Tips for Parents: Summer Provides Time to Reinforce Positive Behaviors at Home

A Brief Overview

  • A tidal wave of emotional meltdowns can douse a family during summer break. Read on for tips to create a positive home environment that encourages expected behaviors.
  • A key concept from Positive Behavioral Interventions and Supports (PBIS) is that punishment doesn’t teach children and youth what they should do instead. Adults can direct a child toward a better choice of actions or interrupt an escalation cycle.
  • The easiest way to change a behavior is to point out what a person does right.
  • Parents might find success with strategies they can share with school in the fall!

Full Article

Summertime brings relief and grief in different measures for families. Taking a break from school can mean more time to sleep in, take a vacation or simply daydream. Still, a change in routine can disrupt some children who prefer days that are all the same amount of busy—and disruption can lead to dysregulation. A few strategies, described below, might help smooth troubled waters. In addition, parents might find success with strategies they can share with the school in the fall!

Experts in education are excited about a framework for creating a positive environment with Positive Behavioral Interventions and Supports (PBIS). Currently a popular topic for webinars and in-service trainings nationwide, PBIS has been implemented in more than 26,000 U.S. schools. The PBIS framework has been shown to decrease disciplinary removals and improve student outcomes, including grades and graduation rates. When done well, PBIS provides positive social skills, communication strategies and “restorative justice,” (working it out instead of punishing) and may prevent 80-90 percent of problem behaviors.

Punishment doesn’t teach

PBIS requires an understanding that punishment doesn’t help a child know what to do instead. Researchers have learned that a child who is being punished enters an emotionally dysregulated state (fight/flight/freeze) that blocks learning. Adults who calmly direct a child toward a new way of problem-solving can interrupt or prevent an escalation. De-escalation strategies might include:

  • Remove what is causing the behavior
  • Get down to eye level
  • Offer empathy—the ability to understand and share the feelings of another
  • Provide choices
  • Re-teach expectations
  • Reinforce desired behaviors
  • Communicate care instead of control

Simple, consistent, predictable language is a critical component. Insights about these strategies and more were shared in a webinar by Change Lab Solutions on April 30, 2019.

Among experts talking about PBIS are staff at the University of Washington’s School Mental Health Assessment, Research and Training (SMART) Center, where staff lead the School Mental Health supplement of the Northwest Mental Health Technology Transfer Center (NWMHTTC). These agencies, in collaboration with the League of Education Voters, in June 2019 hosted a webinar: How to Implement Mental Health Supports in Schools, focused on the importance of blending school and community supports with PBIS.

A University of Washington (UW) expert who participated in the webinar is Kelcey Schmitz, a former OSPI staff member who has written articles for PAVE about positive behavior supports and state initiatives and has experience helping families and schools implement PBIS.

“PBIS is a game changer for children and youth with behavior challenges and their teachers and caregivers,” Schmitz says. “In fact, everyone can benefit from PBIS. Behavior is a form of communication, and PBIS aims to reduce problem behavior by increasing appropriate behavior and ultimately improving quality of life for everyone. The same approaches used by schools to prevent problem behaviors and create positive, safe, consistent and predictable environments can be used by families at home.”

Schmitz, an MTSS training and technical assistance specialist, provides the following specific tips for creating a PBIS home environment to create fun, surfable days instead of emotional tidal waves.

Tier 1: Support Positive Behavior before there’s a problem

First, it’s helpful to understand the structure of PBIS, which is set up with three layers—called tiers—of support. The parent-child relationship is strengthened by loving and positive interactions at each tier.

Tier 1 support is about getting busy before there’s a problem. Much like learning to wash hands to prevent getting sick, expected behavior is taught and modeled to prevent unexpected behaviors.  Parents can take a look at their own actions and choices and consider what children will see as examples of being respectful, responsible and safe.

Tiers 2 and 3 are where adults provide a little more support for specific behaviors that are getting in the way of relationships or how the child or youth functions. Tier 2 is for students who need a social group or some extra teaching, practice and reinforcement. 

Tier 3 supports include conducting a functional behavior assessment to find out why the behavior is occurring and then matching the student’s needs to an individualized intervention. Any student should be able to access supports that include aspects of Social Emotional Learning at all three Tiers. At home, Tiers 2 and 3 naturally will be more blended and may include support from a community provider. Note that targeted interventions in Tiers 2-3 work best when Tier 1 is already well established.

Define, teach and routinely acknowledge family expectations

  • Discuss how you want to live as a family and identify some “pillars” (important, building-block concepts) that represent what you value. Talk about what those pillars look like and sound like in every-day routines. To help the family remember and be consistent, choose only 3-5 and create positive statements about them. Here are a few examples:
    • Speak in a respectful voice.
    • Be responsible for actions.
    • Be safe; keep hands, feet and objects to self.
  • Identify a couple of “hot spots” to begin. Challenging behaviors often occur within routines.  Perhaps mornings or mealtimes create hot spots for the family. After discussing 1-2 ways to be respectful, responsible and safe in the morning, teach what each looks like. Have fun with it! Set up “expectation stations” for practicing the plan and assign each family member one pillar to teach to the rest.
  • Behaviors that get attention get repeated. Notice when a child does the right thing and say something about each success: “I noticed you stopped to pick up your shoes in the hallway. Thanks for putting them away and keeping the walkway safe for others.” The easiest way to change a behavior is to point out what a person does right!
  • Remember this catchy phrase, “5:1 gets it done” to ensure five positive interactions for each negative interaction. When the expected behavior becomes routine, the reinforcement can fade away.

Create engaging and predictable routines

  • Children crave structure and routine. Adults may look forward to a relaxing evening or weekend, but kids often need regular activity and engagement. Consider that either the kids are busy, or the adults are busy managing bored kids!
  • Use visuals to create predictability. A visual schedule can display major routines of the day with pictures that are drawn, real photos or cut-outs from magazines. Create the schedule together!  Parents can ask a child to check the schedule – especially when moving from a preferred to non-preferred activity. It’s hard to argue with a picture!

