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    GUEST POST -Restraint and Seclusion in Schools: Top 5 Recommendations for School-Based Professionals

    October 19, 2016

    Restraint and Seclusion in Schools: Top 5 Recommendations for School-Based Professionals By Brian M. Yankouski, Ed.S., BCBA Restraint and seclusion use in schools has been an ongoing issue over the past few years and has been at the forefront of media attention with reports of students either being seriously injured or killed at the hands […]

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    GUEST POST -Restraint and Seclusion in Schools: Top 5 Recommendations for School-Based Professionals

    October 19, 2016

    Restraint and Seclusion in Schools: Top 5 Recommendations for School-Based Professionals

    By Brian M. Yankouski, Ed.S., BCBA

    Restraint and seclusion use in schools has been an ongoing issue over the past few years and has been at the forefront of media attention with reports of students either being seriously injured or killed at the hands of school-based professionals.  The United States Department of Education Office of Civil Rights (2014) found that students with disabilities are most likely to be restrained or secluded in school and that black students with disabilities are subjected to mechanical restraints in schools more than any other students.  Many school-based professionals working with students with disabilities typically do not receive formalized training for working with severe problem behavior or how to handle crisis situations as part of their undergraduate or graduate training.  Here are some tips for school professionals that are faced with using restraint and seclusion with their students:

    1. Consult a Board Certified Behavior Analyst. Understanding a student’s behaviors and being able to have interventions in place that are based upon evidence-based practices is key in order to prevent the need for using restrictive procedures like restraint and seclusion.  By working with a Board Certified Behavior Analyst a Functional Behavioral Assessment can be performed to understand why a problem behavior is occurring and to then develop a Behavior Intervention Plan that can help reduce maladaptive behaviors while teaching socially acceptable replacement behaviors.
    2. Get trained! It is important for school professionals to receive professional development training in various areas in order to develop a school culture and climate that may reduce the need for restraint and seclusion practices. These areas can include behavior and classroom management, Positive Behavioral Interventions and Supports (PBIS), crisis intervention training, and even just basic understanding of different disabilities and how it can impact a student’s learning and behavior within the classroom.
    3. Collect data. Data is your friend when working in schools. Be sure to collect data on student behaviors, but in addition on the use of restraint and seclusion, such as the frequency of types of restraints being used or how often a student needs to be restrained, how long restraints are being performed, the length of stay in a seclusion room, etc.  This data should then be graphed on each student, every classroom, and each school building to identify trends in the data at the student, classroom, and school-wide levels.  From there use the data to inform practice with interventions at each level and even to analyze potential over use of these restrictive practices within certain classes or schools.  This can indicate where more professional development training may be needed or it could inform administration about the population of students in those classes or schools and can aid in placement decisions each school year.
    4. Document, document, document. It is imperative that school professionals document every time that restraint and seclusion practices are used through an incident report. This information can be used in the even a parent or legal guardian questions what happened during an incident.  Furthermore, if possible, have video recordings of the incident on file for documentation purposes.  These videos can also be used for internal training purposes.
    5. Communicate with parents/guardians. As a school professional it is imperative that you communicate with parents or legal guardians of the student any time when restraint and/or seclusion procedures need to be used. Some states have laws on restraint and seclusion use in schools and will dictate when communication needs to take place so it is best to check your state’s laws on this; however, usually communication needs to occur the day the incident occurs and it is best to provide a written copy of the incident report as well to the parent or legal guardian.

    For more information on restraint and seclusion in schools and even developing school policies in this area you can listen to a podcast done by this author and his colleague through the National Association of School Psychologists here.

    About the Author

    Brian M. Yankouski, Ed.S., BCBA is the Owner/CEO of B.E.S.T. Strategies, a nationally recognized Behavioral Health Center of Excellence that provides Applied Behavior Analysis (ABA) treatment to individuals with disabilities.  He also developed a graduate training program in ABA at Seton Hall University.  He has been nationally recognized for his work on restraint and seclusion use in schools and has published articles and a book chapter on the topic and speaks nationally at conventions annually on the issue.

