Emergency Prevention
Positive Alternatives and De-escalation Strategies

The focus of this article is on providing tools for all school staff  to effectively prevent the need to use restraint or seclusion as an emergency intervention through the use of positive alternatives and de-escalation strategies. 

When considering the prevention of a school emergency in your school or classroom, it’s important to consider the use of positive alternatives and behavior management techniques,  to support the prevention of problem and dangerous behavior as a primary goal. 

Although not required, it is highly recommended that emergency protocols, crisis prevention strategies and a list of the staff designated to handle restraint and seclusion are provided school-wide to all personnel. Please see “10 Tips for Crisis Prevention” and “LOW and SLOW Communication Strategies” attached at the end of this article.

The likelihood for a school emergency occurring can be greatly reduced by implementing positive alternatives like: high rates of positive feedback, providing instruction of social skills and self-coping strategies, providing clear expectations and rules; and behavior planning. 

When students appear agitated or begin to become escalated before there is a need for restraint or seclusion, staff should utilize de-escalation techniques for example: providing clear and simple choices; using calming strategies; being empathetic; and offering a break in a calm, quiet area. 

Techniques for school-wide and classroom use of positive alternatives 

Frequently, preventive strategies at the school and class-wide levels have been shown to reduce problem behaviors. Thus, before thinking about behavioral challenges specifically related to incidences of restraint or seclusion, it is important for schools to consider school and class-wide approaches for the prevention of problem behavior in general. 

The role of Multi-tiered systems of support (MTSS) such as School-wide Positive Behavioral Interventions and Supports (SWPBIS) in the implementation of positive alternatives

Schools interested in reducing problem and dangerous behaviors should consider adopting evidence-based, school-wide approaches for reducing these behaviors. There are few school-wide approaches with broad scientific evidence related to the reduction of problem behavior in schools. One such framework is School-wide Positive Behavioral Interventions and Supports (SWPBIS). 

SWPBIS has been shown to increase academic engagement and reduce problem behaviors including bullying and victimization and other problem behaviors that lead to office discipline referrals and school suspensions. 

Briefly, SWPBIS includes the following:
•	Creating, teaching, and monitoring 3-5 school-wide expectations
•	Recognizing and reinforcing positive behavior
•	Implementing a discipline system that is clear and consistent for all students 
•	Using a team-based, data-informed approach to improving school-wide discipline systems
•	Administrator (school and district) involvement in the development and implementation of school-wide discipline systems
•	Matching the intensity of problem behavior to the intensity of the intervention (i.e., tiers or levels of support)

Note that the first two features of the PBIS framework fit almost perfectly within the definition of positive alternatives. That is, students should receive instruction on pro-social behaviors and receive high rates of positive feedback (e.g., positive reinforcement).

(used with permission from the National Technical Assistance Center on PBIS)

More information about SWPBIS can be found at the:

•	National Technical Assistance Center on Positive Behavioral Interventions and Supports www.pbis.org
•	Maine Technical Assistance Center on Positive Behavioral Interventions and Supports http://usm.maine.edu/smart/mainetac-behavior/ 

Positive alternatives within classrooms

Within school-wide discipline systems such as SWPBIS, it is also important to consider supports to reduce emergencies in the classroom. In addition to implementing the school-wide features of effective discipline systems (see above) within classrooms, specific methods, strategies, and interventions can be applied within classrooms if students are at risk for problem or dangerous behavior. Below are some positive alternatives that can be employed. Each strategy is accompanied by a description of the strategy, its potential uses, and its limitations. Strategies are organized by the general intensity level of behavior although it is certainly possible that less intensive strategies may work with more intense behavior. This list should not be viewed as exhaustive. Additionally, it is often helpful to utilize multiple strategies simultaneously to reduce the likelihood of an emergency. Furthermore, individual students may respond differently to interventions depending on their own learning history and the school context.

As a best practice school staff are strongly encouraged to consider less intrusive interventions and view level 3 interventions as a “last resort” that may be effective strategies to avoid restraint or seclusion  and still keep all students safe. As a last resort, it is best to use level 3 interventions sparingly as they can be disruptive to instruction. 