Set the stage for positive behavior

  • Teach, pre-teach and re-teach. Children need to learn behavior just like they learn colors and shapes. A quick reminder can help reinforce a developing skill: “When we get in the car, sit up, buckle up, and smile!”
  • Give transition warnings or cues to signal the end of one activity and the beginning of another: “In five minutes, it will be bath time.”
  • First/then statements set up a child for delayed gratification: “First take your bath; then we can play dolls.”
  • Focus on Go instead of Stop. Children often tune out words like No, Don’t and Stop and only hear the word that comes next, which is what an adult is trying to avoid. Tell a child what to do instead of what not to do: “Take your plate and put it in the sink.” Save Stop and No for dangerous circumstances that need a quick reaction.  
  • Choices prevent power struggles: “Would you rather play for five more minutes or get in the bath now?”  “Feel free to choose the pink pajamas or the green ones.”

While these strategies may not eliminate all problem behaviors, they create consistency, predictability and a more positive atmosphere. They teach new skills to help children get their needs met. The solid foundation will help even if challenging behaviors persist by creating a bedrock for additional layers of support.  

Here are places to seek additional information:

Parenting with Positive Behavior Support: A Practical Guide to Resolving Your Child’s Difficult Behavior 

Home and Community Based Positive Behavior Support Facebook Page

Home and Community PBS Website

Parent Center Hub Positive Behavior Supports Resource Collection

Intensive Intervention: An Overview for Parents and Families

The Association for Positive Behavior Support

Getting Behavior in Shape at Home

Family Resources for Challenging Behavior

The National Center for Pyramid Model Innovations (NCPMI) Resource Library, articles in multiple languages

Ideas and Resources to Support Your Child’s Behavior at School

A Brief Overview

  • Behavior specialists generally agree that difficult behaviors arise from unmet needs. How adults respond is critical if a child is going to learn new ways to communicate.
  • Humans spend about 80 percent of their brain energy trying to belong. This can explain a lot when a child with a disability feels isolated or unwanted and starts to act out.
  • Positive Behavior Interventions and Supports (PBIS) is a framework that a growing number of schools nationwide are using to improve school climate, which refers to the way a school feels to students and staff.
  • Members of the U.S. Congress discussed PBIS on February 27, 2019, when a committee heard public testimony regarding a bill that would regulate use of isolation and restraint in public schools. Positive behavior interventions are considered “protective” by behavior experts, and there is evidence that isolation and restraint cause trauma.
  • Read on for questions families can consider when they are trying to understand what’s happening with a child and how to intervene for the best outcomes.

Full Article

Families and teachers often struggle to figure out what to do when a child’s behavior at school is getting in the way of learning.  How adults respond to unexpected behavior can impact whether an incident leads down a path of worsening problems or toward improved learning. Parents can help by understanding as much as possible about what the child might be trying to communicate or overcome.

“Difficult behaviors result from unmet needs,” says David Pitonyak, PhD, an educational consultant, author and public speaker who specializes in behavior supports for children with disabilities. Pitonyak speaks nationally and provides a variety of online tools to help families and educators.

One example is a free, online presentation, “All Behavior is Meaning-full.” In it, Pitonyak includes a list of what might be missing when an unmet need leads to a behavior incident:

  • Meaningful relationships
  • A sense of safety and well-being
  • Power
  • Things to look forward to
  • A sense of value and self-worth
  • Relevant skills and knowledge

“Supporting a person requires us to get to know the person as a complicated human being influenced by a complex personal history,” Pitonyak says. “While it is tempting to look for a quick fix, which usually means attacking the person and his or her behavior, suppressing behavior without understanding something about the life the person is living is disrespectful and counterproductive….

“Our challenge is to find out what the person needs so that we can be more supportive.”

A running theme in Pitonyak’s work is that adults need to strengthen their own social and emotional skills in order to effectively help children. He often quotes another specialist in the field, Jean Clark: “A person’s needs are best met by people whose needs are met.” In other words, parents and teachers need to practice self-care and regulate their own behaviors and emotions to provide the best examples to children. Read on for a check-list that adults can use to develop their own skills while they help children.

A brain’s biggest job is to belong

Pitonyak is among specialists who believe that children act out because they feel misunderstood, devalued, lonely or powerless. Other growing themes are the importance of belonging and the human need to contribute meaningfully to a social group. Neuroscientists have found that humans spend about 80 percent of their brain energy trying to belong. This can explain a lot when a child with a disability feels isolated or unwanted and starts to act out.

Parents can use these concepts in a variety of ways to participate in their child’s educational program. Here are examples of questions to ask in any meeting with a school:

  • Who are the adults at school that my child trusts?
  • Does my child have special jobs or responsibilities, so he/she feels important at school?
  • Is someone regularly checking in with my child to see what’s going on?
  • How are positive behavior skills being taught and reinforced?

Positive Behavior Interventions and Supports (PBIS) is a framework that a growing number of schools nationwide are using to improve “school climate,” which refers to the way a school feels to its students and staff.

Schools that embrace PBIS generally create programs to help all students participate in well-being and then offer more targeted social, emotional and behavioral help to students who struggle the most. These different levels of intervention are called Multi-Tiered Systems of Support (MTSS). According to the federal PBIS website, “PBIS improves social, emotional and academic outcomes for all students, including students with disabilities and students from underrepresented groups.”

Information about federal guidelines and programs related to PBIS and MTSS are available online from the U.S. Department of Education’s Office of Special Education Programs (OSEP) and the Office of Elementary and Secondary Education (OESE). PAVE provides an article about PBIS, with parenting tips by Kelcey Schmitz, a longtime MTSS expert who previously worked for OSPI and now is part of the University of Washington’s School of Medicine and the School Mental Health Assessment, Research, & Training (SMART) Center.

