Discipline and Disability Rights: What to do if Your Child is Being Sent Home

Learning the skills to maintain expected behavior and follow school rules is part of education. All students learn social, emotional and behavioral skills. Students with disabilities may get extra help in these areas of learning. Some have individualized behavior support plans.

When the pre-teaching and interventions fail to stop a behavior from causing a problem, the school might call a parent to say, “Take them home.” What happens next could depend on how well-informed parents are about the rights of students with disabilities.

This video provides key information about what to do if your child is being sent home. The first thing to ask is, “Are they being suspended?” If the answer is yes, the school is required to file specific paperwork. If the answer is no, a parent has choices and may support better long-term outcomes by carefully documenting what happens next.

Below are links to resources referenced in the video:

Behavioral Health and School: Key Information for Families

When a student struggles to maintain well-being, achievement at school can be a challenge. This video provides key information for families to seek school-based services for behavioral health needs. Included are two advocacy statements that this information might empower you to say in a meeting with the school:

  1. “I want to make sure my student’s rights are upheld.”
  2. “I’m providing information and resources to help the school follow the law and educational best practices.”

Included in the video is information about truancy and a new state law that schools must excuse absences for behavioral health reasons. Also included is information from the federal Office for Civil Rights (OCR), which provided new guidance in summer 2022 about school responsibility to help instead of discipline students with behavioral health needs.  

PAVE staff cannot provide advocacy or advice. We share information to empower family members and young people who do have legal advocacy rights. You can learn this information and keep in handy when you aren’t sure whether the school is following the law or educational best practices. Please be patient with yourself while you are learning this information. It can feel like a lot! As you learn a little bit at a time, you can see how your increasing knowledge shifts options and outcomes for your student.

Here are resources from this training, listed in video order:

What Parents Need to Know when Disability Impacts Behavior and Discipline at School

A Brief Overview

Full Article

Behavior is a form of communication, and children often try to express their needs and wants more through behavior than words. When a young person has a disability or has experienced trauma or other distress, adults and authorities may need to put in extra effort to understand. Missed cues and unmet needs can result in unexpected and sometimes explosive behaviors, which may lead schools to suspend or expel students. Schools are required to address students’ behavioral health needs and limit use of punitive discipline.

Unfortunately, not all students are adequately supported. State data indicate that students with disabilities are disciplined at least 2.5 times more often than non-disabled peers (See WA State Report Card). For students with disabilities who are Black, Indigenous, or People of Color (BIPOC), the numbers are consistently higher within Washington State and nationwide.

By many state and national measures, children’s behavioral health worsened during the pandemic and many children are developmentally behind in social, emotional, and behavioral skills. Governor Jay Inslee on March 14, 2021, issued an emergency proclamation declaring children’s mental health to be in crisis. At the same time, many schools and behavioral health agencies struggle to meet rising demand for services. PAVE provides a toolkit with further information about options for assisting children and young people with behavioral health conditions and ways to advocate for system change in Washington State.

This article provides information about school discipline. Keep in mind that disability rights protect individuals with all disabilities, including behavioral health disabilities. School policies and practices related to discipline may not discriminate against students, regardless of the nature or severity of the disability condition. Federal and state laws require that students with disabilities receive support and individualized instruction to help them meet behavioral expectations (WAC 392-172A-03110).

Federal and state guidance is written for schools and can help families too

This article includes links to various federal and state guidance documents that are written primarily to help school leaders follow laws that protect the rights of students with disabilities. Families and community members can refer to this guidance and work to help ensure that their local schools follow the law. When this does not happen, families and community members can use the dispute resolution process and incorporate federal and state guidance to support their advocacy efforts.

Dispute Resolution options related to IEP process are described in Procedural Safeguards. Dispute Resolution options when there are civil rights issues are described in the Section 504 Notice of Parent Rights. Both links connect to places where these documents are downloadable in various languages.

Key guidance and legal protections

Here are key state and national resources related to school discipline:

Washington State’s Office of Superintendent of Public Instruction (OSPI) provides information about Discipline Procedures for Students Eligible to Receive Special Education Services.

The Office of Special Education Programs (OSEP) within the US Department of Education issued a guidance letter July 19, 2022, that describes federal work underway to improve behavioral supports and reduce use of disciplinary removal nationwide. OSEP’s Dear Colleague Letter includes links to a Q and A document about disciplinary requirements and A Guide for Stakeholders, describing best practices to support behavior.

Also in July 2022, the US Department of Education’s Office for Civil Rights (OCR) issued guidance about the rights of students with behavioral health needs. Available in multiple languages, the downloadable booklet is titled: Supporting Students with Disabilities and Avoiding the Discriminatory Use of Student Discipline under Section 504 of the Rehabilitation Act of 1973.

In a Dear Colleague letter published with OCR’s guidance on July 19, 2022, Catherine E. Lhamon, Assistant Secretary for Civil Rights, calls out problems related to disability discrimination. “An important part of [OCR’s] mission is to ensure that students are not denied equal educational opportunity or subjected to discrimination based on their disabilities, including through the improper use of discipline,” Sec. Lhamon wrote.

Behavior support is part of FAPE

The right to appropriate behavioral supports is part of a student’s right to a Free Appropriate Public Education (FAPE), which requires services and supports designed to meet identified needs so students with disabilities can access what non-disabled students access without individualized services.

OCR’s guidance includes information about what schools must provide to serve FAPE, including the responsibility to offer regular and/or special education, and related aids and services, that “are designed to meet the student’s individual educational needs as adequately as the needs of students without disabilities are met.”

Qualified personnel are required for FAPE: “Schools must take steps to ensure that any staff responsible for providing a student with the services necessary to receive FAPE understand the student’s needs and have the training and skills required to implement the services. A school’s failure to provide the requisite services is likely to result in a denial of FAPE.”

FAPE violations under Section 504 relate to fundamental disability rights. Denial of those rights is considered disability discrimination, which OCR defines as “excluding, denying benefits to, or otherwise discriminating against a student based on their disability, including by denying them equal educational opportunity in the most integrated setting appropriate to their needs.”

Federal framework for student rights

Families can empower themselves to understand these rights and resources and advocate for their students by learning the federal framework for school-based services:

  • Students who receive accommodations and supports through a Section 504 Plan have anti-discrimination protections from the Rehabilitation Act of 1973.
  • Students with an Individualized Education Program (IEP) have Section 504 protections and specific rights and protections from the Individuals with Disabilities Education Act (IDEA).
  • Section 504 protects all students with disabilities within the public school system, including those with Section 504 Plans, those with IEPs, and those with known or suspected disability conditions that make schools responsible to evaluate them. The right to a non-discriminatory evaluation is protected by Section 504 and by IDEA’s Child Find Mandate.
  • Section 504 applies to elementary and secondary public schools (including public charter schools and state-operated schools), public school districts, State Educational Agencies (OSPI is the SEA for WA State), and private schools and juvenile justice residential facilities that receive federal money directly or indirectly from the Department of Education. Private schools that do not receive federal funding are not bound by IDEA.
  • Title VI of the Civil Rights Act of 1964 prohibits discrimination based on race, color, or national origin. According to its July 2022 guidance, OCR can investigate complex complaints: “OCR is responsible for enforcing several laws that prohibit schools from discriminating based on disability; race, color, or national origin; sex; and age. A student may experience multiple forms of discrimination at once. In addition, a student may experience discrimination due to the combination of protected characteristics, a form of discrimination often called intersectional discrimination. Some instances of intersectional discrimination may stem from a decisionmaker acting upon stereotypes that are specific to a subgroup of individuals, such as stereotypes specific to Black girls that may not necessarily apply to all Black students or all girls. When OCR receives a complaint alleging discrimination in the use of discipline under more than one law, OCR has the authority to investigate and, where appropriate, find a violation under any law in its jurisdiction.” [emphasis added]
  • Contact the Office for Civil Rights (OCR) at OCR@ed.gov or by calling 800-421-3481 (TDD: 800-877- 8339).

What is exclusionary discipline?

Any school disciplinary action that takes a student away from their regularly scheduled placement at school is called exclusionary discipline. Out-of-school suspensions, expulsions, and in-school suspensions count. Shortened school days and informal removals—like when the school calls parents to have a child taken home for their behavior—are forms of exclusionary discipline unless there is a school-and-family meeting in which an alternate placement or schedule is chosen to best meet the needs of the student. 

If such a meeting does take place, the school and family team are responsible to make decisions about program and placement that are individualized. Schools may not unilaterally decide, for example, that all students with certain behavioral characteristics should attend a specific school or program. According to OCR, “A school district would violate Section 504 if it had a one-size-fits-all policy that required students with a particular disability to attend a separate class, program, or school regardless of educational needs.”

Seclusion and restraint may not be used as punishment

Seclusion (also called isolation) and/or restraint are emergency responses when there is severe and imminent danger. Federal guidance emphasizes that these practices may never be used as punishment or discipline:

“OSEP is not aware of any evidence-based support for the view that the use of restraint or seclusion is an effective strategy in modifying a child’s behaviors that are related to their disability. The Department’s longstanding position is that every effort should be made to prevent the need for the use of restraint or seclusion and that behavioral interventions must be consistent with the child’s rights to be treated with dignity and to be free from abuse.”