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    Filed Under: Uncategorized Tagged With: ABA, BCBA, behavior analysis, education, restraint, seclusion, special education

    Grandparents Guide to Autism

    September 2, 2016

    Each person responds differently to events, including learning about a diagnosis of ASD. This news probably feels overwhelming for grandparents just as it does for you as the parent. There may be another layer there in that it is not their child that has been diagnosed, but rather their grandchild and they may also be […]

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    Grandparents Guide to Autism

    September 2, 2016

    Each person responds differently to events, including learning about a diagnosis of ASD. This news probably feels overwhelming for grandparents just as it does for you as the parent. There may be another layer there in that it is not their child that has been diagnosed, but rather their grandchild and they may also be worried about the impact it will have on their child, you, who is now the parent. ASD was not as prevalent during grandparents’ upbringing so they may benefit from learning more about what ASD is and what it isn’t. Learning more may help them feel more prepared which helps decrease anxiety. Helping grandparents to connect with other grandparents of children with ASD can also be a great source of information and support. The Grandparents Autism Network is a great online resource. Ensuring that they are getting the support they may need helps to enable them to be able to provide support to you, their adult child, who has just received this news. You may be unsure how to talk to your parent about the diagnosis or what it means and it’s OK to say that. Sharing your own vulnerability and uncertainty, may help a grandparent feels more comfortable showing theirs. As a family with a child with ASD, you may need additional childcare support. Again, through open communication you and grandparents can talk about what feels manageable to them and helping them set up their home in a way that leads to greater success (i.e. a quiet, cool down area or sensory items). Grandparents can also learn the strategies that are most effective with your child, and likely already know many of them as they’ve likely been around the child his/her whole life. Reminding grandparents that the child is the same child they were before the diagnosis may also be helpful. Sometimes the diagnosis tricks us into focusing on the label and we forget that this is the same delightful, active, and unique child as they were before the diagnosis. Check out Autism Speaks’ Grandparents Guide to Autism for more information. Its an 18 page document available for free to print and share with anyone who may benefit.

    Dr. Becca

    Filed Under: Uncategorized Tagged With: ABA, autism, behavior analysis, grandparents, parenting

    5 Tips to help Parents Manage Anxiety

    August 17, 2016

    Anxiety is a completely normal thing. It is what has kept us alive, quite literally, throughout time. Anxiety is about the anticipation of something bad happening. When we saw a lion, we anticipated that it would try to eat us, so we ran.  That anxiety caused us to go into our fight or flight response […]

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    5 Tips to help Parents Manage Anxiety

    August 17, 2016

    Anxiety is a completely normal thing. It is what has kept us alive, quite literally, throughout time. Anxiety is about the anticipation of something bad happening. When we saw a lion, we anticipated that it would try to eat us, so we ran.  That anxiety caused us to go into our fight or flight response so that we had extra energy necessary to get away and stay alive. It also taught us to avoid lions.

    Luckily, we don’t encounter lions on a daily basis anymore. This is where anxiety can get in our way. Our bodies and minds may be responding as if there is a lion in the area when there isn’t.   Of course, if there is a lion you want that fight or flight system to work so you can run. Here are some quick tips to help you manage your anxiety and remind yourself that there is no lion.

    1.  Pick a mantra.  A mantra is a word or phrase that you can focus on that reminds you that in this moment you are safe.  One of mine is ” there is no lion”.  Other people have shared ones that have been helpful to them such as: ” this will not last forever” or “I am OK”
    2. Look for patterns.  Often times there are similarities in the event or time the triggers our anxiety.  If we can notice those patterns, that can help us be better prepared the next time we are in a similar situation to remain calm so that our anxiety does not get the best of us.  For example, speaking in front of large groups makes many people nervous. They worry about all of the things they could possibly do wrong. Because a person knows that that situation often triggers their anxiety, when they know they have an event coming up where they will need to speak in front of a group, they can take extra good care of themselves and use other skills to help them combat the anxiety before it even starts.
    3. Talk about it.  Anxiety is a normal part of being a human.  Sometimes when we are experiencing it, we think that no one will understand how we feel or that we are the only one experiencing it. Talking with others and being reminded that it is normal and that we are normal can have a huge effect on how we talk to ourselves when we notice we’re getting anxious.  We might also learn something that someone else does to help manage their anxiety that we can also use.
    4. Get enough Sleep.  What does sleep have to do with anxiety? Only everything!  When our body has not had enough time to rest and recharge, we are more sensitive to stress  and less able to effectively manage or control or anxiety without it taking control of us.
    5. See a therapist.  If you have tried different ways to manage your anxiety and had limited success, or if the amount of anxiety you are experiencing regularly keeps you from doing things that you want or need to do, you may want to reach out to a professional.  There is specific training and experience that can help you to gain more control over your anxiety and move towards being able to do the things that you want and need to do