PBIS is a protective strategy

The United States Congressional Committee on Education and Labor received training about PBIS on February 27, 2019, when they heard public testimony (YouTube video): Classrooms in Crisis: Examining the Inappropriate Use of Seclusion and Restraint Practices. Congress is considering legislation that would create a federal standard on accepted practice, accountability and training for teachers who might use isolation or restraint in an emergency.

National Public Radio reported about isolation and restraint in a June 5, 2019, broadcast that included personal comments from two families in Vancouver, Washington.

The State of Washington allows isolation and restraint by trained school staff if a student’s behavior poses an imminent threat of serious bodily harm. PAVE’s comprehensive article about discipline at school includes more information and resources about isolation and restraint, which is described by state law as an emergency response and not a form of disciplinary action.

Among those who provided public testimony for the U.S. Congress was George Sugai, PhD, professor of special education at the University of Connecticut who was a key developer of the PBIS framework. At the public hearing, Sugai spoke about the reduction in trauma among schools who embrace PBIS. He said teachers report more positive feelings toward their work and that students show more progress toward specific educational goals. “PBIS is a protective strategy,” he said.

The behavior itself holds the clues about what to do next

Sugai, who holds a Master of Arts and a PhD in special education from the University of Washington, spoke about understanding a child’s unmet needs. “We have to understand what children are communicating through their behavior,” he said. “The behavior itself holds the clues about what to do next.”

Washington’s Office of Superintendent of Public Instruction (OSPI), which oversees the state’s school districts, has a variety of programs underway to address school climate and improve staff training in Social Emotional Learning, equity in student discipline and development of Compassionate Schools. The state encourages use of a Behavior Intervention Plan (BIP), which promotes positive support and skill-building for expected school behavior. The plan is to prevent the need for disciplinary action or emergency response. A BIP is developed with data collected through a Functional Behavior Analysis (FBA), which is a best-practice tool for schools to figure out what help a student with challenging behavior might need. OSPI’s website includes examples of the FBA and BIP in its Model Forms.

OSPI’s family and community liaison, Scott Raub, partnered with a special services director from the Puget Sound’s Educational Service District 121 to create a slide presentation about isolation and restraint that is available as a free, downloadable PDF. The document is titled, Stop Using Restraint and Isolation: An Evolution or a REVOLUTION? The presentation includes specific guidance for school staff to use a Behavior Intervention Plan (BIP) as a strategy for managing behavior. A flow chart shows how early intervention might diffuse a situation to allow a student to remain in a more regulated state and stay in class. The document also provides detail about recent OSPI rulings about isolation and restraint raised through the Citizen’s Complaint process.

In accordance with the Revised Code of Washington (RCW 28A.600.485), “Restraint or isolation of any student is permitted only when reasonably necessary to control spontaneous behavior that poses an imminent likelihood of serious harm. Restraint or isolation must be closely monitored to prevent harm to the student, and must be discontinued as soon as the likelihood of serious harm has dissipated. Each school district shall adopt a policy providing for the least amount of restraint or isolation appropriate to protect the safety of students and staff under such circumstances.”

In the slide presentation, designed for schools and publicly available, OSPI provides detail about what “imminent likelihood of serious harm” can look like and provides direct guidance to staff, including these statements:

  • Emergency Response Protocols are NOT a substitute for BIPs.
  • BIPs must be updated as part of student’s annual IEP [review].
  • The time to end isolation and restraint is as soon as the likelihood of serious harm has dissipated; this is not equivalent to waiting until the student has calmed.

A state workgroup to study Social Emotional Learning (SEL) in October 2016 proposed a set of Standards and Benchmarks to help school staff identify how best to help children who struggle with their behavior, social skills and emotional regulation. The group established six standards with specific benchmarks. A report from that workgroup includes a chart of the standards (Page 3). Families can share this information with schools when trying to identify what’s happening with a child and what interventions might help.

Below is a brief overview of those SEL standards and a few questions parents can bring to the table. In each target area, parents can ask what school staff are doing to help. This check-list also can be a good starting-point for adults who want to work on their own emotional regulation and coping strategies.

1. Self-Awareness

  • Can the student identify and understand emotions?
  • What is the student good at or interested in?
  • How are family, school and community agencies helping as a team?

2.Self-Management

  • Can the student express emotions and manage stress constructively?
  • What problem-solving skills are in place or need to be learned?

3. Self-Efficacy (self-motivated/seeing self as capable)

  • Can the student understand and work toward a goal?
  • Can the student show problem-solving skills?
  • Can the student request what he/she needs?

4. Social Awareness

  • Can the student recognize another person’s emotions?
  • Can the student show respect for others who are different?
  • Can the student accept another cultural perspective?

5. Social Management

  • Does the student have ways to communicate?
  • Can the student take steps to resolve conflicts with other people?
  • Does the student have constructive relationships with a variety of people?

6. Social Engagement

  • Does the student feel responsibility as part of a community?
  • Can the student work with others to achieve a goal?
  • Does the student contribute productively and recognize his/her contribution?

Additional Resources

PAVE provides a series of three articles with more information and resources about Social Emotional Learning (SEL).

Many parents struggle in their communications with the school when a child’s specific disability and its impact on behavior is not well understood. A place to research specific disabilities related to mental health, such as Oppositional Defiance Disorder (ODD), Attention Deficit Hyperactivity Disorder (ADHD) or Disruptive Mood Dysregulation Disorder (DMDD) is the Child Mind Institute.

A resource for better understanding how children might behave in response to trauma or Adverse Childhood Experiences (ACEs) is the Children’s Health Foundation.

An agency called GoZen offers an online article about Eight Ways a Child’s Anxiety Shows up at Something Else. Included in the list: difficulty sleeping, anger, defiance, lack of focus, avoidance, negativity, over-planning and “chandeliering,” which refers to a full-blown tantrum that seemingly comes out of nowhere. In addition to its free online articles, GoZen provides fee-based programs on resilience.