More information about isolation and restraint is included later in this article.

Exclusionary discipline may violate FAPE, including for students not yet receiving services

A student with an identified disability may be suspended for a behavioral violation that is outlined in district policy. The student “code of conduct” usually explains what it takes to get into trouble.

Schools are limited in their ability to exclude students from school because of behaviors that “manifest” (arise or express) from disability. Federal and state guidance is for schools to suspend students only if there are significant safety concerns.

If a student with disabilities has unmet needs and is consistently sent home instead of helped, the school may be held accountable for not serving the needs. According to OCR, disability discrimination can include instances when there is reasonable suspicion that a disability condition is impacting behavior, but the student is not properly evaluated to see if they are eligible for services and what services they may need.

The right to evaluation is protected by Child Find, which is an aspect of the IDEA, as well as Section 504 of the Rehabilitation Act of 1973. OCR guidance includes information that schools may need to train or hire experts to meet federal requirements: “To ensure effective implementation of its evaluation procedures, a school may need to provide training to school personnel on when a student’s behaviors, or other factors, indicate the need for an evaluation under Section 504.”

A student with a disability that impacts their learning is entitled to FAPE. Again, FAPE stands for Free Appropriate Public Education. FAPE is protected by Section 504 and by IDEA. FAPE is what a student with disabilities is entitled to receive and what schools are responsible to provide.

OCR provides these places to look for data demonstrating a need to evaluate and determine whether a student is entitled to the rights and protections of FAPE:  

  • Information or records shared during enrollment
  • Student behaviors that may harm the student or another person
  • Observations and data collected by school personnel
  • Information voluntarily provided by the student’s parents or guardians
  • The school’s own disciplinary or other actions indicating that school personnel have concerns about the student’s behavior, such as frequent office referrals, demerits, notes to parents or guardians, or use of restraints or seclusion
  • Information that a previous response to student behavior by school personnel resulted in repeated or extended removals from educational instruction or services, or that a previous response (such as a teacher’s use of restraints or seclusion) traumatized a student and resulted in academic or behavioral difficulties

Schools are required to take assertive action to evaluate a student and/or reconsider the services plan if the student is consistently missing school because of their behavior. OCR guidance clearly states that schools cannot use resource shortages as a reason to deny or delay an evaluation:

“OCR would likely find it unreasonable for a district to delay a student’s evaluation because it does not have sufficient personnel trained to perform the needed assessments and fails to secure private evaluators to meet the need. In addition, the fact that a student is doing well academically does not justify the school denying or delaying an evaluation when the district has reason to believe the student has a disability, including if the student has disability-based behavior resulting in removal from class or other discipline (e.g., afterschool detentions).”

Parents can request an evaluation any time

OCR’s guidance states that parents can request an evaluation at public expense any time. “Section 504 does not limit the number of evaluations a student may reasonably request or receive. The student’s parent or guardian is entitled to notice of the school’s decision and may challenge a denial of their request under Section 504’s procedural safeguards.”

Despite a parent’s right to request an evaluation, the school is responsible to evaluate a child if there is reason to believe a disability is disrupting education: “While parents or guardians may request an evaluation, and schools must respond to any such requests, the responsibility to timely identify students who may need an evaluation remains with the school.”

Procedural Safeguards include detail about the evaluation process and the right to an Independent Educational Evaluation (IEE) if the district’s evaluation is incomplete or if parents disagree with its conclusions or recommendations.

Manifestation Determination

Schools are required to document missed educational time and meet with family to review the student’s circumstances. These requirements are related to the provision of FAPE (Free Appropriate Public Education) for students with disabilities. If the time a student with disabilities is removed from their academic placement for discipline adds up to 10 days, the school is required to host a specific meeting called a Manifestation Determination.

OCR guidance states that discussion about what happened and what to do next must be made by a team of people knowledgeable about the student’s needs and disability: “If a single person, such as a principal who is in charge of the school’s general disciplinary process for all students, alone determined whether a student’s behavior was based on the student’s disability, such a unilateral decision would not comply with Section 504.”

The Manifestation Determination requirement includes informal or “off book” removals from school. For example, if the school calls and directs parents to take a child home because of behavior, that missed educational time counts toward the 10 days. Parents can request paperwork to document the missed time to ensure compliance with this requirement. OCR guidance includes this statement:

“OCR is aware that some schools informally exclude students, or impose unreasonable conditions or limitations on a student’s continued school participation, as a result of a student’s disability-based behaviors in many ways, such as:

  • Requiring a parent or guardian not to send their child to, or to pick up their child early from, school or a school-sponsored activity, such as a field trip;
  • Placing a student on a shortened school-day schedule without first convening the Section 504 team to determine whether such a schedule is necessary to meet the student’s disability-specific needs;
  • Requiring a student to participate in a virtual learning program when other students are receiving in-person instruction;
  • Excluding a student from accessing a virtual learning platform that all other students are using for their instruction;
  • Informing a parent or guardian that the school will formally suspend or expel the student, or refer the student to law enforcement, if the parent or guardian does not: pick up the student from school; agree to transfer the student to another school, which may be an alternative school or part of a residential treatment program; agree to a shortened school day schedule; or agree to the use of restraint or seclusion; and
  • Informing a parent or guardian that the student may not attend school for a specific period of time or indefinitely due to their disability-based behavior unless the parent or guardian is present in the classroom or otherwise helps manage the behavior (e.g., through administering medication to the child).

“Depending on the facts and circumstances, OCR could find that one or more of these practices violate Section 504.”

Under Section 504, schools are bound to consider disability-related factors through Manifestation Determination if the disciplinary removal is for more than 10 consecutive school days or when the child is sub­jected to a series of removals that constitute a pattern. For state-specific information, OSPI provides a guidance form for Section 504 circumstances.

For a student with an IEP, removal from regularly scheduled classes for more than 10 days per school year constitutes a “change of placement” and a Manifestation Determination meeting is held to determine whether the disciplinary removals resulted from the school’s failure to implement the IEP. OSPI provides a guidance form for IEP circumstances.

Note that Manifestation Determination is a distinct process for students with known or suspected disabilities and is separate from general education disciplinary hearings or procedures. Under federal requirements (IDEA Sec. 300.530 (e)), the behavior must be determined to manifest from disability if the IEP Team determine that the behavior was:

  1. Caused by, or had a direct and substantial relationship to, the student’s disability
  2. The direct result of the school’s failure to implement the IEP, including situations where the child did not consistently receive all services required by their IEP

A behavior support plan is best practice

During a Manifestation Determination meeting, a student’s circumstances and services are reviewed. An IEP can be amended to provide additional support and a Functional Behavioral Assessment is planned to gather information for a Behavior Intervention Plan (BIP). If the student has a BIP that isn’t working, the plan can be changed. See PAVE’s video: Behavior and School: How to Participate in the FBA/BIP Process.

For students without IEP services, a Manifestation Determination meeting can initiate or expedite an educational evaluation in addition to an FBA. If the school district knew or should have known that the student needed special education services and did not initiate an evaluation, Child Find violations may apply.

Family members are included in this process. According to WAC 392-172A-05146, “If the school district, the parent, and relevant members of the student’s IEP team determine the conduct was a manifestation of the student’s disability, the school district must take immediate steps to remedy those deficiencies.”

If the conduct is determined to be unrelated to disability, then school personnel may use general education discipline procedures. The school must still provide any special education services that the student has already been found to need. The IEP team decides the appropriate alternative setting and special education services to meet the student’s needs while suspended.

A shortened school day may be a suspension

If the school reduces a student’s schedule because of difficult-to-manage behaviors, the change could be considered a suspension and the missed educational time could count toward a Manifestation Determination process. OSPI provides this information in a Technical Assistance Paper (TAP #2):

“A decision to shorten a student’s school day in response to a behavioral violation would constitute a suspension under general state discipline regulations (WAC 392-400-025).

“District authorities should not use a shortened school day as an automatic response to students with challenging behaviors at school or use a shortened day as a form of punishment or as a substitute for a BIP [Behavior Intervention Plan]. An IEP team should consider developing an IEP that includes a BIP describing the use of positive behavioral interventions, supports, and strategies reasonably calculated to address the student’s behavioral needs and enable the student to participate in the full school day.”

OSEP’s federal guidance explains that a shortened school day is a disciplinary removal unless the IEP team has explored all options to serve the student with a full day and agreed that a shortened day is the only adequate option so the student can benefit from their Free Appropriate Public Education (FAPE):

“[The] practice of shortening a child’s school day as a disciplinary measure could be considered a denial of FAPE if the child’s IEP Team does not also consider other options such as additional or different services and supports that could enable a child to remain in school for the full school day.”

OCR’s guidance points out that a shortened school day is an example of a significant change of placement, and that placement changes require a re-evaluation process: “Section 504 requires reevaluations on a periodic basis, in addition to a subsequent evaluation before any significant change in placement.”

