HAMILTON-WENHAM REGIONAL SCHOOL DISTRICT

WENHAM, MA

H8011

PHYSICAL RESTRAINT OF STUDENTS

The Hamilton-Wenham Regional School District complies with the DESE restraint regulations, 603 CMR 46.00 et seq. (“Regulations”), to the extent required by law.  According to their terms, the Regulations apply not only at school but also at school-sponsored events and activities, whether or not on school property.  A brief overview of the Regulations is provided below.

I.        Methods and Conditions for Implementation 

School staff may only use physical restraint, including prone restraint where permitted under 603 CMR 46.03, as an emergency procedure of last resort.  Any physical restraint is prohibited except when a student’s behavior poses a threat of assault, or imminent, serious, physical harm to themselves and/or others and the student is not responsive to verbal directives or other lawful and less intrusive behavior interventions, or such interventions are deemed to be inappropriate under the circumstances.

Physical restraint is prohibited as a means of discipline, punishment, as a response to property destruction, disruption of school order, a student’s refusal to comply with a school rule or staff directive, or verbal threats that do not constitute a threat of imminent, serious, physical harm to the student or others.  Physical restraint will not be used as a standard response for any individual student.  No written individual behavior plan or individualized education program (IEP) may include the use of physical restraint as a standard response to any behavior.  Physical restraint is an emergency procedure of last resort.  The use of “time out” procedures during which a staff member remains accessible to the student shall not be considered “seclusion restraint.”

When an emergency situation arises, and physical restraint is the only option deemed appropriate to prevent a student from injuring himself or herself, another student or school community member, a teacher or employee or agent of the school district may use such reasonable force needed as is necessary to protect students, other persons or themselves from assault or imminent, serious, physical harm.

The definitions of forms of restraint shall be as defined in 603 CMR 46.02

The use of mechanical restraint, medication restraint, and seclusion is prohibited.

Physical restraint is prohibited when it is medically contraindicated for reasons including, but not limited to, asthma, seizures, a cardiac condition, obesity, bronchitis, communication-related disabilities, or risk of vomiting.  During the administration of a restraint, a staff member shall continuously monitor the physical status of the student, including skin temperature and color, and respiration.  A nurse will examine the student as soon as possible after a restraint, recognizing that time is of the essence.

Prone restraint shall be prohibited in public education programs except on an individual student basis, and only under the following circumstances:

  1. The student has a documented history of repeatedly causing serious self-injuries and/or injuries to other students or staff;
  2. All other forms of physical restraints have failed to ensure the safety of the student and/or the safety of others;
  3. There are no medical contraindications as documented by a licensed physician;
  4. There is psychological or behavioral justification for the use of prone restraint and there are no psychological or behavioral contraindications, as documented by a licensed mental health professional;
  5. The program has obtained consent to use prone restraint in an emergency as set out in CMR 46.03(1)(b), and such use has been approved in writing by the principal; and,
  6. The program has documented 603 CMR 46.03(1)(b) 1-5 in advance of the use of prone restraint and maintains the documentation.

As Per DESE Regulations (603 CMR 46.00 et seq.):

Only District personnel who have received formal restraint training, in accordance with DESE regulations, shall administer physical restraint on students. Whenever possible, the administration of a restraint shall be witnessed by at least one adult who does not participate in the restraint.

The DESE regulatory training requirements shall not preclude a teacher, employee or agent of the District from using reasonable force to protect students, other persons or themselves from assault or imminent, serious physical harm.

A person administering a physical restraint shall use only the amount of force be necessary to protect the student or others from physical injury or harm. A person administering the restraint shall use the safest method available and appropriate to the situation subject to the safety requirements contained in the regulations.  

Floor restraints, including prone restraints otherwise permitted, shall be prohibited unless the staff members administering the restraint have received in-depth training and, in the judgment of the trained staff members, such method is required to provide safety for the student or others present.

All physical restraint must be terminated as soon as the student is no longer an immediate danger to himself or others, or the student indicates that he or she cannot breathe, or if the student is observed to be in severe distress, such as having difficulty breathing, or sustained or prolonged crying or coughing.

If a student is restrained for a period longer than 20 minutes, program staff shall obtain the approval of the principal.  The approval shall be based upon the student’s continued agitation during the restraint justifying the need for continued restraint.

The Superintendent shall develop procedures identifying:

The Superintendent will review these procedures annually and they shall be provided to staff, and made available to parents of enrolled students.