Mental Health Education and Support at School can be Critical

A Brief Overview

  • Two Washington students die from suicide each week. In a typical high-school classroom of about 30 students, chances are high that 2-3 students have attempted suicide in the past year. Read on for more detail from the 2018 statewide Healthy Youth Survey.
  • Approximately one in five youth experience a mental illness before age 25. About half of those with diagnosed conditions drop out of school.
  • These outcomes make adolescence a critical time for mental health promotion, early identification and intervention. Read on for ideas about how to seek help.
  • The Adolescent Behavioral Health Care Access Act, signed into law May 13, 2019, provides for more parent involvement in mental healthcare for youth 13-18.
  • Seattle Children’s Hospital has a new referral helpline. Families can call 833-303-5437, Monday-Friday, 8-5, to connect with a referral specialist. The service is for families statewide.
  • A mom in Graham, WA, launched a program to improve education about mental health after her son died by suicide in 2010. The Jordan Binion Project has trained about 500 Washington teachers with an evidence-based curriculum from Teen Mental Health.
  • Emotional Disturbance is a federal category of disability under the Individuals with Disabilities Education Act (IDEA). A student might qualify for an Individualized Education Program (IEP) under this category, regardless of academic ability. To qualify, a disabling condition must significantly impact access to learning. An educational evaluation also must show a need for specialized instruction.
  • Parents can share these resources with school staff, who may be seeking more information about how to help youth struggling to maintain their mental health.
  • Help is available 24/7 from the Suicide Prevention Lifeline: 1-800-273-TALK.
  • Another crisis option is to text “HEAL” to 741741 to reach a trained Crisis Text Line counselor.
  • For youth who need support related to LGBTQ issues, the Trevor Project provides targeted resources and a helpline: 866-488-7386.

Full Article

The thousands of young people who send thank-you letters to Deb Binion didn’t always believe their lives were going to work out. One writer had attempted suicide and been hospitalized many times because of her bipolar disorder. Two years after finishing high school, she reported she was doing well and offered thanks for a course in mental health that helped her understand her illness, its impacts on her brain, and how to participate in her treatment. “It made a total difference in my life,” she said in her thank-you letter.

“Until she got the educational piece and understood her illness, nothing was helping,” Binion says. “No one had ever explained to her why she had this illness and what was occurring.”

The program, which Binion started after her son Jordan’s suicide in 2010, has trained about 500 school staff throughout Washington State to help young people understand mental illness and what to do to support themselves and others. Although the numbers are difficult to track, Binion estimates that about 100,000 Washington students receive education through the curriculum each year.

“My mission is to get this information to the kids,” says Binion, who runs the non-profit Jordan Binion Project from her home in Graham, WA. She says a short-term, limited pilot project with the Office of Superintendent of Public Instruction (OSPI) showed promising results, with 60 teachers throughout Washington informally reporting that about 85 percent of students showed improvement in their “mental health literacy,” a key feature of the program.

Teachers are specially trained to provide the Mental Health Curriculum

The curriculum, available through TeenMentalHealth.org, was developed by a world-renowned adolescent psychiatrist and researcher, Stan Kutcher. He observed that classrooms often struggle to provide an emotionally safe learning environment for students with psychiatric conditions. Some attempts to provide education about mental health have created confusing and triggering circumstances for students impacted by illness and/or trauma, he found.

Kutcher, professor of psychiatry at Dalhousie University in Nova Scotia, Canada, responded with a model for training school staff in how to teach sensitive topics of mental illness:

  • eating disorders
  • anxiety/depression
  • attention deficit hyperactivity disorder (ADHD)
  • obsessive-compulsive disorder (OCD)
  • bipolar disorder
  • schizophrenia
  • post-traumatic stress disorder (PTSD)
  • suicidal thinking

Deb Binion says the program was designed for students in grades 9-10, but middle-school and older students are also learning from it.  She says the program takes about 8-12 hours to teach and that teachers in regular health classes, psychology classes, family and consumer science classes and others have taught the lessons.

Binion suggest that staff receive in-person training to understand how to create a safe learning environment for students. For example, teachers learn to provide individualized help without disclosing a student’s disability or medical condition to the class.

The topics can be confusing or triggering to some learners. Some of the videos might be difficult to watch because they include personal stories of self-harm, hospitalization and people suffering from emotional stress. The program may need individualized modifications for students in special education programs because of intellectual or developmental disabilities.

For information about how to bring a training to your area, individuals can contact Deb Binion through the Jordan Binion Project website or directly through her email: deborah@jordanbinionproject.org.

Washington State recognizes a need for more education and direct support

OSPI, which oversees all school districts in Washington, provides an overview of Kutcher’s work and its connection to the Jordan Binion Project as part of the Mental Health & High School Curriculum Guide. Content in the guide was a collaboration between Kutcher and the Canadian Mental Health Association. At Dalhousie University in Nova Scotia, Kutcher serves as Sun Life Financial Chair in Adolescent Mental Health and Director of the World Health Organization Collaborating Center in Mental Health Training and Policy Development.

Washington State is aware that a lack of mental health services is impacting students. In 2018, OSPI released data that two children enrolled in Washington schools die by suicide weekly.

According to the 2018 Washington Healthy Youth Survey, at least one in three youth in all grades report feeling sad or hopeless for enough time to impact their activities. In ten years, those numbers increased by 10-20 percent across all grades. More than 900 schools administered the survey, representing all 39 Washington counties and 228 school districts.

About one in three 10th and 12th graders report feeling nervous, anxious or on edge, with an inability to stop worrying. From 2016 to 2018, the percentage experiencing these feelings increased for all grades. Rates of reported suicide have remained alarmingly high, with about 10 percent of students reporting that they have attempted suicide recently.

This means that in a typical high-school classroom of about 30 students, chances are high that two or three students have attempted suicide in the past year.