A school’s decision to keep a student out of school is separate from a student or family decision for the student to stay home to care for their mental health. In 2022, the Washington Legislature passed HB 1834, which establishes a student absence from school for mental health reasons as an excused absence.

Alternative learning options for longer suspensions

If a student’s behavioral violation includes weapons or illegal substances, or causes severe injury, the school can remove the student from their placement for longer than 10 days, regardless of their disability. Those situations are referred to as “Special Circumstances.”

Some Section 504 protections do not apply when a school disciplines a student with a disability because of current drug or alcohol use. According to OCR, “Schools may discipline a student with a disability who is currently engaging in the illegal use of drugs or the use of alcohol to the same extent that the school disciplines students without disabilities for this conduct.”

OCR goes on to say that Section 504 protections apply to students who:

  1. Successfully complete a supervised drug rehabilitation program or are otherwise rehabilitated successfully and no longer engaging in the illegal use of drugs
  2. Are participating in a supervised rehabilitation program and are no longer using
  3. Were erroneously [incorrectly] regarded as engaging in substance use

Under Special Circumstances, a student might shift into an Interim Alternative Educational Setting (IAES) for up to 45 school days, regardless of whether the violation was caused by disability related behaviors. The following information from federal law uses a couple of acronyms not previously defined in this article:

  • SEA is a State Educational Agency (OSPI is the SEA for Washington State)
  • LEA is a Lead Educational Agency, which in our state refers to a school district

Under federal law (34 C.F.R. § 300.530(g)):

School personnel may consider removing a child with a disability from their current placement and placing them in an IAES for not more than 45 school days without regard to whether the behavior is determined to be a manifestation of the child’s disability if the child:

  1. Carries a weapon to or possesses a weapon at school, on school premises, or to or at a school function under the jurisdiction of an SEA or an LEA
  2. Knowingly possesses or uses illegal drugs or sells or solicits the sale of a controlled substance, while at school, on school premises, or at a school function under the jurisdiction of an SEA or an LEA
  3. Has inflicted serious bodily injury upon another person while at school, on school premises, or at a school function under the jurisdiction of an SEA or an LEA

The temporary setting (IAES) is chosen by the IEP team and must support the student’s ongoing participation in the general education curriculum as well as progress toward IEP goals. As appropriate, the student’s behavior is assessed through the Functional Behavioral Assessment (FBA—see below) while they are learning in the alternate setting, so a behavior plan is in place to prevent future problems when the student returns to their regular schedule and classes.

If the school pursues a threat/risk assessment, they are required to safeguard a student’s right to be treated in non-discriminatory ways. According to OCR, “Schools can do so by ensuring that school personnel who are involved in screening for and conducting threat or risk assessments for a student with a disability are aware that the student has a disability and are sufficiently knowledgeable about the school’s FAPE responsibilities so that they can coordinate with the student’s Section 504 [or IEP] team….

“For example, the Section 504 [or IEP] team can provide valuable information about: the nature of the student’s disability-based behaviors and common triggers; whether the student has been receiving behavioral supports, and, if so, the effectiveness of those supports; and specific supports and services that may be able to mitigate or eliminate the risk of harm without requiring exclusion from school.”

Schools are required to support behavior and work with families

Schools are required to provide education and support before resorting to discipline for children who struggle with behavior because of their impairments. According to OCR, “Individualized behavioral supports may include, among other examples: regular group or individual counseling sessions, school social worker services, school-based mental health services, physical activity, and opportunities for the student to leave class on a scheduled or unscheduled basis to visit a counselor or behavioral coach when they need time and space to ‘cool down’ or self-regulate.”

Regardless of whether the student has previously qualified for services, best practice is for the school to conduct a Functional Behavioral Assessment (FBA) following a significant disciplinary action. The FBA is used to develop a Behavior Intervention Plan (BIP), which helps a child learn expected behaviors and prevent escalations. The BIP identifies target behaviors that disrupt learning and calls out “antecedents,” conditions or events that occur first—before the targeted behavior. A BIP supports “replacement” behavior so a student can develop skills for expected learning behaviors.  

Schools are guided by the state to use best practices when evaluating and serving students with special needs. OSPI’s website is k12.wa.us. A page called Model Forms for Services to Students in Special Education has links to downloadable forms schools use to develop IEPs, Section 504 Plans, and more.

Here are links to OSPI’s model forms for:

When a student’s behaviors aren’t working, there’s an opportunity for learning

In addition to a BIP, a student receiving special education services whose behavior impedes their learning may need Specially Designed Instruction (SDI) to support skill-development in an area of education called Social Emotional Learning (SEL). If targeted SEL instruction is needed, the student will have specific IEP goals to support the learning.

Another way that an IEP can support students with behavioral disabilities is through related services. Counseling and other behavioral health supports can be written into an IEP as related services. When included in a student’s IEP as educationally necessary for FAPE, a school district is responsible to provide and fund those services. If they participate in the state’s School-Based Health Services (SBHS) program, school districts can receive reimbursement for 70 percent of the cost of behavioral health services for students who are covered by Medicaid and on an IEP.

All students access behavioral supports when schools use Multi-Tiered Systems of Support (MTSS). Families can ask school staff to describe their MTSS structure and how students receive support through Tier 1 (all students), Tier 2 (targeted groups), and Tier 3 (individualized support). An element of MTSS is Positive Behavioral Interventions and Supports (PBIS), which also supports students across levels of need.

Keep in mind that participation in MTSS does not replace a school’s responsibility to evaluate a student with a known or suspected disability that is impacting their access to education.

PAVE provides resources to support families and schools:

Washington is a local control state

As a local control state, individual school districts determine their specific policies related to disciplinary criteria and actions. According to OSPI, school districts are required to engage with community members and families when updating their discipline policies, which must align with state and federal regulations.

When a student is suspended, the school is required to submit a report to the family and the state. That report must include an explanation of how school staff attempted to de-escalate a situation before resorting to disciplinary removal. OSPI provides information for schools and families related to state guidance and requirements. A one-page introductory handout for parents is a place to begin.

In general, Washington rules:

  • Encourage schools to minimize the use of suspensions and expulsions and focus instead on evidence-based, best-practice educational strategies
  • Prohibit schools from excluding students due to absences or tardiness
  • Require schools to excuse absences related to mental health (HB 1834)
  • Limit use of exclusionary discipline for behaviors that do not present a safety threat
  • Prohibit expulsion for students in kindergarten through grade four (children in that age range cannot be excluded from their classroom placements/suspended for more than 10 cumulative days per academic term)
  • Require schools to provide educational access while a student is suspended or expelled

Schools must provide educational services during a suspension

State law requires that all suspended and expelled students have an opportunity to receive educational services (RCW 28A.600.015). According to the Washington Administrative Codes (WAC 392-400-610) educational services provided in an alternative setting must enable the student to:

  • Continue to participate in the general education curriculum
  • Meet the educational standards established within the district
  • Complete subject, grade-level, and graduation requirements

Guidance related to isolation and restraint

The state has specific rules related to the use of isolation (sometimes called seclusion) and restraint, which are implemented only when a student’s behavior poses an imminent likelihood of serious bodily harm and are discontinued when the likelihood of serious harm has passed. Isolation and restraint are not used as a form of standard discipline or aversive intervention.

In simpler words, isolation and restraint are an emergency action for safety and cannot be used to punish a student. The isolation or restraint ends the moment the safety threat has passed, not after everything is all better.

The Washington State Governor’s Office of the Education Ombuds (OEO) offers an online resource page that details state guidance related to isolation and restraint. Included is this statement:

“Schools in Washington State are not allowed to use restraint or isolation as a form of discipline or punishment, or as a way to try to correct a child’s behavior. Restraint and isolation are only allowed as emergency measures, to be used if necessary, to keep a student or others safe from serious harm. They can continue only as long as the emergency continues.”

School districts are required to collect and report data on the use of restraint and isolation. That data is posted on OSPI’s website as part of the School Safety Resource Library. 

Emergency Response Protocol (ERP)

If emergency responses and/or severe disciplinary actions become frequent, schools might ask the parent/guardian to sign an Emergency Response Protocol (ERP) for an individual student. Families are not required to sign this.

The ERP explains what the school’s policies are related to isolation and restraint and what the training requirements are for staff authorized to conduct isolation and restraint. Parents can request a copy of the district’s general education policies on this topic. The ERP can include a statement about how parents are contacted if the school uses isolation or restraint.

Reporting requirements for disciplinary removal

Schools are required to provide a report to the parent/guardian and to the state any time disciplinary or emergency actions are taken.

