Putting out the fire: Dissecting and dismantling the dynamics of restraint and seclusion

Join us for "Putting out the fire: Dissecting and dismantling the dynamics of restraint and seclusion." with Dr. Arielle Silverman.

Arielle is a disabled activist and a social scientist who is passionate about improving public understanding of life with disabilities.

Professionally, she has spent fifteen years conducting research on the social psychology of disability. Personally, she has spent a lifetime learning and teaching with fellow members of the disability community.

An excerpt from Just Human:
"The most important thing I have discovered as a leader, a supervisor, an educator, and even an aunt, is that respect must be given before it can be received. When we offer respect and compassion to our children, our students, our employees, and others under our authority, we can bring out their full potential. What we get back is not just compliance and cooperation, but a real, mutual, human connection."

Transcript

Guy Stephens: 0:12

Well, hello and welcome back to the Alliance Against Seclusion and Restraint Live series. Really excited to have you here today. Of course, my name is Guy Stevens, I'm the founder and executive director of the Alliance Against Seclusion and Restraint. Those of you that may not be familiar with the Alliance, we started, oh, gosh, about four years ago, really begin around the issue of restraint, seclusion, happening in schools across the country. But as you can imagine, our mission continue to grow. It's not just about restraint and seclusion. It's about a lot of things that are often done to people in the name of behavior, not just in schools, we see things, we can even find restraint, seclusion, happening, of course, in hospitals, mental health settings, in the troubled teen industry in many places. And of course, we are on a mission to bring about change, we know there are better things that we can do to support really everyone. Our mission, as it relates to all of this is really to educate the public and connect people together. And it's about changing laws, minds and policies. It's about, you know, ultimately helping to eliminate things like the school-to-prison pipeline. And we want to help by making a difference in this work. So as always, you know, I'm really excited about today's guests, we just have this phenomenal lineup of guests. And we've actually got people already booked out until I think, January or February of next year. I keep meeting incredible people and saying, hey, you've got to join us on the Alliance Live. Today, we're really excited to have Dr. Arielle Silverman joining us for a special presentation and discussion. Arielle is a disabled activist and a social scientist who is passionate about improving public understanding of disability. And I'm going to introduce Arielle here in just a moment, I do want to let you know that, as always, we do record these sessions. So, of course, we hope that you're going to be on here live and able to watch with us live. But if you're not, these sessions are recorded. They're available after the fact, on Facebook, YouTube, and LinkedIn. We also make it available on audio podcasts. And with that, along with our audio podcast, you can actually get the transcripts as well. So we encourage you to look for different ways to engage with this. And hopefully, if you're not able to hear the whole thing right now, you'll be able to go back and listen. And of course, we always want to encourage people to share these conversations. The reason we do this is it's important. It's important to, you know, to share stories, experiences, information, so that we can ultimately make positive change. So with that, let me go ahead and introduce to you our very special guests. And I do want to ask you before I do that, if you're watching live, and I see a number of you are on the stream live, if you're watching live, let me know who you are and where you're from. It's always great to know where people are joining us from. I was telling our guests before we got started that we often have people from around the globe that join us. So let us know who you are and where you're from. If you want to share anything else, you're welcome to do that as well. But please feel free to share that in the chat. And with that, let me go ahead and bring Dr. Arielle Silverman up on our screen, and I am going to introduce Arielle, and it's great to have her here today. Arielle is a disabled activist and social scientist who is passionate about improving public understanding of life with disabilities. Professionally, she spent 15 years conducting research on social psychology of disability. Personally, she has spent a lifetime learning and teaching with fellow members of the disability community. And I want to share with you one that Dr. Silverman has a fantastic book. And I'm going to lift this up on the screen and you can see it here. T,he book is called "Just Human." And I'll try to put a link to this in the chat as well. It is the quest for disability, wisdom, respect, and inclusion. And it's a fantastic, fantastic book that shares not only Arielle's story, but really how we can ultimately move people in a better direction, and do better. So here's a quick excerpt from the book, "The most important thing that I have discovered as a leader, a supervisor, and educator, and even as an aunt, is that respect must be given before it can be received. When we offer respect and compassion to our children, our students, our employees, and others under our authority, we can bring out their full potential. What we get back is not just compliance and cooperation, but real mutual human connection." And any of you that are, you know, with us on a regular basis, know how much we talk about the importance of human connection. And I love that quote. So with all that said in your introduction Arielle, you'll be able to tell us more about yourself and your work, because I'm sure I probably could have read about a three-page introduction, given all the things that you've been doing throughout your life and your career. So welcome. And thank you for joining us today.