Female students and students who identify as lesbian, gay, or bisexual report higher rates of considering, planning, and attempting suicide. For youth who need support related to LGBTQ issues, the Trevor Project provides targeted resources and a helpline: 866-488-7386.

High rates of suicide attempts also are reported among students who identify as American Indian or Alaskan Native (18 percent) and students who identify as Hispanic (13 percent). Help for all is available 24/7 from the Suicide Prevention Lifeline: 1-800-273-TALK. Another crisis option is to text “HEAL” to 741741 to reach a trained Crisis Text Line counselor.

Despite the alarming data and evidence that adult support can impact outcomes, only half of students say they have access to direct adult support when they feel extremely sad or suicidal.

The 2018 Healthy Youth Survey introduced a modified Children’s Hope Scale, which measures students’ ability to initiate and sustain action towards goals. Across grades, only about half of students feel hopeful for their futures. Students who identify as lesbian, gay or bisexual and students of color were less likely to report adult support and were less likely to be highly hopeful for their futures.

State, local, community and school efforts are crucial for supporting youth mental health. With the release of the survey in Spring, 2019, the state issued a guide to information and resources to provide more detail about the survey and to direct families and school staff toward sources for support.

Latest data for 10th graders female students and lesbian, gay or bisexual students report higher rates of considering making a plan for and attempting suicide

An OSPI survey in 2018 found that the number one concern statewide is that students don’t receive enough direct support in mental health, counseling and advising at school. The Washington School-Based Health Alliance (WASBHA) is working with some districts who have varied grants throughout the state to build on-campus health clinics to address a range of student health-care needs, including mental health. The Alliance sponsored an all-day summit May 3, 2019, at the Seattle Flight Museum that was attended by several hundred professionals invested in building collaborations between public health agencies and schools. Throughout the day, professionals discussed how students are much more likely to seek a counselor at school than in the community and that outcomes improve when providers and school staff collaborate and provide individualized help focused on relationship-building.

New state law expands parent involvement in mental-health treatment

Youth older than 13 have the right to consent or not consent to any medical treatment in Washington State. Parents and lawmakers throughout 2018-2019 engaged in conversations about how that creates barriers to care for may teens who don’t fully grasp their mental condition or how to recover.

In response, lawmakers wrote and passed the Adolescent Behavioral Health Care Access Act (HB 1874), signed into law by Gov. Jay Inslee May 13, 2019. The new law allows behavioral health professionals to provide parents or guardians with certain treatment information if they determine the release of that information is appropriate and not harmful to the adolescent. The bill also permits parents and guardians to request outpatient treatment for their adolescent, expanding the current parent-initiated treatment process so that adolescents can get treatment before they reach the point of hospitalization.

“Parents across the state are desperate to be allowed to help their children struggling with mental health issues or a substance use disorder,” says Rep. Noel Frame from the Seattle area. “At the same time, we need to protect the rights and privacy of these youth. This bill strikes a balance by ensuring adolescents can continue to access treatment on their own, while giving concerned parents an avenue to help their children and be involved with their treatment.”

Parents also have a new option for helping their children and youth by contacting Seattle Children’s Hospital, which in 2019 launched a new referral helpline. Families can call 833-303-5437, Monday-Friday, 8-5, to connect with a referral specialist. The service is for families statewide. In addition to helping to connect families with services, the hospital will be positioned to identify gaps in the system through its engagement with families.

One in five youth are at risk

The Teen Mental Health website cites an international statistic that 1 in 5 youth experience a mental illness before age 25. Many of those illnesses lead to life challenges that require help, the agency concludes, and this makes adolescence a critical time for mental health promotion, prevention, early identification, and intervention. The agency provides a School-Based Pathway Through Care that promotes linkages between schools and healthcare agencies, parent involvement and strong educational programs that reduce stigma through knowledge and timely treatment access.

One way that Washington State has responded to the crisis is through promotion of trainings in Youth Mental Health First Aid. Through Project AWARE (Advancing Wellness and Resilience in Education) and other initiatives, Washington has grown a network of about 100 trainers for Youth Mental Health First Aid and about 4,000 first aid providers. These trained individuals can listen actively in order to offer immediate caring and can also refer youth to providers. OSPI reports that Project AWARE has led to 3,964 referrals for youth to connect with community- or school-based mental health services.  

Washington has a program for treatment response for youth experiencing psychosis. The New Journeys Program is designed for youth 15-25 who are early in their diagnoses, but there is some flexibility in who might be eligible to participate. Families can contact the program for additional information about how to apply.

Information about psychosis, early warning signs and places to seek help are available through the website of the Washington Health Care Authority (HCA). The website contains a link to information about the Wraparound with Intensive Services program (WISe), which provides community case management for children and youth experiencing a high-level of impact from a mental illness.

Special Education is one pathway toward more help

Students access some aspects of mental health support through the special education system. Emotional Disturbance is a federal category of disability under the Individuals with Disabilities Education Act (IDEA). In Washington State, the category is referred to as Emotional Behavior Disability (EBD). The IEP might list any set of these words or the initials EBD or ED.

A student might qualify for an Individualized Education Program (IEP) under this category, regardless of academic ability. A comprehensive educational evaluation can determine whether a student’s mental condition causes a significant disruption to the student’s ability to access school and learning and whether the student needs specialized instruction. Generally, that specialized instruction is provided through a category of education known as Social Emotional Learning (SEL). SEL can be provided in multiple tiers that might include schoolwide education, small group training and individualized programming. OSPI provides recommendations from a 2016 Social Emotional Learning Benchmarks Workgroup.

A student with a mental health condition also might qualify for an IEP under the category of Other Health Impairment (OHI), which can capture needs related to anxiety, ADHD, Tourette’s Syndrome or another specific diagnosis. Students with a mental health condition that co-occurs with another disability might qualify under another category, and Social Emotional Learning might be an aspect of a more comprehensive program. PAVE’s articles about the IDEA and the IEP provide further information about IEP process, the 14 categories of qualifying disabilities and access to special education services. A student with a mental health condition who doesn’t qualify for an IEP might qualify for a Section 504 plan.