The Washington Administrative Code (WAC 392-400-455) describes what is required in a notice to students and parents when a student is suspended or expelled from school:

  • Initial notice. Before administering any suspension or expulsion, a school district must attempt to notify the student’s parents, as soon as reasonably possible, regarding the behavioral violation.
  • Written notice. No later than one school business day following the initial hearing with the student in WAC 392-400-450, a school district must provide written notice of the suspension or expulsion to the student and parents in person, by mail, or by email. The written notice must include:
    • A description of the student’s behavior and how the behavior violated the school district’s policy adopted under WAC 392-400-110;
    • The duration and conditions of the suspension or expulsion, including the dates on which the suspension or expulsion will begin and end;
    • The other forms of discipline that the school district considered or attempted, and an explanation of the district’s decision to administer the suspension or expulsion;
    • The opportunity to receive educational services during the suspension or expulsion under WAC 392-400-610;
    • The student’s and parents’ right to an informal conference with the principal or designee under WAC 392-400-460;
    • The student’s and parents’ right to appeal the suspension or expulsion under WAC 392-400-465, including where and to whom the appeal must be requested;
    • For a long-term suspension or expulsion, the opportunity for the student and parents to participate in a reengagement meeting under WAC 392-400-710
  • Language assistance. The school district must ensure the initial and written notices required under this section are provided in a language the student and parents understand, which may require language assistance for students and parents with limited-English proficiency under Title VI of the Civil Rights Act of 1964.

Reporting requirements for isolation/restraint

The state has similar reporting requirements when a student is isolated or restrained at school. Following are statements from the Revised Code of Washington (RCW 28A.600.485):

“Any school employee, resource officer, or school security officer who uses isolation or restraint on a student during school-sponsored instruction or activities must inform the building administrator or building administrator’s designee as soon as possible, and within two business days submit a written report of the incident to the district office. The written report must include, at a minimum, the following information:

  • The date and time of the incident
  • The name and job title of the individual who administered the restraint or isolation
  • A description of the activity that led to the restraint or isolation
  • The type of restraint or isolation used on the student, including the duration
  • Whether the student or staff was physically injured during the restraint or isolation incident and any medical care provided
  • Any recommendations for changing the nature or amount of resources available to the student and staff members in order to avoid similar incidents”

The RCW also states that school staff “must make a reasonable effort to verbally inform the student’s parent or guardian within 24 hours of the incident and must send written notification as soon as practical but postmarked no later than five business days after the restraint or isolation occurred. If the school or school district customarily provides the parent or guardian with school-related information in a language other than English, the written report under this section must be provided to the parent or guardian in that language.”

Equity work in student discipline is ongoing

A graph that shows disparity in discipline is provided on OSPI’s website, which includes training and materials for schools to support improvements. “Like other states, Washington has experienced significant and persistent disparities in the discipline of students based upon race/ethnicity, disability status, language, sex and other factors,” OSPI’s website states.

“While overall rates of exclusionary discipline (suspension and expulsion) have declined over the last decade, significant disparities persist. These trends warrant serious attention from school districts, as well as OSPI, to work toward equitable opportunities and outcomes for each and every student.”

Summer Daily Activity List – Taking care of YOU!

PAVE has created a suggested list of activities to follow every day this summer. Give yourself grace if you cannot do everything on the list. Nobody is keeping track. Your reward will be a healthy mindset! Type Mindfulness into the search bar on our website to find other articles and videos to support self-care for everyone in the family. 

List of Daily Activities for the Summer Print list on wapave.org

Click to view this list in PDF form

Start the day with a self-care routine – Do all!

  • Eat breakfast
  • Get dressed and take a shower if needed
  • Brush teeth and hair
  • Pick up your room and make your bed
  • Put away four things that are out of place

Take care of your home – Pick one!

  • Help to wash dishes
  • Load /unload the dishwasher
  • Vacuum one room
  • Empty the garbage
  • Do a new chore!

Build your body – Pick one or more!

  • Challenge yourself to do something outside for at least one hour
  • Go for a walk, walk a pet, or draw with sidewalk chalk
  • Help make a yummy healthy meal
  • Play with friends or swing at a nearby park
  • Tired or crabby? Take a nap!

Build your brain

Build your brain – Pick one or more!

  • Do a puzzle, play with Lego bricks, make music
  • Write a story, read a book (at least 1 chapter or 20 minutes)
  • Choose something else creative that you enjoy

Build up others – Pick one or more!

  • Write a letter to a friend or family member
  • Give a compliment
  • Find a small or large way to help someone: a little kindness goes a long way!

Self-Care is Critical for Caregivers with Unique Challenges

  • Self-care is not selfish. Self-care is any activity or strategy that helps you survive and thrive in your life. Without regular self-care, it can become impossible to keep up with work, support and care for others, and manage daily activities.
  • PAVE knows that self-care can be particularly challenging for family members caring for someone with a disability or complex medical condition. This article includes tips and guidance especially for you.
  • For a quick takeaway, here is a short video to inspire self-care today: Self Care for Caregivers.
  • PAVE provides a library with more strategies to cultivate resilience, create calm through organization, improve sleep, and more: Self-Care Videos for Families Series.

Full Article

Raising children requires patience, creativity, problem-solving skills and infinite energy. Think about that last word—energy. A car doesn’t keep going if it runs out of gas, right? The same is true for parents and other caregivers. If we don’t refill our tanks regularly we cannot keep going. We humans refuel with self-care, which is a broad term to describe any activity or strategy that gives us a boost.

Self-care is not selfish! Without ways to refresh, we cannot maintain our jobs, manage our homes, or take care of people who need us to keep showing up. Because the demands of caring for someone with a disability or complex medical condition can require even more energy, refueling through self-care is especially critical for caregivers. This article is for you!

Before you read anymore, try this simple self-care tool called Two Feet, One Breath. Doctors use this one in between seeing patients:

  • Notice your two feet on the ground. Feel the ground and feel your feet under you, with the weight of your body dropping into the ground through your feet. If you don’t stand on two feet, then notice whatever part of your body is connecting you to furniture or the floor.
  • Notice that you are breathing in and imagine that breath starts in your feet (or seated body) and travels all the way to the top of your head.
  • Notice that you are breathing out and imagine that your outbreath goes all the way down and out through your feet (or seated body).

Two Feet, One Breath can become part of every transition in your day: when you get out of bed or the car, before you start a task, after you finish something, or any time you go into a different space or prepare to talk with someone. This simple practice highlights how self-care can become integrated into your day.

Keep in mind: Although a day at the spa might be an excellent idea, self-care doesn’t have to be fancy or expensive to have a big impact!

These practices matter a lot, especially because almost everyone knows or cares for someone with special needs. According to the Centers for Disease Control (CDC), at least 26 percent of the population experiences a disability. The result is widespread compassion fatigue, which is a way to talk about burnout from giving more than you get.

Anyone who isn’t convinced that self-care matters may want to watch a film by National Geographic, Stress, Portrait of a Killer, which includes research data to show how caring for a child with special needs can impact parents (minute 38 includes that report).

Below are some ways to pull on your own oxygen mask first!

Connect with others

Meet up regularly with people who have similar life stressors. The Parent-to-Parent network can help by matching parents with similar interests or by providing regular events and group meetings.

Caregivers of youth who are Deaf or Hard of Hearing (DHH) can connect with other family caregivers at Washington Hands and Voices

For caregivers of young people with behavioral health conditions, there are several family-serving agencies that might provide help and solidarity. Some agencies are listed at the end of this article and in PAVE’s Behavioral Health Toolkit.

Here are additional places to find one another:

  • School
  • Sports teams
  • Community center
  • Special Needs Parent Teacher Association
  • Extracurricular events
  • Online support groups

Get Enough Sleep

The body uses sleep to recover, heal, and process stress. If anxiety or intrusive thinking consistently interrupts sleep, self-care starts with some sleeping preparations:

Move the Body

Moving releases feel-good chemicals into the body, improves mood, and reduces the body’s stress response. Walk or hike, practice yoga, swim, wrestle with the kids, chop wood, work in the yard, or start a spontaneous living-room dance party.

Here is information from the Mayo Clinic about exercise:

  • It pumps up endorphins. Physical activity may help bump up the production of your brain’s feel-good neurotransmitters, called endorphins. Although this function is often referred to as a runner’s high, any aerobic activity, such as a rousing game of tennis or a nature hike, can contribute to this same feeling.
  • It reduces negative effects of stress. Exercise can provide stress relief for your body while imitating effects of stress, such as the flight or fight response, and helping your body and its systems practice working together through those effects. This can also lead to positive effects in your body—including your cardiovascular, digestive and immune systems—by helping protect your body from harmful effects of stress.
  • It’s meditation in motion. After a fast-paced game of racquetball, a long walk or run, or several laps in the pool, you may often find that you’ve forgotten the day’s irritations and concentrated only on your body’s movements.
  • It improves your mood. Regular exercise can increase self-confidence, improve your mood, help you relax, and lower symptoms of mild depression and anxiety. Exercise can also improve your sleep, which is often disrupted by stress, depression and anxiety. All of these exercise benefits can ease your stress levels and give you a sense of command over your body and your life.

Be Mindful

Mindfulness can be as simple as the Two Feet, One Breath practice described at the top of this article. Mindfulness means paying attention or putting your full attention into something.