Dr. Arielle Silverman: 5:05

Thank you so much, Guy. And thank you for the book promotion as well, I really appreciate it.

Guy Stephens: 5:10

Oh, absolutely. In fact, I will put a link in the chat, but we actually put a link to your booking website earlier on our social media. It's I was actually thinking, and I don't want to put you on the spot here. But we've been doing a book club and we've been doing book clubs where, over the course of three to four weeks, we invite people to join us and we talk about different books. And we've done some really great ones. So far, we did Mona Delahooke's new parenting book, Brain-Body Parenting. We recently did a book by Dr. Lori Desautels, which is called Intentional Neuroplasticity. We've got a couple of great ones coming up this summer. But as I had this book today, and I was reading it again, I thought this would be a great one for a book club. And, you know, one of the things that we've done with the book club, and I've just throw this out, you don't have to answer me now. But we often try to get the author to join us for the final session because it's a really great way that people can engage and ask questions. So I might be, this is an idea that kind of randomly came up today. But I might be talking to you about doing the book for a book club. And maybe you can join us if we do so really excited about that.

Dr. Arielle Silverman: 6:19

I would love that, that would be a great opportunity. I've spoken to a couple of book clubs over the past year and a half since the books come out. So I would love that.

Guy Stephens: 6:27

Fantastic. And you know, we've had so much fun doing those because it's such a great opportunity. And I think, you know, I share with you a little bit about the community here at the alliance. And, of course, we have a lot of parents, we have a lot of self-advocates, we have a lot of educators. And it's really, you know, I think a beautiful thing when people come together and have these discussions and kind of go through, you know, discovery and, you know, connected together. So I will definitely be hitting you up about that kind of after this. So I do want to, again, remind people if you are joining us on the chat, a couple of you have already jumped in, but let us know who you are and where you're from. And I will tell you just real quickly a couple of people have joined on. Amy told us that she shared the event already, which is great. Cassie, who is from Holland, Michigan, and actually part of a group called the Michigan Advocates to End Seclusion and Restraint and is doing amazing work in Michigan, is on here with us. We have Kimberly Kerrigan, from Wisconsin, who is a survivor of seclusion in my public school. Kimberly, I'm sorry to hear about your experience and appreciate you being here. Cass Griffith Bennett is joining us today as well and commented about the books and she said that would be lovely. So already, I think you've got some fans. Mickey Marinelli from Texas. I've got somebody here, Christina from Cleveland, Ohio. Cass mentioned that autistic mom of autistic kids in Washington State. So we've got a number of people that jumped on already. And I'm sure we'll have more people jumping on and introducing themselves as we go here. I am going to, Arielle, kind of bring up your presentation. I know you want to do a little bit more intro here. So let me go ahead and bring this up. And bear with me for one second. And then I will let you take it away. All right, so we're just going to start your slideshow here. Alright, so your slideshow is now started. And I can advance the slides as you are ready so I've got your title up right now. And we'll let you take it away.