If a student, because of a disability, is not accessing school and learning, then the school district holds the responsibility for appropriately evaluating that student and determining the level of support needed to provide access to a Free Appropriate Public Education (FAPE). Questions about FAPE might arise if a student with a mental health condition is not accessing school because of “school refusal,” which sometimes leads to truancy, or because a student is being disciplined a lot. Students with identified disabilities have protections in the disciplinary process; PAVE provides an article about school discipline.

Help NOW can mean a lifetime of better opportunities

The Center for Parent Information and Resources (ParentCenterHub.org) has a variety of resources related to mental health awareness, including a link to a video that details results from a national study. The study showed that students who qualified for special education programming because of Emotional Disturbance experienced the highest drop-out rates when they went into higher education, work and vocational programs. Meaningful relationships with adults who cared about them in school provided a significant protective factor. Students were more likely to succeed in life-after-high-school plans if specific caring adults provided a soft hand-off into whatever came next after graduation.

Here are a few additional resources:

 Here are some articles specifically about Bipolar Disorder in Youth:

Accommodations for Students with Bipolar Disorder and Related Disabilities

Educating the Child with Bipolar

Bipolar & Seasons: Fall Brings More Than Just a Change in Colors

 

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

A Brief Overview

  • Students with disabilities are disciplined twice as often as non-disabled peers. Washington is taking actions to remedy the inequities. Read on for examples of the new state rules and where to go for more information.  
  • Schools are required to provide education and support before resorting to discipline. This article includes resources and information to help families ensure that students are receiving the best-practice services they need and that disciplinary actions are non-discriminatory.
  • Chris Reykdal, Superintendent of Public Instruction, says, “We should do what we can to make suspensions and expulsions the last option while ensuring our schools are safe. The numbers are clear: This is an equity issue, and some groups of students are impacted much more than others.”
  • Concern is nationwide. The Center for Civil Rights Remedies in 2018 issued a state-by-state estimate of lost instruction due to discipline for students with disabilities: “Schools once routinely denied students with disabilities access to public education. Federal law makes it clear that such denial is unlawful, yet some schools may still be meting out discipline in a manner that has the same effect.”
  • If the school calls to send a child home, parents can ask whether the student is being suspended. If the school is not taking formal disciplinary action, parents are not required to take a child home. If the action is a formal suspension, specific rules apply. Read on for more detail.

Full Article

Some disabilities make it difficult for students to communicate distress or manage their behavior in ways that schools expect or require from typically developing students. Data clearly show that students with disabilities are disciplined more frequently than their non-disabled peers. By learning about state and federal guidelines, parents can advocate to ensure that students with disabilities are receiving the services they need to successfully access school and that disciplinary actions are non-discriminatory.

Parents can empower themselves by learning the federal framework for special education protections. Students who receive services or accommodations through the Individuals with Disabilities Education Act (IDEA) or through Section 504 of the Rehabilitation Act of 1973 are guaranteed access to a Free Appropriate Public Education (FAPE). Disciplinary actions that deny access to FAPE may be discriminatory. Schools follow specific procedures when they discipline students with special needs to avoid violations of FAPE.

For example, a student with an Individualized Education Program (IEP) cannot be excluded from school because of behavior that results from a disability: Read on for further information about Manifestation Determination Hearings. Also, schools are required to provide education and support before resorting to discipline for children who struggle with behavior because of their impairments.

Some agencies are researching the impacts of exclusionary discipline, such as suspensions and expulsions, on children and their families. Some research shows that trauma and a worsening of mental health are outcomes. Excessive punishments are linked to negative lifelong outcomes, such as reduced graduation rates and more incarcerations. The National Center for Pyramid Model Innovations (challengingbehavior.org) has a webinar about the impact of suspensions on children in early learning.

Unexpected behavior may indicate that a student has a disability and needs services

Federal laws can protect students who haven’t yet been identified as having disabilities. School districts have a duty to evaluate students to determine eligibility for special education if they exhibit behavior that may indicate a disability. Under IDEA, this responsibility is called the Child Find mandate. Suspension, expulsion, isolation or restraint due to unexpected behavior can initiate an evaluation process, and students who qualify for services can retroactively be afforded protections from the IDEA or Section 504.

The Office for Civil Rights within the United States Department of Education in December 2016 issued a two-page Fact Sheet on Restraint and Seclusion that succinctly describes some federal guidelines related to disciplinary action and disability:

“A student’s behavioral challenges, such as those that lead to an emergency situation in which a school believes restraint or seclusion is a justified response could be a sign that the student actually has a disability and needs special education or related aids and services in order to receive FAPE.”

Washington State has new rules for schools

The Office of Superintendent of Public Instruction (OSPI), which oversees all Washington school districts, in July 2018 adopted new state guidelines related to discipline. OSPI provides a Parent Guide to discipline, available in multiple languages, on its website.

Also available is a Menu of Best Practices and Strategies. Restorative justice, behavioral health support and social skills instruction are on the menu for a more proactive, student-centered approach. The state includes requirements for parent notification and family engagement in the new rules, which are being implemented over two years, 2018-2020.

“The state discipline rules were created four decades ago,” says Chris Reykdal, Superintendent of Public Instruction. “Our students and schools are vastly different today. The new rules provide more clarity and they allow for student, family, and community input in developing local discipline policies.

“While some students do occasionally need discipline, our approach must be different. We should do what we can to make suspensions and expulsions the last option while ensuring our schools are safe. The numbers are clear: This is an equity issue, and some groups of students are impacted much more than others.”

Students with disabilities and students of color are disciplined more frequently

OSPI reports that 3.5 percent of all students were suspended or expelled during the 2016–17 school year. Among students receiving special education services, the percentage was 7.1 percent. For African-American students, the percentage was 7.4 percent. For Latino students, the rate was 4.1 percent. Students of color who also have disabilities are impacted at the highest rates. Seattle’s King 5 News on Oct. 25, 2018, broadcast a news report about the disparities in discipline for students with disabilities.