Focusing the mind can be fun and simple and doesn’t have to be quiet. Here are a few ways to practice that don’t involve a yoga mat or a meditation cushion:

  • Color
  • Work on/wash the car
  • Build something
  • Make art or do a craft project
  • Put together a puzzle
  • Laugh
  • Clean
  • More ideas: Mindful.org

Schedule Time

A day can disappear into unscheduled chaos without some intentional planning. A carefully organized calendar, with realistic boundaries, can help make sure there’s breathing room.

Set personal appointments on the calendar for fun, dates with kids, healthcare routines, and personal “me time.” If the calendar is full, be courageous about saying no and setting boundaries. If someone needs your help, find a day and time where you might be able to say yes without compromising your self-care. Remember that self-care is how you refuel; schedule it so you won’t run out of gas!

One of PAVE’s self-care videos for families is this one: Get Calm by Getting Organized.

Here’s more guidance: calendar.com: Why Stress Management and Time Management go Hand in Hand.

Seek Help

Respite care provides temporary relief for a primary caregiver. In Washington State, a resource to find respite providers is Lifespan Respite. PAVE provides an article with more information:  Respite Offers a Break for Caregivers and Those They Support.

Parents of children with developmental disabilities can seek in-home personal care services and request a waiver for respite care from the Developmental Disabilities Administration (DDA). Here are resources to help with that process:

For parents whose children and youth experience conditions related to behavioral health, PAVE provides a toolkit with resources for navigating crisis systems, medical care, school, and family support networks. Here are some family serving agencies:

Parents of youth who are blind or low vision may seek support from the Washington State Department of Services for the Blind (DSB). Learn from youth at PAVE: My story: The Benefits of Working with Agencies like the Washington State Department of Services for the Blind.

Parents of youth who are Deaf or Hard of Hearing (DHH) can connect with the  Office of the Deaf and Hard of Hearing | DSHS or connect with other family caregivers at Washington Hands and Voices.

Mental Health Education and Support at School can be Critical

A Brief Overview

  • Alarming statistics indicate the pandemic worsened many behavioral health outcomes for young people. Governor Jay Inslee on March 14, 2021, issued an emergency proclamation declaring children’s mental health to be in crisis.
  • President Joe Biden issued a Fact Sheet about the nation’s mental health crisis on March 1, 2022, as part of his State of the Union message. This article includes some of what the president shared about youth impacts.
  • Washington State’s 2021 Healthy Youth Survey confirms that children and youth are struggling to maintain well-being.
  • These outcomes make adolescence a critical time for mental health promotion, early identification and intervention. Read on for information and resources.
  • The emotional well-being of students may be served through Multi-Tiered Systems of Support (MTSS), which provide a structure for schools to provide education and supports related to student well-being schoolwide.
  • Students with high levels of need may access mental health support through the special education system. Emotional Disturbance is a federal category of disability under the Individuals with Disabilities Education Act (IDEA).

Full Article

Alarming statistics indicate that children and young people are in crisis. Governor Jay Inslee issued an emergency proclamation for children’s mental health on March 14, 2021. Data from Washington’s 2021 Healthy Youth Survey confirm the distressing trends:

Seven out of ten students in tenth grade report feeling nervous, anxious, on edge, or cannot stop worrying. Eight percent said they tried suicide within the past year. Almost 40 percent said their feelings were disturbing enough to interrupt their regular activities, and more than 10 percent of students said they didn’t have anyone to talk to about their feelings. According to the Centers for Disease Control and Prevention (CDC), only about half of young people who need behavioral health services get them.

According to the 2021 statewide survey, students with disabilities struggle more than most. Also over-represented are girls, students from lower income households, and students whose gender or sexuality is non-binary. Non-binary refers to more than two things; it’s a term often used when discussing people who identify as Lesbian, Gay, Bi-sexual, Transgender, Queer, or questioning (LGBTQ+). LGBTQ+ youth can seek crisis help and more from The Trevor Project.

“Reports of our children suffering with mental health issues are a worrisome public health concern,” said Umair A. Shah, MD, MPH, Washington’s Secretary of Health. “Mental health is a part of our children’s overall health and well-being. It is imperative that we all continue to work together to fully support the whole child by providing information and access to behavioral health resources to youth and the trusted adults in their lives.”

Concerns are nationwide. On March 1, 2022, President Joe Biden issued a Fact Sheet stating that grief, trauma, and physical isolation during the past two years have driven Americans to a breaking point:

“Our youth have been particularly impacted as losses from COVID and disruptions in routines and relationships have led to increased social isolation, anxiety, and learning loss.  More than half of parents express concern over their children’s mental well-being. An early study has found that students are about five months behind in math and four months behind in reading, compared with students prior to the pandemic.

“In 2019, one in three high school students and half of female students reported persistent feelings of sadness or hopelessness, an overall increase of 40 percent from 2009. Emergency department visits for attempted suicide have risen 51 percent among adolescent girls.”

Mental Health support to students is a statewide priority

Recognizing the unmet needs, Washington State’s 2022 legislature passed a variety of bills to increase support to children and youth with behavioral health conditions. Here are a few examples:

  • HB 1664: Provides funding and incentives for schools to increase numbers of staff who provide physical, social, and emotional support to students. Schools are responsible to report to the state how these funds were used for hiring staff that directly support students and not something else.
  • HB 1800: Requires Health Care Authority (HCA) to build and maintain a website (“parent portal”) to help families seek out behavioral health services. Also supports growth and training requirements for behavioral health ombuds serving youth through the Office of Behavioral Health Consumer Advocacy.
  • HB 1834: Establishes a student absence from school for mental health reasons as an excused absence.
  • HB 1890: Creates an advisory group under the Children and Youth Behavioral Health Work Group (CYBHWG) to build a strategic plan for children, youth transitioning to adulthood, and their caregivers. Also establishes a $200/day stipend (up to 6 meetings per year) for members of the CYBHWG with lived experience who are not attending in a paid professional capacity.

TIP: Family caregivers can get involved in advocacy work!

Here’s another TIP: Families can ask their school who is on site to support students with their mental health needs. Some school districts seek support from an Educational Service District (ESD) to meet student behavioral health needs, so families can also ask whether ESD supports are available. Some ESDs are licensed as behavioral health providers—just ask.

What is MTSS, and why learn this acronym to ask the school about it?

A priority for agencies involved in statewide work is implementation of Multi-Tiered Systems of Support (MTSS). Through MTSS, schools support well-being for all students and offer higher levels of support based on student need. Social Emotional Learning (SEL) is key to MTSS, which creates a structure for positive behavioral supports and trauma-informed interventions.

The Office of Superintendent of Public Instruction (OSPI) is the state educational agency for Washington schools. In its 2021 budget, OSPI prioritized MTSS as part of a plan to Empower all Schools to Support the Whole Child. In January, 2021, OSPI was awarded a five-year, $5.3 million grant from the U.S. Department of Education help districts implement MTSS. As a local control state, Washington districts determine their own specific policies and procedures.

TIP: Families can ask school and district staff to describe their MTSS work and how students are receiving support through the various levels/tiers.

Special Education is one pathway for more help

Students may access mental health support through the special education system. Emotional Disturbance is a federal category of disability under the Individuals with Disabilities Education Act (IDEA). Appropriate support can be especially critical for these students: According to the U.S. Office of Special Education Programs (OSEP), students eligible for school-based services under the ED category are twice as likely to drop out of high school before graduating.

How a student is supported in their life planning could have an impact. PAVE provides a toolkit of information about how to support a student in their preparations for graduation and beyond: School to Adulthood: Transition Planning Toolkit for High School, Life, and Work.

Note that a student with a mental health condition might qualify for an Individualized Education Program (IEP) under the category of Other Health Impairment (OHI), which captures needs related to various medical diagnoses. Other categories that often overlap with behavioral health are Autism and Traumatic Brain Injury (TBI). IEP eligibility categories are described in the Washington Administrative Codes (WAC 392-172A-01035).

In Washington State, the ED category is referred to as Emotional Behavioral Disability (EBD). If the student’s behavioral health is impaired to a degree that the student is struggling to access school, and the student needs Specially Designed Instruction (SDI), then the student may be eligible for an IEP. Keep in mind that academic subjects are only a part of learning in school: Social Emotional Learning (SEL) is part of the core curriculum. 

An educational evaluation determines whether a student has a disability that significantly impacts access to school and whether Specially Designed Instruction (SDI) and related services are needed for the student to receive a Free Appropriate Public Education (FAPE). FAPE is the entitlement of a student eligible for special education services. An IEP team determines how FAPE/educational services are provided to an individual student.

Behavioral health counseling can be part of an IEP

Counseling can be written into an IEP as a related service. When included in a student’s IEP as educationally necessary for FAPE, a school district is responsible to provide and fund those services. School districts can receive reimbursement for most of the cost of behavioral health services for students who are covered by Medicaid and on an IEP. The Health Care Authority provides information about school-based health services for students who are covered by Medicaid and on an IEP.