Dr. Arielle Silverman: 8:36

Excellent. Thank you so much. I really appreciate this opportunity to talk to everyone today. So let me just start off by sharing a little bit of how and why I became interested in this topic and some of the things that I've learned over the past few years. My background is probably a little bit different than the background of some of the other guests who have been on recently. I am a social psychologist by training, and I'm also a person who has been totally blind since birth. And so I think I originally became interested in some of these issues. When as a child, I was growing up and attending programs through a local first preschool and then, later on a summer camp for children in the area who are blind. And some of my peers also had intellectual and developmental disabilities. And I remember even as a child and preteen noticing that of course, there were times when I or my peers did not always comply with instructions from the authority figures for one reason or another. And at times, the people in charge would react in these really unnecessarily negative ways. And I remember observing, even kind of as a young teenager, not only that the reactions were triggering and upsetting to the students, especially my peers who had developmental disabilities. But they also were making the people in charge were making their own jobs more difficult. And even as an adolescent, I remember having the sense that there's got to be a better way. And sometimes, my friends and I would even kind of quietly go over and intervene in situations where our peers were being treated poorly. And we found that when we took the time to kind of reach out and connect and provide safety and support to our peers, things always de-escalatedSailor pretty quickly. Then, a few years ago, after I finished my social psychology training, and I did a postdoctoral fellowship in rehab medicine, and then I decided to start a small business called Disability wisdom consulting. And so I spent a lot of time really trying to actively educate myself about other types of disability experiences that I had not personally had. And unfortunately, I kind of was learning about some very disturbing things that were happening in the schools and other places to people with all kinds of disabilities. But again, primarily people with intellectual developmental disabilities, I was reading about restraint, seclusion, other kinds of punitive practices like the Judge Rotenberg Center in Massachusetts, where students actually literally receive electric shocks as punishment, to try to decrease behaviors that they deem undesirable behaviors. And that center is still open today, despite a lot of advocacy to try to get it shut down. And I also learned about instances happening to adults, including instances perpetrated by police. When I was living in Maryland, I learned about a situation with a young man with Down syndrome named Ethan Sailor, who was killed by off-duty police officers at a movie theater, all because he wanted to see the same movie twice and did not understand that he needed to buy a second ticket. And he had a support worker with him who tried to intervene and try to de-escalate things. And these off-duty police officers did not allow that to happen, and instead tried to physically carry him out of the movie theater. And eventually, he ended up in a prone restraint that caused him to be killed. And so as I was learning about a lot of these situations, I started to recognize, especially with my training as a social psychologist, I started to recognize patterns. And that a lot of these instances follow the same kind of general pattern between two individuals, one who holds power and one who holds less power. And I also recognize, just like I did as a child, that these patterns were very much and their outcomes were very much preventable. And at the same time, I was working in a program for blind and low vision teens and young adults, and I was learning firsthand that there's a better way. And that when young people are treated with compassion and connection and validation, things rapidly turn around. And so combining that kind of scholarly knowledge and some of my practical experience, I then started to read books like Ross Greene's books, and Alfie Kohn. And Mona Delahooke, who was mentioned earlier. And so a lot of what I'm going to be presenting today is kind of a synthesis of what I've learned both from direct observation and from what I've learned from some of these scholars. And I know Guy and I talked about the beginning that I'm happy to take questions throughout the presentation, you don't have to save them all to the end. Feel free to write your questions or comments in the chat. And I would encourage you to challenge me, if you have experiences, thoughts that contradict anything that I say, because I'm still learning. And I really hope that this will be a conversation and not just me lecturing and presenting knowledge to all of you. So with that, we'll go ahead and move to the next slide, Slide two.

Guy Stephens: 14:01

Okay. And before I move on, I just wanted to thank you one for mentioning that I was thinking here a second ago like I need to remind people that they can ask questions during, so thank you for mentioning that. I just do want to share with you real quickly, a few more people that have jumped on board here, and as we get started, we've got the Divina from Connecticut. We've got Bridget from, let me spell it out who is from Chicago and a parent advocate and coach to other parents, and mentioned really enjoying our book studies. And then I have a name that jumped out at me from memory in your book. And that's Sharona Silverman. So you that name is very familiar to me. And then we've also got here, Janelle, Janelle Abraham who is from Edmonton, Alberta, Canada, who works with a nonprofit that supports individuals with intellectual disability. So with that, again, feel free anytime to introduce yourself. We're going to let you go with the presentation again, as was mentioned. If you have questions, feel free to put those in the chat. And I will be monitoring the questions and, at the appropriate time, trying to come back to those so that we can ask some questions as we go. Right. And I have now advanced to the next slide. So you're ready to go.