In 2016, the Washington Legislature passed House Bill 1541 to help close opportunity gaps in learning. OSPI spent two years researching the statutes and guidance. In rewriting the rules that were adopted in July 2018, the agency gathered feedback from families, students, educators, and community members through three public comment periods and eight public hearings.

New state policies are designed to discourage disciplinary actions that take a child out of the learning environment and encourage family engagement and positive behavior supports and other evidence-based practices. OSPI’s one-page introductory handout for parents outlines the new guidance.

According to OSPI, the new rules aim to make policies fair statewide. They require districts to include parents and guardians when updating discipline policies. The overarching goal is to keep children in school and learning and avoid severe or exclusionary disciplinary measures. 

In general, Washington’s new state 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 from school for absences or tardiness

Further limit use of exclusionary discipline (suspension, expulsion) for behaviors that do not present a safety threat

Prohibit the use of expulsion for students in kindergarten through grade four (children in that age range already cannot be excluded from their classroom placements for more than 10 cumulative days per academic term)

Clarify expectations for how school districts must provide students access to educational services during a suspension or expulsion

When are students entitled to a Manifestation Determination Hearing?

In Washington, a student with an identified disability may be suspended for a short period of time if there are safety concerns or if other interventions are failing to control behaviors that cause a significant disruption. However, if a suspension or an accumulation of in- or out-of-school suspensions within a semester or trimester totals 10 days, the school holds a Manifestation Determination Hearing to determine whether the behavior resulted—or “manifested”—from the disability. This hearing is a distinct process for students with IEPS or Section 504 accommodation plans and is separate from any other general education disciplinary hearings or procedures. Removal for more than 10 days is considered a change in placement and could violate the school district’s responsibility to provide the special education student with FAPE.

If a student’s behavior manifested from disability, the school and parents meet to discuss program or placement changes likely to help. A Manifestation Determination hearing can also initiate an evaluation process for students not yet identified as needing special education services or disability-related accommodations. Regardless of whether the student has qualified for services, the hearing can trigger a Functional Behavior Assessment (FBA), which can be done for students with or without IEPs or Section 504 plans. Keep reading for more detail about the FBA and how it’s used to generate positive behavior interventions and supports.

The IDEA guarantees parent participation in the IEP process, which includes disciplinary hearings and any other formal meetings in which a student’s educational program or placement is reviewed or amended.  

If the conduct is determined to be unrelated to a disability, then school personnel may use general education discipline procedures. In that case, 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 during the suspension.

The school district is required to 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). OSPI issued a bulletin September 8, 2016, that states, “When educational services are provided in an alternative setting, the alternative setting should be comparable, equitable and appropriate to the regular education services a student would have received without the exclusionary discipline.” The bulletin mentions alternative schools, 1:1 tutoring and online learning as examples of alternative settings.

Note: If a student’s conduct involves Special Circumstances – weapons, illegal drugs, or serious bodily injury—a student may be removed for up to 45 school days regardless of whether the student’s behavior was a manifestation of disability. However, a manifestation determination hearing still is required within the first 10 days of removal from school and educational services still are provided.

The American Civil Liberties Union of Washington provides a free, downloadable Parents’ Guide to Public School Discipline in Washington. Part III includes information about laws and procedures that are specific to students in special education. The ACLU guidebook encourages parents to gather as much information as possible when a student is disciplined:

“It is important to fully understand the type of proposed discipline, the underlying behavior, how the behavior relates to the student’s disability, and what additional supports may be available in order to fully advocate for your student.”

Do you need to pick up your student every time the school calls?

The ACLU booklet commits a page to addressing the question, “Do you need to pick up your student every time the school calls?” A parent can ask whether the student is being suspended.  “If your student has not been officially suspended,” ACLU advises, “The school cannot force you to pick up the student.

“If you choose to pick up your student when he or she has not been suspended, the school may not record the removal from class and may not trigger additional protections (such as Manifestation Determination Hearings) that apply when students with disabilities are removed from school for 10 days or more.”

The ACLU points out that without formal paperwork that describes a disciplinary action and its specific start and end times, a school may not be accountable to specific rules that govern special education: “Any time your student misses class time because of a behavior problem, it may be considered a discipline and should be considered as counting towards the 10 days that would be a ‘change of placement’ under the law and trigger additional protections. If your student is having behavioral problems that do not lead to suspension, you may suggest that the IEP team should consider holding an IEP meeting to reevaluate your student’s behavior supports, or that the 504 team meet to consider changes to the accommodation plan.”

The ACLU guidebook includes a list of supports parents can ask for: “The law requires behavior supports to be based on evidence, and so you can ask for additional expert evaluation to determine whether the behavior supports offered to your student are appropriate.”

Schools teach skills for expected behavior

Specialized instruction designed to meet a student’s unique needs can include education in social communication, self-regulation, choice-making and other areas of Social Emotional Learning (SEL) that may impact behavior. These strategies are well recognized as best-practice for keeping children engaged in school and avoiding problems that might lead to discipline.

In addition, schools can conduct a Functional Behavior Assessment (FBA) to develop a Behavior Intervention Plan (BIP). A BIP is developed to proactively help a child learn expected behaviors and shift away from circumstances that might lead to escalations. The BIP identifies target behaviors that are disrupting education and determines “antecedents,” which means conditions or events that occur before the targeted behavior. A BIP is intended to support “replacement” behavior so a student can develop skills that prevent escalations and keep the student in school and learning.  

A BIP can be a stand-alone plan or can work with an IEP or a Section 504 accommodations plan. OSPI offers guidance to schools and families about FBA/BIP process. Another place to find valuable information is through the Parent Center Hub, a website operated by the Center for Parent Information and Resources (CPIR).