A student with a mental health condition who doesn’t qualify for an IEP might be eligible for a Section 504 Plan. A disability that impairs a major life activity triggers Section 504 protections, which include the right to appropriate and individualized accommodations at school. Section 504 is an aspect of the Rehabilitation Act of 1973, a Civil Rights law that protects against disability discrimination. Students with IEPs and 504 plans are protected by Section 504 rights.

Behavioral Health encompasses a wide range of disability conditions, including those related to substance use disorder, that impact a person’s ability to manage behavior. Sometimes students with behavioral health disabilities bump into disciplinary issues at school. Students with identified disabilities have protections in the disciplinary process: PAVE provides a detailed article about student and family rights related to school discipline.

Placement options for students who struggle with behavior

IEP teams determine the program and placement for a student. In accordance with federal law (IDEA), students have a right to FAPE in the Least Restrictive Environment (LRE) to the maximum extent appropriate. That means educational services and supports are designed to help students access their general education classroom and curriculum first. If the student is unable to make meaningful progress there because of their individual circumstances and disability condition, then the IEP team considers more restrictive placement options. See PAVE’s article: Special Education is a Service, Not a Place.

If general education is not working, the IEP team is responsible to consider all placement options to find the right fit. There is not a requirement to rule out every “less restrictive” option before choosing a placement that the team agrees will best serve the student’s needs.

Sometimes the IEP team, which includes family, will determine that in order to receive FAPE a student needs to be placed in a Day Treatment or Residential school. OSPI maintains a list of Non-Public Agencies that districts might pay to support the educational needs of a student. Districts may also consider schools that are not listed. Washington State has almost no residential options for students. Schools almost always send students to other states when residential placement is needed.

On May 23, 2022, a Washington affiliate of National Public Radio (KUOW) provided a report about the lack of residential programs in the state and the challenges for families whose students go out of state for residential education: Washington is sending youth in crisis to out-of-state boarding schools; taxpayers pick up the tab.

Residential placement may be necessary because educational needs cannot be served unless medical needs are fully supported. School districts may be responsible in those situations to pay for a residential placement. A precedent-setting court ruling in 2017 was Edmonds v. A.T. The parents of a student with behavioral disabilities filed due process against the Edmonds School District for reimbursement of residential education. The administrative law judge ruled that the district must pay for the residential services because “students cannot be separated from their disabilities.”

Strategies and safety measures for families and teachers

The Healthy Youth Survey is conducted every other year and was delayed from 2020 to 2021 because of the pandemic. Over the years, results are shared along with tips for families and schools. Here are a few considerations built from various data points within the survey:

Hopeful students:

  • Are more interested in schoolwork: Is there a way to make every day at school more connected to what a child cares about?
  • See people who can help: Who are the adults at school that a student can trust and go to for encouragement or guidance?
  • Believe that school is relevant to life: Who is helping the student connect what they are learning now to who they want to become?
  • Are academically successful: Are supports in place to provide adequate help so the student can succeed in learning? Evidence-based instructional strategies are key when students struggle in reading, writing, or math because of learning disabilities, for example.

TIP: Make sure these four topics are part of a school/family discussion when a student is struggling with emotional well-being or behavior that may be impacted by hopelessness.

A 2018 handout includes tips for parents and other adults who support teens who feel anxious or depressed:

  • Bond with them: Unconditional love includes clear statements that you value them, and your actions show you want to stay involved in their lives.
  • Talk with teens about their feelings and show you care. Listen to their point of view. Suicidal thinking often comes from a wish to end psychological pain.
  • Help teens learn effective coping strategies and resiliency skills to deal with stress, expectations of others, relationship problems, and challenging life events.
  • Have an evening as a family where everyone creates their own mental health safety plan.
  • Learn about warning signs and where to get help
  • Ask: “Are you thinking about suicide?” Don’t be afraid that talking about it will give them the idea. If you’ve observed any warning signs, chances are they’re already thinking about it.
  • If you own a firearm, keep it secured where a teen could not access it.
  • Lock up medications children shouldn’t have access to.

A press for school-based services and mental health literacy

Advocacy for direct school-based mental health services and education about mental health topics comes from the University of Washington’s SMART Center. SMART stands for School Mental Health Assessment Research and Training. The SMART center in 2020 provided a report: The Case for School Mental Health. The document includes state and national data that strongly indicate school-based behavioral health services are effective:

“Increased access to mental health services and supports in schools is vital to improving the physical and psychological safety of our students and schools, as well as academic performance and problem-solving skills. Availability of comprehensive school mental health promotes a school culture in which students feel safe to report safety concerns, which is proven to be among the most effective school safety strategies.”

The SMART Center in partnership with the non-profit Chad’s Legacy Project in 2021 established an online Student/Youth Mental Health Literacy Library. Intended for staff at middle and high schools, the library provides resources to help schools choose curricula for mental health education on topics that include Social Emotional Learning, Substance Use Disorder, and Suicide Prevention.

Goals of mental health literacy are:

  • Understanding how to foster and maintain good mental health
  • Understanding mental disorders and their treatments
  • Decreasing Stigma
  • Understanding how to seek help effectively for self and others

TIP: Families can direct their schools to this resource to support development or growth of a mental health education program.

For information, help during a crisis, emotional support, and referrals:  

  • Suicide Prevention Lifeline (1-800-273-TALK): After July 16, 2022, call 988
  • Text “HEAL” to 741741 to reach a trained Crisis Text Line counselor
  • Trevor Project Lifeline (LGBTQ) (1-866-488-7386)
  • The Washington Recovery Help Line (1-866-789-1511)
  • TeenLink (1-866-833-6546; 6pm-10pm PST)
  • Seattle Children’s Hospital has a referral helpline. Families can call 833-303-5437, Monday-Friday, 8-5, to connect with a referral specialist. The service is free for families statewide

Further information on mental health and suicide:  

Family Support

  • PAVE’s Family-to-Family Health Information Center provides technical assistance to families navigating health systems related to disability. Click Get Help at wapave.org or call 800-572-7368 for individualized assistance. Family Voices of Washington provides further information and resources.
  • A Facebook group called Healthy Minds Healthy Futures provides a place to connect with other families.
  • Family caregivers can request support and training from COPE (Center of Parent Excellence), which offers support group meetings and direct help from lead parent support specialists as part of a statewide program called A Common Voice.
  • Washington State Community Connectors (WSCC) sponsors an annual family training weekend, manages an SUD Family Navigator training, and offers ways for families to share their experiences and support one another. With passage of HB 1800 in 2022, WSCC is working with the Health Care Authority to build a statewide website to help families navigate behavioral health services.
  • Family, Youth, and System Partner Round Table (FYSPRT) is a statewide hub for family networking and emotional support. Some regions have distinct groups for young people.

Behavior and School: How to Participate in the FBA/BIP Process

This training has information about how to support a child’s behavior at school. When behavior gets in the way of learning, schools are responsible to figure out what the child is trying to communicate and to teach the child what to do instead.

The process of figuring out why a child is acting out is called a Functional Behavioral Assessment—FBA for short. A Behavior Intervention Plan—BIP for short—is a working document that the school and family build together and review regularly to make sure the child is supported with positive reinforcement and encouragement for meeting behavioral expectations. This training will help you know how to participate in the FBA/BIP process.

Schools are guided by the state to use best practices when evaluating and serving students with special needs. The Office of Superintendent of Public Instruction (OSPI) is the state educational agency in Washington State. OSPI’s website is k12.wa.us. A page called Model Forms for Services to Students in Special Education has links to downloadable forms schools use to develop IEPs, Section 504 Plans, and more.

Here are links to OSPI’s model forms for:

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Sample Letter to Request a Functional Behavioral Assessment

When a student’s behavior gets in the way of their learning and/or the learning of others, the school is responsible to figure out how to support behavioral expectations. One way to do that is to assess why the student might be acting out and use that information to consider how positive behavioral interventions might teach the student what to do instead.

The end of this article includes a sample letter to ask the school to begin a specific evaluation called a Functional Behavioral Assessment (FBA). Data from the FBA is used to build a Behavior Intervention Plan (BIP).

PAVE provides a video training called Behavior and School: How to Participate in the FBA/BIP Process.

Ideally a school will notice if a student’s behavior has patterns of disruption and begin the FBA/BIP process before a student with disabilities is disciplined. PAVE provides an article: What Parents Need to Know when Disability Impacts Behavior and Discipline at School.

A teacher or school administrator might alert parents and request consent to begin an FBA. The Office of Superintendent of Public Instruction (OSPI) is the state agency for Washington schools. OSPI provides guidance about discipline in a Technical Assistance Paper (TAP #2). Included are best practices for schools to follow when there are persistent behavioral concerns:

  • Develop behavioral goals in the Individualized Education Program (IEP)
  • Provide related services needed to achieve those behavioral IEP goals (specific therapies or counseling, for example)
  • Provide classroom accommodations, modifications and/or supplementary aids and supports (a 1:1 paraeducator, for example)
  • Provide support to the student’s teachers and service providers (staff training)
  • Conduct a reevaluation that includes a Functional Behavioral Assessment (FBA)
  • Develop a Behavioral Intervention Plan (BIP), as defined in the Washington Administrative Code (WAC 392-172A-01031

Manifestation Determination

If an FBA process begins after a student has been excluded from school through a disciplinary removal (suspension, expulsion, or emergency expulsion), families can review their procedural safeguards to understand rules related to a special education process called Manifestation Determination.