Dr. Arielle Silverman: 15:16

Sounds good. Thank you so much. And hi, Mom, I'm glad you're here. So I'm going to talk about this five-stage model of escalation. And as I did in my book, I'm going to compare this to a fire. And for those of you who live in the Northeastern US or Canada and that area, you're probably, you know, pretty familiar with the recent wildfires that have happened in Canada and some of the downstream effects in terms of smoke and air quality issues in the Northeastern US. I'm sorry, I certainly experienced that last week. And an escalation is like a fire in a couple of different ways. So a fire is an interactive and dynamic process that requires some kind of flammable material. And then it also requires some kind of catalysts like a match or other kind of spark To start the fire, and then also requires oxygen to keep the fire going. And there's a constant chemical reaction happening between the oxygen and the flammable material. And so you can't have a fire with just one of those things. Like if you just have a match by itself, or you try to light something on fire, that's not flammable, it's not going to go anywhere. Similarly, you can have all the most flammable material in the world, all gathered up. But if there's no spark, it's never going to catch on fire. And if there's no oxygen supply, the fire is not going to last. And similarly, similarly, this escalation process is an interaction between two individuals, and sometimes also includes some other environmental catalysts as well. The other thing about fires is that it's easier to stop a fire early. So if you can stop a fire either from starting in the first place, or put it out while it's still small, you have a much better chance of getting it under control than if you wait, or even unintentionally, put things on the fire to make it bigger. And wait until it's gotten so big that it's acquired kind of a life of its own, and it has become self-sustaining. And similarly, with this escalation process, if you can intervene early, either kind of before there's an issue or in the very early stages of signs, that there's an issue, the outcome is going to be much better than if you wait until things are out of control, and then engage in some kind of intervention. Those interventions are less likely to be effective. So I'm going to talk about these five steps of escalation between two people, one holding power in the relationship and the other holding less power. And I'm going to talk about the reasons why some types of people are more likely than others to be impacted by escalation. So people, so we know in the schools, that students with disabilities, black students, Brown students, and students with trauma histories are more likely by several orders of magnitude, as you'll see in a couple of slides, more likely to be restrained or secluded than white students, students without disabilities, etc. And there are several reasons for that, I'll get into during this presentation. And then, once we've kind of explored the default case, so what goes wrong? Why do these fires get so out of control, to the point where people are suffering from restraint, seclusion, and other kinds of punitive interventions? Then I'm going to talk about how do we do better. So identified concrete strategies for the three stages of intervention. Next slide, please. So I'm going to go through this very quickly, because I think most of you are already familiar with these definitions, but in case anyone is not, we have the definition of seclusion, forcing someone into a space by themselves that they cannot escape. And restraint is physically limiting a person's bodily movement. One second. And of course also, it's important to note that restraint and seclusion are not the only types of issues of this kind. related issues include corporal punishment, and other kinds of punishments, like expulsions or suspensions. timeouts might be considered kind of a milder form of seclusion, where the person is compelled to go into a space by themselves, but they're not necessarily forced to remain in that space. Domestic Abuse often follows this type of pattern and violence, including police violence. Next slide. Here is a table of data that came from the Department of Education Office of Civil Rights Data Collection from the year 2017 to 2018. And it describes some of the disparities that I was talking about between students of different races and students with and without disabilities regarding restraint and seclusion, so we had a population of 50.9 million students during that year. And out of those students, there were about 74,000 reported incidents of students who had suffered at least one incident of restraint. And 28,000 students who had suffered at least one incident of seclusion. What we see is that the percentage of students who have a disability meaning that they receive services under the Individuals with Disabilities Education Act is 13% for all students, but if you look at the pool of only students who have suffered restraint, that number climbs up to 80%. If you look at the pool of only those students who have suffered seclusion, that number rises to 77%. So the vast majority of students who are being subjected to these kinds of interventions are students with disabilities. And this is something we probably all know, but it's important to see kind of how it's quantified. Next, when we look at Black or African American students, 15% of the general student body in this pool is black or African American, but 28%, so almost twice as many amongst the subset of students who have been physically restrained are black or African American, and 23%. So about 50% Higher of students who are secluded are black or African American. And then what's really striking is if you look at the intersection between being black and being disabled, so OCR presents percentages of just the pool of students who have disabilities in terms of their racial breakdown. So I was able to calculate the percentage who are both black and a student with a disability. So in the general pool, that percentage is only 2.7%, which makes sense because disability is a minority, and then being black is a further minority. But amongst the subset of students who have been restrained, 22% are black or African American, and disabled that combination. So almost one in four of the students who have suffered a restraint, are both black and have a disability. And then with seclusion, it's about one in six 16% of students who have suffered a seclusion event during that year are both black and disabled. So very clear disparities here. A couple of other disparities that I don't have numbers for necessarily. We know that children who present as boys are far more likely to be restrained or secluded than children who present as girls. We also know that Brown students are more likely to be restrained or secluded than other white or other other races, ethnicities of students. And students with trauma histories are also at greater risk of restraint and seclusion than those without trauma histories. And we'll talk more about why that is over the next few slides. I think I did a little bit of searching on