School discipline is a national topic of concern

On August 1, 2016, the U.S. Department of Education published a Dear Colleague Letter for public-school staff: “Recent data on short-term disciplinary removals from the current placement strongly suggest that many children with disabilities may not be receiving appropriate behavioral interventions and supports, and other strategies, in their IEPs.” The letter included data that 10 percent of all children with disabilities, ages 3-21, were subject to a disciplinary removal from school. Children of color with disabilities faced an even higher rate.

The letter encourages all schools to develop robust programs for Positive Behavior Interventions and Supports (PBIS) and provides specific guidance for IEP teams. “In the case of a child whose behavior impedes the child’s learning or that of others, the IEP Team must consider – and, when necessary to provide FAPE, include in the IEP – the use of positive behavioral interventions and supports, and other strategies, to address that behavior.”

The federal guidance includes statements about staff development: “School personnel may need training, coaching, and tools to appropriately address the behavioral needs of a particular child. Supports for school personnel may be designed, as appropriate, to better implement effective instructional and behavior management strategies and specific behavioral interventions that are included in the child’s IEP.”

In 2014, the federal government issued guidance to discourage disciplinary actions that discriminate against students with disabilities, particularly students of color. A variety of federal sources have highlighted disparities, and the Center for Civil Rights Remedies and the Charles Hamilton Houston Institute for Race and Justice in April 2018 issued the first state-by-state estimate of lost instruction due to discipline for students with disabilities. The data include a finding that children of color who also have disabilities lost 77 more days of instruction because of disciplinary actions than peers who are Caucasian.

“These data on lost instruction are rarely reported,” the report concludes in its executive summary. “Although many could guess that the racially disparate impact is large, these dramatic disparities were derived from reliable publicly reported federal data, and they should be cause for alarm. Students with disabilities receive much more than classroom instruction when they are in school. For example, they often receive related counseling services, occupational and physical therapy as well as additional small group or one-on-one tutoring. Therefore, they lose much more when they are removed from school.”

Inappropriate discipline may be a denial of FAPE

The full report from the Center for Civil Rights Remedies includes this statement in its introduction: “Schools once routinely denied students with disabilities access to public education. Federal law makes it clear that such denial is unlawful, yet some schools may still be meting out discipline in a manner that has the same effect. To suspend a student because of behavior that is a result of their disability is the equivalent of denying that student access to education.”

However, in December 2018, a federal school safety commission recommended that the U.S. Department of Education rescind the 2014 guidance intended to prevent discriminatory practices. OSPI responded by stating that Washington State’s policies and updated guidance would be unaffected. “Rescinding the 2014 guidelines will have no effect on Washington’s laws and rules related to student discipline…and will have no effect on OSPI’s enforcement of civil rights laws that prohibit discrimination in the administration of student discipline,” OSPI stated.

Washington discipline laws include statutes in the Revised Code of Washington (RCW) and rules in the Washington Administrative Code (WAC). Washington State student discipline laws apply to all K–12 students. Students with disabilities are subject to both general education and special education rules and statutes. For the most up-to-date information about general education discipline procedures and the rules changes underway, visit OSPI’s Student Discipline page. For more information about special education discipline procedures, visit OSPI’s Special Education Behavior and Discipline page.

Guidance related to isolation and restraint

The state has specific rules related to the use of isolation and restraint, which are implemented only when a student’s behavior poses an imminent likelihood of serious 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.

When 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 specifically explains what the school’s policies are related to isolation and restraint and what the training requirements are for staff who are authorized to provide 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. Schools are required to provide a report to the parent/guardian any time formal disciplinary actions are taken and any time that their child experiences isolation or restraint.

Where to find the state laws

For a link to the complete Washington Administrative Codes (WACs) that describe the Final Rules for the 2018-19 and 2019-20 school years, visit OSPI’s website and click on links for the downloadable PDF documents: www.k12.wa.us/studentdiscipline

Holidays Can Hurt When Trauma is Present

Songs in the store tell us this is the “hap/happiest” time of the year, but for people who have experienced trauma this season can trigger difficult emotions. For children with disabilities, those emotions can be particularly complex and confusing. Unexpected behaviors might show up at home or at school, especially when routines are disrupted.

Helping children understand their emotional responses to difficult circumstances is part of education, and schools are adopting new strategies around Social Emotional Learning (SEL). Social and emotional skills can be analyzed through educational evaluations, and the Individualized Education Program (IEP) establishes specific programming and goals around SEL for children with deficits in those areas.

A Functional Behavior Analysis (FBA) is another tool for determining what supports a child needs to behave in ways that are “expected” for success at school. The FBA leads to design of a Behavior Intervention Plan (BIP), which provides specific guidance to school staff for positively reinforcing expected behavior.

When designing behavior plans, parents and school staff may need to discuss whether unexpected behaviors are the result of trauma and/or overwhelm. Strategies for helping may need to consider whether rewards and punishments will work if behaviors are related to emotional dysregulation and fight/flight/freeze responses to internalized and persistent anxiety. Formed Families Forward, a community and family-focused resource center in Virginia, provides a video series to help families and professionals better understand trauma and how to respond. The agency’s website also provides a resource collection related to trauma-informed approaches in multiple environments.

The Office of Superintendent of Public Instruction (OSPI), which oversees Washington school districts, has developed curricula to help school staff teach children how to understand their emotions and become more skillful in social communication. PAVE’s website includes a three-part series of articles about the state’s initiatives and research related to SEL. Those articles include practical tips and a variety of additional links to further information.

Everyone can help create a calm environment. Best practice is to exhale long and slow, triggering the body’s relaxation response. Your feeling of calm can help someone else relax. Try it! Take 5 breaths, focusing on a long, slow exhale through your nose. Notice how you feel. If you feel calm, consider sharing that feeling with someone else through a loving smile, soft eyes or even a hug! Even if this is not the hap/happiest time of your year, give yourself permission to relish a simple moment of contentment or curiosity when you pause to breathe.