Here are the basics: When a behavior “manifests” (is directly caused by) a disability condition, then there is recognition that the student has limited fault for violating the student code of conduct. Management of behavior is part of the special education process. A Manifestation Determination meeting is to talk about how a student’s services can better serve their needs to prevent future behavioral episodes that are getting in the way of education.

Students with Individualized Education Programs (IEPs) may not be excluded from their regular educational placement, due to discipline, for more than 10 days in a school year without the school and family holding a Manifestation Determination meeting. According to the Washington Administrative Code (WAC 392-172A-05146),thestudent’s behavior is considered a manifestation of disability if the conduct was:

  • Caused by, or had a direct and substantial relationship to, the student’s disability
  • The direct result of the school district’s failure to implement student’s IEP

When these criteria are met, the school is responsible to review and amend the student’s services to ensure that the behaviors are addressed to prevent future escalations. If there isn’t a BIP, the school is required to develop one by initiating an FBA. If there is a BIP, the school is required to review and amend it to better serve the student’s needs.

Request FBA formally, in writing

Family caregivers can request an FBA/BIP process any time there are concerns that a student’s behavior is a barrier to their education. Families have the right to participate in all educational decision making for their students. See PAVE’s article: Parent Participation in Special Education Process is a Priority Under Federal Law.

Make any request for an evaluation in writing. This is important because:

  1. There will be no confusion about how/when/why request was made.
  2. The letter provides critical initial information about what is going on with the student.
  3. The letter supports a written record of family/school interactions.

If the family wishes, they can attach information from outside providers with their request. For example, if an outside therapist or counselor has recommendations for behavioral interventions at school, the family has the option to share those. The school district is responsible to review all documents and respond with written rationale about how the information is incorporated into recommendations. Families may choose to disclose all, a portion, or none of a student’s medical information. Schools may not require disclosure of medical records.

Family caregivers/guardians must sign consent for any school evaluation to begin.

The FBA/BIP might prevent a shortened school day

According to OSPI, serving a student through a Behavior Intervention Plan (BIP) is a priority. OSPI discourages schools from reducing the student’s schedule because of behaviors:

“District authorities should not use a shortened school day as an automatic response to students with challenging behaviors at school or use a shortened day as a form of punishment or as a substitute for a BIP. An IEP team should consider developing an IEP that includes a BIP describing the use of positive behavioral interventions, supports, and strategies reasonably calculated to address the student’s behavioral needs and enable the student to participate in the full school day.”

Special Education is a service, not a location within the school

Please note that a request for behavioral support is NOT a recommendation to remove a student from the regular classroom and move them into an exclusive learning environment. Federal and state laws require that students eligible for special education services receive their education in the Least Restrictive Environment (LRE) to the maximum extent appropriate.

Special Education is a service, while LRE refers to placement. PAVE’s article provides further information: Special Education is a Service, Not a Place.

General education classrooms and spaces are the least restrictive. A child may be placed in a more restrictive setting if an IEP team, which includes family participants, determines that FAPE is not accessible even with specially designed instruction, accommodations, modifications, ancillary aids, behavioral interventions and supports, and other documented attempts to support a Free Appropriate Public Education (FAPE) within the general education environment.

If the student was removed from their previous placement prior to a manifestation determination meeting, the school district is responsible to return the student to their placement unless the parent and school district agree to a different placement as part of the modification of the student’s services on their IEP and BIP.

Sample letter to request an FBA

Below is a sample letter family caregivers can use when requesting a Functional Behavioral Assessment (FBA). You can cut and paste the text into your choice of word processing program to help you start a letter that you can print and mail or attach to an email. Or you can build your letter directly into an email format. Be sure to keep a record of all requests and correspondence with the school.

Your Name
Street Address
City, State, Zip
Date

Name (if known, otherwise use title)
Title/Director of Special Education/Special Services Program Coordinator
School District
Street Address
City, State, Zip

Dear Name (if known, otherwise use district person’s title):

I am requesting a Functional Behavioral Assessment (FBA) for my [child, son, daughter], NAME, (BD: 00-00-0000).

I have concerns that (NAME) is not receiving full educational benefit from school because of their struggles to meet behavioral expectations due to their disability circumstances. Their condition includes [brief summary of any diagnoses], which makes it difficult to [brief summary of the challenges]. I believe this has become a pattern of behavior that needs to be addressed with a positive behavioral support plan so my child with special educational needs can receive a Free Appropriate Public Education (FAPE).

I understand that the FBA will look for triggers and seek to understand what is happening in the environment when my child’s behaviors become problematic. I have learned that these are “antecedents” that the school can identify through data tracking. I hope we can begin to understand how [name] may be trying to communicate their needs through these behaviors. Here are some of my thoughts about what might be going on:

  • Use bullet points if the list is long.
  • Use bullet points if the list is long.
  • Use bullet points if the list is long.

I look forward to discussing the results of the FBA and working with school staff on development of a Behavioral Intervention Plan (BIP). I hope we can choose a small number of target behaviors to focus on in the BIP. I understand that we will work together to identify replacement behaviors that the school can teach [name] to do instead. I hope these will be skills we can work on at home also. I look forward to learning how we can partner to encourage the learning that I know [name] is capable of.

I have attached documentation from [any outside providers/therapists/counselors who may have provided letters or reports or shared behavioral recommendations].

I understand that I am an equal member of the team for development of educational services and that I will be involved in any meetings where decisions are made regarding my child’s access to a Free Appropriate Public Education (FAPE). I will also expect a copy of the FBA and a draft of the BIP before our meeting.

I understand you must have my written permission for this assessment to be administered, and I will be happy to provide that upon receipt of the proper forms.

I appreciate your help in behalf of [child’s name]. If you have any questions please call me at [telephone number] or email me at [email address, optional].

Sincerely,

Your Name

CC: (Names and titles of anyone else you give copies to)

You can email this letter or send it by certified mail (keep your receipt), or hand carry it to the district office and get a date/time receipt. Remember to keep a copy of this letter and all school-related correspondence for your records. Get organized with a binder or a filing system that will help you keep track of all letters, meetings, conversations, etc. These documents will be important for you and your child for many years to come, including when your child transitions out of school.

Please Note: PAVE is a nonprofit organization that provides information, training, individual assistance, and resources. PAVE is not a legal firm or legal service agency, and the information contained in this handout is provided for informing the reviewer and should not be considered as a means of taking the place of legal advice that must be obtained through an attorney. PAVE may be able to assist you in identifying an attorney in your area but cannot provide direct referrals. The contents of this handout were developed under a grant from the US Department of Education. The contents do not represent the policy of the US Department of Education and you should not assume endorsement by the Government.

Adolescent Health Care Act Provides Options for Families Seeking Mental Health and Substance Use Help for Young People Resistant to Treatment

A Brief Overview

  • The Adolescent Behavioral Health Care Access Act, passed into law by the Washington Legislature in 2019, gives parents and providers more leverage in treating a young person who will not or cannot independently seek medical help for a behavioral health condition.
  • The Washington State Health Care Authority (HCA) hosts website links with information about the law, which allows Family Initiated Treatment (FIT). The landing page includes an email address: hcafamilyinitiatedtreatment@hca.wa.gov.
  • Access to FIT is a topic of the state’s Children and Youth Behavioral Health Work Group. CYBHWG supports several sub-work groups, including one focused on school-based services and suicide prevention. Information about group membership, public meetings, resources, events and training is available on the HCA website.
  • If a person ages 15-40 is newly experiencing psychosis, Washington offers a wraparound-style program called New Journeys. This website link includes access to a referral form.

Full Article

Getting mental health help for a youth in crisis can be complicated, frustrating, and frightening.

Mental Health America ranks states based on the incidence of mental illness and access to services. The 2022 youth rankings list Washington 39th in the nation. Various measures indicate a high prevalence of major depression, substance use disorder, and/or emotional disturbance as a category of disability on the Individualized Education Program (IEP). Barriers to treatment consider insurance as well as availability of services.  

Sometimes a barrier to treatment involves a complicated balance of youth autonomy and parental responsibility. The most severe psychiatric conditions often include a symptom called anosognosia, which blocks the brain’s ability to see the impairment or understand why professional help could be of benefit. In youth whose brains are still forming, symptoms that impact insight and choice-making are particularly problematic.

New Journeys is an option when psychosis is present

Sometimes anosognosia co-occurs with psychosis, which indicates a person has lost touch with reality. Delusions and hallucinations may be present. If a person is newly experiencing psychosis, Washington offers a wraparound-style program called New Journeys: This link provides access to information for clients and families and includes an online referral form.