Guy Stephens: 23:35

Arielle, Can I pop in with a quick question? Yeah. Okay. So I have a question here from Cass, who says, Has anyone been able to guess at the percentage for non-speaking or minimally speaking students? Which is a great question, because, you know, we know from what we hear that, you know, if you look at disability codes, and I've looked at data, we, unfortunately, don't have all the data at the federal level. But when I've looked at state level data, you often, if you kind of drill into disability, I find that autistic students are much more at risk of being restrained, and secluded. And, of course, we often hear non-speaking students. Have you had any luck finding any information on that? that. And I couldn't find numbers. I didn't search, necessarily exhaustively, on that. So that would be a subset of students with disabilities, of course, you know, I am going to talk about some risk factors that are unique to non-speaking autistic students that will put them at risk in terms of how they're treated by educators, so I'm sure it's a high percentage, but I don't know exactly what that number is. Yeah. I mean, we certainly hear that anecdotally. But, you know, the one point this brings up, Cass is, you know, we're always advocating not only for the education piece, but you know, how do we change laws and policies? And we do know that, aside from the Office of Civil Rights Data reporting that there are states around the country that do report data. And if your state is not one of them, you should push to make sure they're one of them. But this is something that probably should be considered to be added to the data collected by state. So I just thought about that, as I saw this question. Two other questions here, I think, one from Karen, who says, this may be a silly question. But how does one go about getting this data for their district without asking your district?

Dr. Arielle Silverman: 25:29

How does one go about getting it? Yeah, I mean, I don't know if it's collected on the national level on a district-by-district basis.

Guy Stephens: 25:41

Yeah, actually, I can help with that one a little bit. There actually is on the OCR website. There is an OCR data website. And you can actually drill down by school and district, as I recall, and I'll put that link in the chat here. But just if you go there, you'll see find schools and find districts. And you can drill down and see all sorts of data. Now, of course, the big caveat there is that the OCR data is the best national data that we have. And it's horrific. I mean, if I'm being honest with you, the data that we're getting through OCR is very incomplete. And that's not just a matter of opinion, the office, excuse me, the Government Accountability Office back in 2019, actually came out in a strongly worded letter to the Office of Civil Rights and said, there's a problem here we have these large districts reporting zero. That said, you know, there is data there that you can find, even beyond the data that's not reported. We also know that this goes unreported so often. I just want to see what else we have here in terms of questions, and then we can move on. Let's see, these stats are so very insightful. Being Canadian, we don't collect race-based data, which is problematic. And again, we're actually working with people in Canada as well, to try to get changes made there. And that's important data. That's an important piece of looking at all of this. All right. So that's enough of the questions for now. So let me let you be ready for me to advance the next slide. Yes, please. So slide number five and move forward.

Dr. Arielle Silverman: 27:14

So just to note, before I go into this is that I'm going to use a little bit of shorthand here, when I talk about the five stages of escalation. So I'm going to use the term student to talk about the person in the situation who has lesser power, and the term teacher to talk about the person who has greater power. Of course, if we're talking about classrooms that dynamic makes sense. But I just need to note that teachers and students are not the only ones. That's not the only relationship where this kind of dynamic can occur. Students can also have this dynamic with paraprofessionals, with school administrators, you know, other types of service providers, parents and children can have this dynamic. Adults can have this dynamic if one of the adults is in some kind of custodial situation. So Guy was talking about residential treatment centers, nursing homes, those kinds of dynamics where one person is in kind of a custodial arrangement with another person. And then, of course, police-civilian interactions are interactions of unequal power. So when I say student teacher, you know, personalize that to your particular situation if you're thinking about a situation that's not a student-teacher dynamic. But what we have here is step one, and that is that there's some sort of what I refer to as conflict. And that's a pretty broad term. So Ross Greene uses the term incompatibility, and that term would also work. This conflict is really any kind of discrepancy between the student and the environment. So if you think about it, and we'll get into this more on the next slide, when we think about like sensory challenges constitute conflicts where there might be sensory stimuli in the environment that challenges the student, overwhelms, or causes pain to the student. We might also think of more interpersonal conflict, like a demand from the teacher to the student. So the transition is a big one, you know, the student or the teacher requesting the student to come in from recess or pack their belongings or move from one class to another, you know, go to lunch, come back from lunch, all those kinds of transitions can present conflict if the student has difficulty with the transition demand for any number of reasons. Conflicts can also go in the other direction if the student has a desire or request, or a need that's not being met. So the student might be hungry and they might ask for food that's not provided. Or they might have a sensory need to go outside and move their body, and they're being asked to sit still, that would create a conflict. We might also think about conflicts in the environment that are not interpersonal. So like I said sensory triggers physical conflicts, like maybe the temperature in the room is problematic, or the student has some kind of physical dysregulation going on that can create a conflict or even conflicts between the student and a piece of technology like an iPad dies, or something isn't working right with a piece of technology. Academic conflicts can also occur; students are expected to do things academically that either maybe they don't understand the expectation, or they have difficulty meeting the expectation, and due to some kind of a lagging academic skill or some kind of processing difference, that makes it difficult to meet that expectation. And we have a picture here of a burning match to kind of signify that this is the first step in the fire. Next slide, please.

