate use of blocking strategy is when staff member blocks a student from climbing up multiple shelves in the PE equipment storage room. 

Proximity Control: 

Proximity Control is another environmental strategy that can be used. Proximity Control is all about the teacher not standing in the front of the classroom, by the chalkboard, dry erase board, or the Promethean Board, but instead walking around the classroom between student desks. When you see misbehavior, or a student heading in that direction, the teacher might walk closer to that student who's getting ready to engage in that negative behavior.  Proximity Control is the teachers floating around the classroom so they're not always in a central location. Proximity control can reduce a lot of different behaviors.

Environmental Checklist: 

There is an environmental checklist that can be used to assess classroom environments. The environmental check list prompts scanning the room for visual clutter, assessing the classroom walls to see if they are organized with information grouped simply.

The next area of assessment on the environmental checklist is lighting.  Some questions to ask are:

What is the lighting like in the room? 

Is the lighting adjusted throughout the day? 

Is natural lighting being used?

Fluorescent lights actually have a little bit of a flicker that most people can't see and the ballast in the fluorescent lights have a little bit of hum that most people can't hear.  These aspects can become overstimulating for some students. 

The next area of assessment on the environmental checklist is the noise level in the classroom. Noise damping materials, such as rugs and cloth on bulletin boards can be used in the classroom setting to reduce noise levels. The use of noise canceling headphones, or earbuds might be beneficial to some students. The use of a noise meter might be helpful that measures the decibels levels in the classroom. 

Hydration and nutrition are the next assessment area on the environmental checklist. Do students have access to water that is easy and convenient such as having water bottles on their desk?

Seating options should also be examined. Are there different sitting options available within the classroom environment? Standing options that allow for movement?

The classroom Environment Checklist also includes smells. What are some of the different smells within the environment? Smell can be a powerful behavioral trigger. Different smells such as perfume or cologne can trigger allergies. Dr Laura, Riffel, gives the example of a student whose behaviors was triggered by the smell of a teacher's perfume.  The perfume was identical to the student’s mother's perfume reminding the student of his mother who was very abusive.

5. Social Emotional Learning

SEL (Social Emotional Learning): 

Social Emotional Learning is an important part of the intervention continuum that can promote a positive school climate and culture.

Social emotional learning is the process of acquiring and effectively applying the knowledge, attitude and skills necessary to recognize and manage one's own emotions.  It involves developing care and concern for others, making responsible decisions, establishing positive relationships and handling challenging situations. There is over 20 years of research in the area of Social Emotional Learning (SEL). The research agrees on the same five domains of SEL. CASEL  is an agency that focuses on SEL and has collected large amounts of research on SEL.  Additionally, CASEL will assess any SEL curriculum submitted looking for the five different SEL domains. This is the link to the CASEL.org website: CASEL’S SEL Framework - CASEL

The five domains of social emotional learning are:

1. Self-awareness, which is the ability to identify one's own emotions
2. Social awareness, which is empathy, and respect for others
3. Responsible decision making
4. Self- Management which is impulse control, stress management, and persistence, or not giving up
5. Relationship skills such as cooperation and communication.

PBIS and SEL: 

6. IEP and Behavior

Relationship Between Behavior and Learning: 

Monitoring the relationship between behaviors and learning, is essential to ensure an individual education program or IEP is reasonably calculated to enable a child with a disability to make appropriate progress in the light of the child’s circumstances. We need to set reasonable attainable goals and expect progress that's challenging for students. We also want to monitor our relationships, particularly interactions as relationships are being re-negotiated. Research shows that academic success and behaviors are intertwined impacting one another. By constantly monitoring relationships, we can increase academic achievement since they are interconnected. All students can learn and progress we just need to have the expectation that they can.

IDEA Individual with Disability Educational Act): 

The Individuals with Disability Educational Act (IDEA) requires IEP teams to address behavior that impedes a child's learning, or the learning of others. The IEP team must consider a child's need for Behavioral Interventions and Supports on an individual basis during the IEP development review and revision. Parents and guardians need to be active participants in the IEP and Behavioral Intervention Plan development processes and are required to be notified throughout the FBA process.

7. Behavioral Guidance

PPRA Regulations and Best Practice: 

When a child’s behavior impedes his or her learning or that of other children, the child's team must consider the use of positive behavioral interventions and supports to address the behavior.

These behavioral interventions and supports, are uniquely designed for the individual student and may include a Functional Behavior Assessment and a Behavior Intervention Plan. They must be used proactively as determined by the IEP team.

8. Best Practices

Best practice around when to conduct and functional Behavior Assessments (FBA) and Behavior Intervention Plans (BIP) includes: 

• Conducting and FBA when there is a pattern of maladaptive behavior.
• The current behavior program is not effective.
• The student or others are at risk of harm
• A more restricted placement, or more intensive intervention is being contemplated.