II.        Staff Training

All school staff must receive training with respect to the DESE Regulations and the district’s restraint policy (i.e., following the Regulations), including receiving information about interventions that may preclude the need for restraint, types of restraint and related safety considerations, and administering physical restraint in accordance with known medical or psychological limitations and/or behavioral intervention plans applicable to an individual student.  The Principal will arrange training to occur in the first month of each school year, or for staff hired after the beginning of the school year, within a month of their employment.  This policy and its accompanying procedures shall be reviewed and disseminated to staff annually and made available to parents of enrolled students.   The training shall include the following information:

(a) The role of the student, family, and staff in preventing restraint;

(b) The district's restraint prevention and behavior support policy and procedures, including use of time-out as a behavior support strategy distinct from seclusion;

(c) Interventions that may preclude the need for restraint, including de-escalation of problematic behaviors and other alternatives to restraint in emergency circumstances;

(d) When behavior presents an emergency that requires physical restraint, the types of permitted physical restraints and related safety considerations, including information regarding the increased risk of injury to a student when any restraint is used, in particular a restraint of extended duration;

(e) Administering physical restraint in accordance with medical or psychological limitations, known or suspected trauma history, and/or behavioral intervention plans applicable to an individual student; and

(f) Identification of program staff who have received in-depth training pursuant to 603 CMR 46.03(3) in the use of physical restraint.

Additionally, each school principal must identify specific staff to serve as a school-wide resource to assist in ensuring proper administration of physical restraint.  These individuals must participate in in-depth training with respect to restraint and implementation of the Regulations.  The training requirements contained in 603 CMR 46.00 shall not preclude a teacher, employee, or agent of a public education program from using reasonable force to protect students, other persons or themselves from assault or imminent, serious, physical harm.

III.        Reporting Requirements and Follow-Up

 School staff who administer the restraint shall verbally inform the principal or a designee as soon as possible, and by written report no later than the next school working day.  If the principal administered the restraint, he or she shall prepare the report and submit it to an individual or team designated by the superintendent.  The principal/designee must maintain an ongoing record of all such reported instances, which will be made available in accordance with state and federal law and regulations. The principal/designee must also verbally inform the student’s parent or guardian of the restraint within 24 hours of the event, and by written report postmarked no later than three school working days following the use of the restraint.  The written restraint report must be provided to the parent or guardian in the language in which report cards and other necessary school-related information are customarily provided.  The principal shall provide the student and the parent an opportunity to comment orally and in writing on the use of the restraint and on the information in the written report.

In the event that a physical restraint results in injury to the student or staff member, the school must, within three school working days of the reported restraint, provide a copy of the written report to DESE along with a copy of the school’s record of physical restraints covering the thirty-day period prior to the date of the restraint.

Follow-up procedures for restraint include not only the reporting requirements set forth above, but also reviewing the incident with the student, staff and consideration of whether follow-up is appropriate for students who witnessed the incident.

The principal shall conduct a weekly review of restraint data to identify students who have been restrained multiple times during the week.  If such students are identified, the principal shall convene one or more review teams as the principal deems appropriate to assess each student’s progress and needs. The assessment shall include at least the following:

(a) review and discussion of the written reports submitted and any comments provided by the student and parent about such reports and the use of the restraints;

(b) analysis of the circumstances leading up to each restraint, including factors such as time of day, day of the week, antecedent events, and individuals involved;

(c) consideration of factors that may have contributed to escalation of behaviors,  consideration of alternatives to restraint, including de-escalation techniques and possible interventions, and such other strategies and decisions as appropriate, with the goal of reducing or eliminating the use of restraint in the future;  

(d) agreement on a written plan of action by the program.

The principal shall conduct a monthly review of school-wide restraint data.  This review shall consider patterns of use of restraints by similarities in the time of day, day of the week, or individuals involved; the number and duration of physical restraints school-wide and for individual students; the duration of restraints; and the number and type of injuries, if any, resulting from the use of restraint.  The principal shall determine whether it is necessary or appropriate to modify the school’s restraint prevention and management policy, conduct additional staff training on restraint reduction/prevention strategies, such as training on positive behavioral interventions and supports, or take such other action as necessary or appropriate to reduce or eliminate restraints.  

IV.        Additional information

Additional information, including a copy of the regulations, can be obtained from the Director of Special Education who can be reached at (978) 626-0850. A copy of the regulations may also be obtained at www.doe.edu/lawsregs/603cmr46.html.

Legal References:          603 CMR 46.00 and Massachusetts General Law (M.G.L.) 71:37G

Adopted: February 13, 2003

Reviewed: December 3, 2015