Guy Stephens: 30:54

Sure, as we advance, I'll just mention real quickly, Mickey who looks at data and looked at data in Texas found that 21% of the students that were restrained were autistic 41% had an emotional disability of some sort. And I'm not a big fan of that categorization. But nonetheless, that's for sure. And I also just wanted to let you know, my friend and colleague, Linda, who is in New Zealand, has joined on. And so you know, you've made it all the way around the world now. So with that, I will advance your slide, and let you move on.

Dr. Arielle Silverman: 31:35

I don't know what time it is New Zealand but thank you for getting up early for this.

Guy Stephens: 31:38

It's bright and early. And my recollection is it's somewhere around six or seven o'clock in the morning, tomorrow. So it's Friday. But if Linda is still there she may tell us.

Dr. Arielle Silverman: 31:48

Right. So why are these conflicts more likely to occur for certain types of students? I think some of these answers maybe are pretty obvious. People with sensory processing differences might have reactions to stimuli and the environment that might be okay, for you know, the average neurotypical student might create a lot of distress or even physical pain for people with sensory processing differences. Generally, we can think of students with disabilities as just having more incompatibilities with the environment generally because by definition, a disability creates a disadvantage in the typical environment, the typical environment is not set up for us. And so environments can simply be inaccessible. Academic expectations can be out of reach for students with certain types of disabilities. Transitions can actually involve a lot of processes, cognitive and emotional processes that for someone with an executive functioning disability can be very hard to achieve in order to meet the expectations of an external person like a teacher. So transitions could pose a lot of challenges and conflicts for students with disabilities, communication disabilities, so students who are non-speaking, or students who are situationally non-speaking, so they may be able to speak, but in certain situations, they may not be able to speak. So if the teacher is expecting them to speak, that can cause distress. And the other, so there are a lot of reasons why students with disabilities would face step one. We might also think about cultural differences. So when we talk about Brown students in that category, many of those students may be English language learners, or they may be immigrants or children of immigrants who are still adjusting to being in the country that they're in. And so due to these language and cultural differences, they may not understand expectations, or they may have difficulty meeting the expectations of others across cultural or language lines. So all of those things can create conflicts for the subgroups of students. Next slide. So now we get to step two, and step two is when there's been a conflict, and then the student has a stress response. So let's think a little bit about what's happening internally for the student at this point. Oftentimes, what happens when there's a conflict, and this is what the term that Mona Delahooke uses is neuroception. So we all have a mechanism in our brains that is intended to keep us safe. And this neuroception mechanism tells us when there's an immediate survival danger in the environment. So if you think about being chased by a bear. So when we're being chased by a bear or when we're confronted with something that feels like we're being chased by a bear. We have these kind of primitively wired emotional and neurological reactions where we experience physical changes, like increased heart rate, increases in physical tension and blood flow to our legs, for example, and our bodies are gearing up to either fight, or run away from the bear, or whatever it is. And so similarly, for students who are facing these kinds of conflicts, that they have limited power in the situation limited, controlled, to be able to overcome these conflicts, their bodies and emotions can go into a stress response. And it's important to note that the stress response is mediated by this bottom-up part of our brain, it's the emotional processing part of our brain that's not necessarily thinking deeply or carefully or making, you know, careful plans or goal-directed behavior, this part of our brain is really intended to keep us alive. And so when neuroception engages, people may experience emotions like fear, anxiety, desire to avoid whatever the stimulus is that triggered the stress response. Sometimes students might also experience anger or frustration, for example, if they're in the middle of doing something, and then they get interrupted by a demand to transition to the next activity. Or if they feel like