A note on language: Any student who is in an escalated state may not be able to process information. Some students may also have disabilities that make comprehending spoken language difficult. Any adult approaching an escalated student should minimize and simplify the use of language. When speaking, slow down your rate of speech, don’t ask a lot of questions or try to reason with the student, keeping your tone firm and neutral. Avoid using complex language that the student may be less familiar with and save consequences or teaching of pro-social behaviors for when the student has returned to a calm state. Once the student has calmed, you can process the situation and provide empathetic comments. 

Interventions	Description	Example/ Illustration	
Level 1:
Preventive interventions when student is calm and engaged in classroom activities
1.	Praise students for expected and positive behavior.
2.	Practice social skills and anger management techniques.
3.	Anticipate, and provide support for transitions and changes to the routine.
4.	Provide clear expectations and rules.	

1.	Providing reinforcement and encouragement for positive behaviors is one of the most effective ways to reduce and prevent problem behavior. Praise that is specific and immediate provides students with feedback on the types of behaviors that will effectively support their learning in classrooms.
2.	Students with effective social and anger management skills may be less likely to experience behavioral difficulties that can result in restraint or seclusion. Thus, direct instruction of these skills to students may be helpful. However, these skills should only be taught when students are calm and open to such suggestions. Attempting to teach social and anger management skills when students are escalated or angry can often be counterproductive. 
3.	Many students experience the greatest amount of behavioral difficulties when transitions (both planned and unanticipated) occur. Thus, many students may benefit from warning of when transitions may be occurring or if scheduled activities are changing.	

1.	“Mikayla, you are doing an excellent job keeping your hands to yourself”
2.	Teaching calming strategies such as deep breathing or social skills that support students to collaboratively solve problems in a non-violent manner may reduce the need for restraint or seclusion.
3.	Provide students with timers that visibly display how long an activity will last or provide verbal reminders periodically (e.g., “in 5 minutes we are going to put away our laptops and open up our math textbooks to begin math.”)
4.	Use picture cues to illustrate the class schedule.	
Level 2:
De-escalation strategies when a student appears agitated or begins to become escalated but not escalated to the point where restraint or seclusion may be appropriate
1.	Provide clear and simple choices.
2.	Calmly restate expectations positively.
3.	Ask student to utilize self-calming strategies.
4.	Respect personal space.
5.	Be aware of body position.
6.	Be empathic.
7.	Permit student to vent.
8.	Ignore challenging questions.
9.	Avoid overreacting
10.	Offer a break in a safe, quiet area.

Please also refer to “10 Tips for Crisis Prevention” 	

1.	The student is given a small number (2 or 3) of choices that are acceptable to both the teacher and student.
2.	The teacher calmly restates what is expected of the student at that particular time or within that particular context. Consider letting go of expectations until the student calms.
3.	Students previously taught calming strategies are prompted to use the strategy.
4.	Invading personal space tends to increase the student’s anxiety.
5.	Standing eye-to-eye and toe-to-toe with a student sends a challenging message.
6.	Try to not judge or discount the feelings of others.
7.	Permit student to release as much as energy as allowable by venting verbally.
8.	Answering challenging questions often results in a power struggle.
9.	Remain calm, rational and professional
10.	The teacher offers the student a break in a safe, quiet area for student to be able to calm and return to regular programming.

Within level two interventions, it is important to note that these are NOT intended to be punishments. Students shouldn’t be forced to do what is expected, use a calming strategy, or take a break as a result of a problem behavior. Although consequences such as punishments may be considered, these interventions should not be considered punishments as the teacher is giving the student the opportunity to engage in more pro-social behaviors in order to reengage in educational activities in a safe, calm manner.
1.	“Sam, we are working on math now. You can complete these five problems or finish the worksheet we were working on yesterday. Which would you like to do?”
2.	“Jill, we are completing our reading now. We are on chapter four. I can help if you need it.”
3.	“Miguel, it looks like you are having a hard time. You might want to try slowly counting backwards from 10 to calm yourself.”
4.	“Beth, it looks like you are upset. Would you like to take a break by sitting quietly by my desk?”	
Level 3:
“Last resort” interventions and considerations for safety when a students is escalated and restraint or seclusion may be considered appropriate
1.	Provide the choice for the student to leave the room voluntarily.
2.	Remove expectation by ending the activity that may be causing the student to become escalated.
3.	Keep a safe physical distance.
4.	Request assistance from trained school staff as per emergency protocols.
5.	Remove other students from the environment.