Causes of psychosis are the subject of ongoing research, but some theories suspect the brain is trying to make sense out of a world that does not make sense. Synapses fire errantly, and the brain tries to organize them into stories to calm itself. Synaptic loops get built during these firestorms of neural activity, and the stories that emerge become reality to the person whose brain is narrating the experience, even if they are untrue or grounded in false perceptions. Choice-making in the empirical world is often compromised.

Family education about psychosis is an aspect of New Journeys, which is for youth and adults ages 15-40 who have experienced psychotic symptoms for more than or equal to 1 week and less than or equal to 2 years. Staff from the University of the Washington contribute support to the state’s New Journeys program, which is offered in various but not all regions of the state.

University staff also support a program called Psychosis REACH, which provides evidence-based skill-building for relatives and friends of individuals with psychotic disorders. The practices are based in cognitive behavioral therapy (CBT). The program’s website includes information about training opportunities and resources.

Age of Consent in Washington is 13

In Washington State, the age of medical consent is 13. That means that a person 13-17 years old can independently seek medical treatment, without the consent or knowledge of parents.

Age of consent laws also have meant that Washington youth could say no to behavioral health treatment, regardless of whether parents and providers agreed that such treatment was necessary to protect the safety and well-being of the adolescent. Exceptions are made when there is a threat of imminent danger or grave disability due to psychiatric deterioration. Read on for more information about involuntary treatment/commitment.

The Adolescent Behavioral Health Care Access Act, passed by the Washington legislature in 2019, gives parents and providers more leverage when a young person is struggling with behavioral health and does not independently engage with treatment. The law allows parents/caregivers to bring a youth, ages 13-17, to a provider for evaluation without requiring consent from the youth.

The law includes elements introduced by the state Senate and House of Representatives, which originally titled the bill as HB 1874. In 2020, passage of HB 2883 added residential treatment as an additional option under Family Initiated Treatment (FIT).

The law does not limit an adolescent’s ability to initiate treatment on their own.

Parents have felt shut out of their teenager’s care

January 8, 2020, article in Crosscut profiles several families impacted by the new law. “Until the new law,” the article states, “parents often were shut out of their teenager’s care and treatment plans and couldn’t push a teen toward necessary outpatient or inpatient care without their consent.”

Passage of FIT marks a win for the Children and Youth Behavioral Health Work Group, which studied and reviewed recommendations from a stakeholder advisory group authorized by the 2018 legislature. Final language in the law was impacted by family members, youth, clinicians, hospital staff and many others who met dozens of times.

“Parent” is broadly defined, and information sharing is more open

Under the law, the definition of parent is expanded to include a wide range of family caregivers, guardians and others who have authority to initiate treatment. The Revised Code of Washington (RCW 9A.72.085) provides standards for “subscribing to an unsworn statement” that can apply to a caregiver initiating treatment. 

The law enables providers to share information with parents without an adolescent’s consent, if the provider determines that information sharing with family is in the best interests of the adolescent patient. A list of information-sharing guidelines is included below.

Note that parents retain the right to make medical decisions for children younger than 13, and adults 18 and older are responsible for medical decision-making if there is no guardianship.

In accordance with RCW 71.34.375, providers are required to provide notice to parents of all available treatment options, including Family Initiated Treatment. The state Health Care Authority provides a fact sheet to clarify those requirements.

Family-Initiated Treatment (FIT)

The FIT law allows a parent/caregiver to escort their adolescent child to certain licensed behavioral health facilities and request that a professional person examine the adolescent to determine whether treatment is medically necessary. That treatment might include outpatient, inpatient, or residential care.

According to the Health Care Authority (HCA), FIT is not a guarantee of immediate services, and no provider is obligated to provide services under FIT. Each provider has processes, procedures, and requirements pertaining to evaluation and admission to services. However, the only reason for not providing services cannot be the youth’s lack of consent (RCW 71.34.600).

If a facility covered by this law does not have a professional person available to perform the examination, the facility is not required to make staff available on demand. Additionally, if the professional determines the adolescent needs in-patient treatment but the facility does not have a bed available, the facility is not required to make a bed available. Included are those facilities that house children and youth under the Children’s Long-term Inpatient Program (CLIP). CLIP beds are generally subject to a waiting list and a multi-step referral process.

According to staff at Washington’s Health Care Authority, staffing shortages and other limitations within the behavioral health system have slowed implementation of the law. Families are encouraged to contact providers before taking an adolescent to a facility to determine if the provider has the capacity or ability to perform an assessment.

FIT in a community setting

If medical necessity is found by an outpatient provider who evaluates a young person brought into care through FIT, the provider is limited to 12 sessions over 3 months to attempt to work with the adolescent. If the young person still refuses to engage with treatment, then the period of Family-Initiated Treatment with that provider ends. The family at that point could seek treatment elsewhere.

State laws continue to encourage autonomy for young people, despite recognition that family involvement is important. According to the Revised Code of Washington (RCW 71.34.010):

 “Mental health and chemical dependency professionals shall guard against needless hospitalization and deprivations of liberty, enable treatment decisions to be made in response to clinical needs in accordance with sound professional judgment, and encourage the use of voluntary services. Mental health and chemical dependency professionals shall, whenever clinically appropriate, offer less restrictive alternatives to inpatient treatment. Additionally, all mental health care and treatment providers shall assure that minors’ parents are given an opportunity to participate in the treatment decisions for their minor children.”

For children and youth eligible for Apple Health, Wraparound with Intensive Services (WISe) is Washington’s most intensive outpatient treatment. PAVE provides an article: WISe Provides Team-Based Services for Washington Youth with Severe Behavioral Health Disorders.

The Health Care Authority (HCA) maintains a website page with information about WISe in multiple languages. Families can discuss their options for FIT with WISe staff and HCA leadership.

FIT in a hospital setting

An inpatient or residential facility can detain the adolescent under Family-Initiated Treatment (FIT) if medically necessary for a mental health condition. In these settings, FIT may last up to 30 days. Then the adolescent must be discharged, unless:

  • they agree to stay voluntarily, or
  • a designated crisis responder (DCR) initiates involuntary commitment proceedings

What is required for involuntary treatment?

The Involuntary Treatment Act (ITA) can apply to persons of any age who are determined to be gravely disabled or at imminent risk of harm to self, others, or property. Under Ricky’s Law, community members of any age who are a danger or gravely disabled due to a drug or alcohol problem may be involuntarily detained to a secure withdrawal management and stabilization facility—also known as secure detox.

For substance use disorder treatment, due to Federal Privacy Laws, a parent/caregiver can only provide consent for an assessment. The youth would have to consent to the results of the assessment being shared with their parent/caregiver and volunteer for ongoing treatment if it is deemed medically necessary.

Guidance for Information Sharing

Federal law, 42 CFR Part 2, restricts information sharing related to substance use, and clinicians cannot share that information without a patient’s written consent, regardless of whether the substance use co-occurs with mental illness.

Providers have discretion in determining what information about mental health diagnoses and treatment is clinically appropriate to share with parents of an adolescent 13-17. A provider retains discretion in withholding information from family/caregivers to protect an adolescent’s well-being. In general, however, the Adolescent Behavioral Healthcare Access Act encourages sharing information to support collaboration between the clinical setting and home. Specifically, providers and families are encouraged to discuss:

  • Diagnosis
  • Treatment Plan and Progress
  • Recommended medications, including risks, benefits, side effects, typical efficacy, dosages, and schedule
  • Education about the child’s mental health condition
  • Referrals to community resources
  • Coaching on parenting or behavioral management strategies
  • Crisis prevention planning and safety planning

To support family caregiving for individuals of all ages, the Washington State Hospital Association provides general guidance about exceptions to federal confidentiality laws (HIPAA): Permitted disclosures of mental health information and substance use disorder information without patient consent.

Family Support

For individualized, non-emergency support, please click Get Help and someone from PAVE will contact you. Family Voices of Washington, PAVE’s Family-to-Family Health Information Center, is another place for information and resources.

In addition to PAVE, here are places for family support:

  • COPE (Center of Parent Excellence) offers support group meetings and direct help from lead parent support specialists as part of a statewide program called A Common Voice.
  • Family, Youth, and System Partner Round Table (FYSPRT). Regional groups are a hub for family networking and emotional support. Some have distinct groups for young people.
  • Washington State Community Connectors (WSCC) sponsors an annual family training weekend, manages an SUD Family Navigator training, and offers ways for families to share their experiences and support one another. With passage of HB 1800 in 2022, WSCC is working with the Health Care Authority to build a statewide website (Parent Portal) to help families navigate behavioral health services.
  • Healthy Minds Healthy Futures is an informal network of family caregivers on Facebook. The group advocated for Family Initiated Treatment (FIT) and is part of the work to build the Parent Portal website.

Additional Resources

The  Health Care Authority (HCA) provides a range of information about behavioral health services for children and youth, including this downloadable resource: Parent’s Guide to Family Initiated Treatment.

Families can direct specific questions to: hcafamilyinitiatedtreatment@hca.wa.govPlease note that this business email is not intended for crisis response.

An agency called CaseText organizes links related to Family Initiated Treatment for direct access to various statutes.