there's, they have a need that's not being met, or if there's a perception of injustice. That because they're being compelled to do something that maybe peers are not being compelled to do, or they're facing a barrier in the environment. Students may experience those emotions of anger or frustration, negative self cognitions, especially if this is a conflict that has come up a lot, repeatedly. And the student might have thoughts like, Oh, I'm not good at this, I'll never be good at this, or my teacher doesn't like me, those kinds of thoughts can come up. And so we start to see the first little sparks of the fire here we have a picture of a barbecue grill, and there's a few little sparks starting to come out here. Next slide, please. And so then what we see is a behavioral manifestation of the student stress response. And this can look different for different people. So in some cases, you might see kind of fight behavior. So the student might verbally protest and say, No, I don't want to come in from recess, or I don't want to do that. There might be you know, use of profanity, there might be angry appearing body language, or what some people refer to as having an attitude, you know, verbal or nonverbal kind of gestures of fight or protest. So the student is expressing that there's distressed by the situation, or we might see Flight Behavior, so eloping, running away hiding, avoiding interaction with the teacher, because the demand is causing the stress response, and the student is protecting themselves by engaging in flight. A third way that these stress responses might come out is through freeze behavior. So and with any of these responses, a common kind of visible reaction is crying tears can express a lot of different emotions. Students might show more anxious body language, or they might just freeze in place and not be able to comply with the directive from the teacher. And it's critically important to note that these reactions are bottom-up reactions. They have limited control. So this is not something the student is putting on or purposely engaging in order to try to get out of a demand or to try to get their way or to try to meet specific goals. These responses are stress responses that are mediated by the emotional part of the student's brain. And as students get older and more mature, they can learn we can all learn coping skills and self-regulation skills to be able to manage those stress responses, but they are not deliberate responses. Next slide, please. So now we'll just briefly explore some reasons why some types of students may have a bigger kind of stuff to stress response than other types of students. Some disabilities can make stress responses more sensitive. So autistic people will often describe not only having more sensitivity to sensory stimuli, but also sometimes more sensitivity to emotional stimuli, and more sensitive neuroception response. And then kind of compounding that autistic people face a lot of trauma from the environment not being accessible or sometimes applying very explicit pressure to try to modify their stress responses. Communication or mobility challenges can make it harder to get needs met. So we talked about non-speaking students. If someone is unable to clearly say, this stimulus is bothering me, or the stimulus is hurting me, please stop it. It can be more difficult for those students to get their needs met. And that can cause stress. Similarly, if someone has a mobility challenge, or even somebody like me, as a blind person, if I'm in a sensory environment that's problematic, I don't necessarily always know the best way to exit the environment where someone who can see can easily kind of move themselves out of the environment. And so that can put me at risk for more of a stress response. And trauma is a big factor that directly increases the intensity of stress responses. So if we think about our neuroception system that is picking up on threat, and it is helping protect us from threat, if we've, if we've had a threatening situation happened to us before, you know, if we've been attacked by a bear once, then the next time anything comes out, that seems a little bit like it could be a bear, our body and mind is going to immediately engage the stress response, just in case it's a bear, we, you know, better safe than sorry. So that that stress response gets enhanced, every time someone experiences a traumatic event. And we know that racialized trauma is a thing that affects students, you know, interacting with teachers across racial lines. Often there is a sense of distrust or even danger in the schools when people are working across race lines, and of course, other types of trauma, including a lot of trauma that is concomitant with the way disabilities are handled, can increase the magnitude of these Step Two stress responses. Next slide, please.