1.	Ask the student if they would like to take a break. If the student complies with this request, it may indicate that they are able to control their behavior, thus avoiding an emergency.
2.	If the student is escalated because they are finding an academic task problem, allow them to stop the activity and either take a break or engage in a less stressful activity.
3.	If possible, stand at least 1.5 to 3 feet from the escalating student.
4.	Using emergency protocols, contact designated staff trained in restraint and seclusion and de-escalation strategies.
5.	Calmly ask students to leave the room in an orderly fashion.	

1.	“Jackson, it looks like you are frustrated, would you like to leave the room and sit quietly in the hall for a few minutes?”
2.	“Emily, it looks like this science work is really tough for you. Would you like to take a break from it?”
3.	See your school’s emergency protocol
4.	“Class, please stop what you are doing, push your chairs in and line up to go out into the hallway.”	

LOW and SLOW:  Communication and Interaction Strategy 
(adapted) www.thebolickhouse.com
LOW and SLOW refers to a way in which adults approach a student when they are distressed or disregulated (or becoming so). It is based on both the understanding of "fight or flight response" and the function of behavior.  These considerations are designed to potentially help students return to a regulated level.
Best Practice Strategies:
LOW: Lower your body so that your eyes are at or below his eye level. Stay at a safe distance if necessary. Lower your voice—both in volume and in pitch. Keep your tone firm/neutral and lower the complexity of your language. Use as little language as possible to convey your message with understanding. Don’t ask a lot of questions. Don’t try to reason with a student when they’re not able to process information. 
SLOW:  Slow down your rate of speech and pause between sentences. Slow down your movements as students may feel threatened by sudden movement. Assess the situation and adapt the student’s schedule (as well as your expectations) accordingly.
Things to Remember:  Wait to process the situation and/or teach prosocial replacement strategies until the student is regulated and ready to process information. Wait to announce possible negative consequences at this point while the student is still escalated. 
THE NEXT STEP… 
Once the student demonstrates a calm body, you can make objective, empathetic, and descriptive comments (use this as a teaching moment for prosocial behaviors).  If the student attempts to express their perceptions of what’s happened, try to listen and validate their feelings (ie:  “I’m sorry that you felt sad”, or “I could tell that you were really mad”).  If the student is unable to assign language to their feelings (ie: identify their emotional and physical responses as “angry”, “sad”, “nervous”, etc.), help the student identify the feeling.  **If you observe that the student is either still escalated and/or is unavailable to process the message, take a step back. If possible, do the problem solving and talk about consequences at a later time, when the student is calm and able to hear the message. 

10 Tips for Crisis Prevention, Level 2 Strategies 

By using the following tips listed below, you have the best possible chance of preventing a school emergency and providing for the safety of all individuals. 

1. Provide clear and simple choices.

The student is given a small number (2 or 3) of choices that are acceptable to both the teacher and student.

2. Calmly restate expectations positively and consider letting them go.

The teacher restates what is expected student at that particular time or within that particular context. Consider letting go of expectations until the student calms.

3. Ask student to utilize self-calming strategies.

Students previously taught calming strategies are prompted either verbally or through the use of picture cues to utilize self-calming strategies like deep breathing or counting slowly.

4. Respect personal space.

Stand at least 1.5 to three feet from an escalating student. Invading personal space tends to increase the student’s anxiety and may lead to dangerous behavior.

5. Be aware of your body position.

Standing eye-to-eye and toe-to-toe with a student sends a challenging message. Standing one leg length away and at angle off to the side is less likely to escalate the individual.

6. Be empathic.

Try not to judge or discount the feeling of others. Whether or not you think the feelings are justified. Pay attention to them.

7. Permit verbal venting when possible.

Permit the student to release as much energy as allowable by venting verbally. 

8. Ignore challenging questions.

When a student challenges your authority or a school policy, redirect the individual’s attention to the issue at hand. Answering challenging questions often results in a power struggle.

9. Avoid overreacting.

Remain calm, rational, and professional. Your response will directly affect the student’s behavior.

10.  Offer a break in a safe, quiet area

The teacher offers the student a break in a safe, quiet area for student to be able to calm and return to regular programming.

This was adapted from a pamphlet called “10 Tips for Crisis Prevention” by CPI, Crisis Prevention Institute. For more information infor@crisisprevention.com and crisisprevention.com