Format

Individual Presentation

First Presenter's Institution

Millcreek Township School District

First Presenter’s Email Address

triana@mtsd.org

First Presenter's Brief Biography

Dr. Mary E. Triana, D.Ed., completed her doctoral work in October 2022 with Slippery Rock University of Pennsylvania and is currently pursuing her Superintendent Letter of Eligibility through Penn West University. She has been a Supervisor of Special Education for over ten years. Prior to that, she was an Autism Consultant, an Autistic Support Teacher, educational assistant, and one on one behavioral support staff. For the majority of her career, her work has focused on supporting school age children with low incidence disabilities. She completed her Master’s in Special Education in 2006, and Supervisory Program in 2013 both with Edinboro University. She holds a Bachelor’s in Psychology from Penn State University. She lives in Erie, Pennsylvania with her husband and two children.

Second Presenter's Institution

Slippery Rock University

Second Presenter’s Email Address

eric.bieniek@sru.edu

Second Presenter's Brief Biography

Dr. Eric J. Bieniek, PhD is an associate professor in the Department of Special Education at Slippery Rock University of Pennsylvania and graduate coordinator of the Master’s in Special Education, concentration in Applied Behavior Analysis program. He is also a licensed behavior specialist in the state of Pennsylvania (LBS) and board-certified behavior analyst (BCBA-D). Dr. Bieniek has a range of educational, clinical and supervisory experiences supporting the needs of learners having autism spectrum disorders and similar neurological, behavioral and emotional disorders across the lifespan in public, private educational settings as well as residential, community and vocational programs. Dr. Bieniek has also served as a curriculum developer for higher education and program developer for vocational and community programs for transition age learners. He also serves as an independent evaluator and expert witness supporting families of children involved in due process disputes. Finally, Dr. Bieniek has presented at a variety of professional conferences locally, regionally, nationally and internationally and is an author, with his most recent peer-reviewed publications being in The 2019 and 2020 American Association for Employment in Education Handbooks as well as a chapter in "Contemporary Issues in Special Education,1st edition." Dr. Bieniek received his PhD in Instructional Management and Leadership from Robert Morris University in 2011, his graduate certificate in Applied Behavior Analysis from Pennsylvania State University in 2003, his M.Ed in Educational Psychology from Indiana University of Pa in 2001 and his BA in Psychology from Edinboro University of Pa in 1999. He resides in Pittsburgh, PA with his wife and three children. He is an avid scuba diver, and lover of all things outdoors.

Location

Session Seven

Strand #1

Hands: Safety & Violence Prevention

Strand #2

Health: Mental & Physical Health

Relevance

The purpose of this study was to understand the perspectives of students with disabilities who have experienced two different types of crisis intervention for aggressive or self-injurious behaviors, one being restraint and the other a restraint-free, trauma-informed approach. Studies on the use of restraint have found that it has detrimental emotional and physical effects, along with the risk of injury and death. Emerging research into the use of trauma-informed approaches (TIA) has demonstrated that they can substantially reduce or effectively negate the need for restrictive practices. This links directly with safety in schools and student mental and physical health. The results of this study indicate that schools can safely support students in crisis without the use of restraint using a TIA that avoids re-traumatization, increases safety, and maintains connections with staff.

Brief Program Description

This presentation reviews first-of-its-kind research that directly interviewed students who have experienced both restraint and a restraint-free trauma-informed approach during crisis. It will review the results of these interviews including students’ understanding of interventions, relationships with staff, and recommendations for schools.

Summary

The purpose of this presentation is to review first-of-its-kind research that can impact the way districts support students during crisis situations. Public schools provide support to every student, including those with a history of aggression and/or self-injury. This study was conducted to understand the perspectives of students who have experienced two different types of crisis intervention for aggressive or self-injurious behaviors, one being restraint and the other a restraint-free, trauma-informed approach. Studies on the use of restraint have found that it has detrimental emotional and physical effects, along with the risk of injury and death. Emerging research into the use of trauma-informed approaches (TIA) has demonstrated that they can substantially reduce or effectively negate the need for restrictive practices. For the purposes of this qualitative study, participants were in grades six through twelve and had a history with both restraint and the TIA, Ukeru™. All were recruited from one school district in Pennsylvania and took part in face-to-face interviews with the researcher. Resulting themes confirmed previous negative associations with restraint. Conversely, the TIA was described using neutral or positive terms and was deemed a safer option when students recalled experiences. Given the choice between the two, students consistently chose the trauma-informed approach. The results of this study indicate that schools can safely support students in crisis without the use of restraint using a TIA that avoids re-traumatization, increases safety, and maintains connections with staff.