    Hopefully these hints are helpful. I’d love to hear your feedback about how they work for you. Remember, there is no lion

    Dr. Becca

    Filed Under: Uncategorized Tagged With: ABA, anxiety, autism, behavior analysis, north carolina, parenting, parents

    Understanding SB 676 in NC

    August 13, 2016

    SB 676 in North Carolina is also referred to as the “Autism Health Insurance Legislation”. It was passed by Governor McCory in October 2015 and has an implementation date of July 2016. The information below was taken from the Autism Society of North Carolina’s website  What does it do? SB 676 requires health plans to […]

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    Understanding SB 676 in NC

    August 13, 2016

    SB 676 in North Carolina is also referred to as the “Autism Health Insurance Legislation”. It was passed by Governor McCory in October 2015 and has an implementation date of July 2016. The information below was taken from the Autism Society of North Carolina’s website 

    What does it do?

    • SB 676 requires health plans to cover treatment of autism for children up to age 18.
    • Requires coverage of Adaptive Behavior Treatment, which includes Applied Behavioral Analysis (ABA) therapy and other evidence-based therapies such as TEACCH, Pivotal Response, etc.
    • Coverage for Adaptive Behavior Treatment is limited to $40,000 per year.

    Does this law cover all health insurance plans?

    This law covers the large group plans for companies in North Carolina that follow state law. As we have pointed out in our policy paper on insurance, state laws can only affect certain kinds of health insurance plans that make up a small part of the health plan marketplace. Employers are more likely to offer coverage voluntarily, even when they are not required to do so, in states where coverage is required.

    The law mentions DSM-5. Does this law require that children diagnosed under DSM-IV (4) be re-diagnosed using DSM-5 criteria to receive the autism benefit?

    The law does not require re-diagnosis under DSM-5 criteria. DSM-5 changes to the insurance statutes reflect an update in the law. DSM-5 is now in effect, so the DSM-IV (4) language should not remain in the law. The DSM-5 specifically states that “individuals with a well-established DSM-IV diagnosis of autistic disorder, Asperger’s disorder, or pervasive developmental disorder not otherwise specified should be given the diagnosis of autism spectrum disorder.” 

    Does SB 676 cover Applied Behavior Analysis (ABA)?

    YES. The definition of Adaptive Behavior Treatment includes Applied Behavior Analysis as well as other treatments for autism. By using the broad term and not naming only one treatment option, the law allows for a range of behavioral and development interventions, including ABA, “that have been shown to be clinically effective.”

    Does SB 676 allow ABA therapists (BCBAs) to provide ABA therapy in North Carolina and be reimbursed?

    YES. ABA therapists (BCBAs) are already providing services in North Carolina and their services are being reimbursed. Even though they are not licensed, current law allows BCBAs to practice in NC as long as they are supervised. This law does not change any ability to work. The House passed a behavior analyst licensure bill to license BCBAs to practice without supervision. That bill is still eligible to be passed during the short session from April 25 to June 30, 2016. Many organizations worked together to come up with the licensure bill, and although the Autism Society of North Carolina does not typically take a position on the licensing of professional groups, ASNC has endorsed the bill and will be working to pass it in the Senate.

    Contact us today to start taking advantage of this coverage!

    Dr. Becca

    Filed Under: Uncategorized Tagged With: ABA, autism, behavior analysis, north carolina, SB 676

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