Evidence

The need for a trauma-informed focus for all school staff members is not without precedent. Data collected by The Child & Adolescent Health Measurement Initiative (2017), released a national and state report analyzing the prevalence of trauma across the United States using data collected through the Adverse Childhood Experiences (ACEs) survey. Adverse experiences include: physical, emotional, and/or sexual abuse, physical or emotional neglect, and household dysfunction, including mental illness, domestic violence, divorce, substance abuse, and incarceration. Results indicated that, nationally, 45% of children have been exposed to least one adverse childhood experience, and more than 20% have experienced two or more. For those children with two or more ACEs, the likelihood of the child engaging in school decreases significantly. Moreover, 20% of children with two or more ACES will go on to be identified with an ongoing emotional or behavioral disorder (Bethell, et al, 2019).

In 2018-19, students identified with a disability made up 14% of all learners nationwide and approximately six percent are identified as having an emotional or behavioral disorder (NCES, 2021). The needs of these diverse learners include, at times, supports for aggressive or self-injurious behaviors. Knowing that students with challenging behaviors will be entering the public-school setting, some districts have chosen to train their staff in the use of restraint to help protect staff and students. However, multiple advocacy groups, including the Alliance Against Seclusion and Restraint and Autistic Self Advocacy Network, along with several others, have continued to decry the use of physically restrictive practices in school settings (Murphy, 2021).

The use of restraint undeniably has the potential for harm. Several studies have found that there are multiple student deaths each year due to the use of restrictive practices (Child Welfare League of America, 2000; Buter, 2019; Holden & Nunno, 2019). Physical injury (Holden & Nunno, 2019) and psychological trauma, especially for those students who have a history of abuse from caregivers, are also a real possibility (Butler, 2019). Both staff who have performed restraints and individuals who have been restrained report feelings of sadness, guilt, and fear (Mèrineua-Côtè & Morin, 2014, Morgan, 2012, Hawkins, 2004). In interviewing students in residential facilities who had been restrained, anger was the most commonly reported emotion (Steckley and Kendrick, 2008). A summary of these studies is provided in Table 1.

The use of restraint comes at a cost, both fiscal (Chan, et al, 2012) and emotional (Mèrineua-Côtè & Morin, 2014; Jones & Kroese, 2006; Hawkins, 2004; Steckley and Kendrick, 2008). Steckley and Kedrick posit that in order for there to be a positive relationship between staff and students, “there must be congruence between staff members’ affect, action, and communication of ‘care’” (p. 566, 2008). As districts begin implementing restraint-free, trauma informed systems for supporting students, it seems likely that the risk for psychological traumatization or re-traumatization are less likely to occur (Zee & Fennick, 2019). There is a need to offer a voice to those who are most directly affected by practices put in place in schools, especially those used during crisis situations. In 2020, the Council for Children with Behavioral Disorders noted the lack of research into the psychological effects from students who have been restrained. To date, there has been minimal research that focuses on understanding the perspective and experiences of students with disabilities who have experienced restraint-based interventions and a restraint-free TIA. This research, completed through one on one interviews with students who have direct experience with both types of interventions, reinforces the need to move toward a TIA for all students, and away from restrictive practices like restraint.

Learning Objective 1

Participants will be able to understand how students feel about the use of restraint versus a TIA

Learning Objective 2

Participants will be able to recognize how the use of restrictive practices and TIAs impact relationships between staff and students

Learning Objective 3

Participants will be able to understand how students and staff perceive the safety of restrictive practices versus a TIA

Keyword Descriptors

restraint, restrictive practices, trauma-informed approach, Ukeru, students, public schools, safety, support, crisis, intervention

Presentation Year

2024

Start Date

3-5-2024 2:15 PM

End Date

3-5-2024 2:45 PM

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Mar 5th, 2:15 PM Mar 5th, 2:45 PM

Students’ Perceptions of Crisis Intervention: Using a Trauma Informed Approach Versus Restraint

Session Seven

This presentation reviews first-of-its-kind research that directly interviewed students who have experienced both restraint and a restraint-free trauma-informed approach during crisis. It will review the results of these interviews including students’ understanding of interventions, relationships with staff, and recommendations for schools.