Guy Stephens: 41:52

Before we move on, just had a quick comment here from Moot's Place, the page, and just said often for Autistics during a stress-related shutdown, even expecting nonverbal communication is escalating.

Dr. Arielle Silverman: 42:06

Yeah, expecting any communication at all.

Guy Stephens: 42:11

Yeah, I'm gonna go ahead and bench.

Dr. Arielle Silverman: 42:15

Okay, so we should be on slide 10. And so, at this point, we're at a crossroads. So the student has expressed and has developed a stress response, and that has become apparent. And we're at a point where the teacher can either intervene, de-escalate, defuse, support, and coregulate with the student and in that case, the fire goes out. That's what we want. But all too often, what happens instead, is that the teacher, you know, either intentionally or unintentionally does things that makes a fire bigger and make the stress response bigger. So let's explore that pathway and why we often end up going down that pathway before we talk about how to do it better. Teachers will often have their own stress reactions for a variety of reasons. Teachers are under a lot of pressure, there are a lot of expectations from of course from administration, and teachers are often under-resourced, and under-supported. There can be competing needs, if you think about a teacher with a class of 30 students, and one of them is having a stress response about coming in from recess. There are 29 other students who also require attention. And if the teacher doesn't have enough support, to be able to support that one student who's struggling, and then also support the other 29 students, that can create a conflict situation for the teacher. Of course, safety concerns, if the student is eloping, it's natural to have safety concerns, and some of those fears and anxieties, fear of judgment from outsiders. And this also affects parents, in a lot of cases, if their child is having a visible stress response. The parent worries about being judged by others on the outside. There are also thoughts and beliefs in addition to these emotional reactions. There are also thoughts and beliefs that can be problematic. So catastrophic thinking is basically worrying about something far off into the future that could happen. So I've seen, you know, sometimes parents express fears that if their six-year-old continues to behave the way that they do under stress, that when they're 18, they might end up getting arrested. And so sometimes those catastrophic thoughts can blow out of proportion. There's also a lot of societally accepted beliefs about the nature of children's behavior, which are worse for some types of children, which we'll talk about it on the next slide, but generally for beliefs about how to work with all children. There's a lot of beliefs out there suggesting that If kids are showing stress responses, they're doing it on purpose. Because they're trying to achieve a goal or they're trying to avoid some kind of non-preferred activity. And so for example, when I was working on this presentation, and just for fun, I typed in the four functions of behavior into Google. And I got this website that was actually an Applied Behavior Analysis website, which we'll talk about more in a second. But they were trying to argue that all actions they said could be attributed to either attention-seeking, escape, access to tangible items, or sensory needs, and I'm glad that they acknowledged sensory needs. But generally, the tone of that website, first of all, the idea that all of our behaviors are only done for four reasons is preposterous. As a social psychologist, I'll just say that right now, behavior is far more complicated than that. Secondly, it does not account for, again, this primitive survival fight, flight, or freeze reflex as a cause of behavior. And thirdly, and most importantly, a lot of the implications of that way of thinking are very problematic. So people have argued that stress response behavior is attention seeking, and so we should just ignore it. But you know, if you ignore a fire, it's just gonna get bigger. You never want to ignore fire. And at the same time, you never want to ignore somebody who is showing signs of distress. Or the argument is that, and this was actually explicitly said on their website is that children have meltdowns intentionally. And that they shouldn't be reinforced for having meltdowns. And that's a really problematic belief that's in the industry, especially affecting autistic children and other children with disabilities, is that if someone is showing stress, we don't want to reinforce their stress by giving them what they want, or by giving in. And there are also beliefs about punishment and consequences that are problematic as well. So commonly, people believe that, and it comes from a very positive place and a very loving place of wanting to teach kids to grow up and be resilient and be accountable to others and be self-reliant. And so the belief goes that if someone is doing something that we don't like, we should impose a consequence so that they won't do it again. And in fact, what behavioral scientists have found even with animals, even with rats and pigeons, is that punishment is just disregarding the humanitarian impacts of punishment, and that punishment is not effective. Basically, when you punish someone, or when you threaten to punish someone, you're introducing a new bear. So you're introducing something else for them to be afraid of, that might cause immediate compliance. And so people think it works because they threatened to take something away from a child and the child will immediately comply. But when the child is in that situation, again, they haven't generalized the behavior change. And if the behavior is arising from a stress response that they can't control or have limited control over, punishment is completely useless. And yet people cling to this idea that imposing consequences and being consistent with imposed consequences, helps students and children grow in the long run. And in fact, what we know from neuroscience research is that being responsive to children's needs, so not just rigidly enforcing rules, but actually being responsive, and connecting and co-regulating with young people. It's not giving in and being permissive, and giving them what they want, it's collaborating with them and working with them and supporting them so that they have the emotional safety, and psychological safety to be able to build up their resilience as they grow and to be able to solve problems as they grow, because they learned how to solve problems collaboratively. Next slide.

Guy Stephens: 48:57

Before you move on to the next slide, I had to say, first of all, I was off, you know, kind of off the screen over here cheering you along there. I love the way that you address all of that. And you're so right. I mean, so often there's this idea, you know, the four functions of behavior. I mean, behavior is biology, behavior is far more complex than one of these simple four functions. But, you know, I think just the idea that many people think that all behavior is intentional, is so problematic. We had a comment here. So anyway, I just want you to know, everything you said there. Yeah, everything you said they're just really well put. Let's see, Bridget said from Let Me Spell It Out, that problematic belief of simple behaviorism is rampant. And mainstream in many parenting and education communities in the world of autism. And absolutely, I think that's correct. I mean, absolutely. Our schools are full of behaviorism there's still an awful lot of really bad parenting advice out there that is very focused on behaviorism. And of course, you know, I think probably like you, Arielle, I'm a big fan of Dr. Alfie or Alfie Kohen's work. And, you know, we know better, we know better. So anyway, I just wanted to let you know that I and probably others are cheering you on with what you were saying there. And I will advance the next slide.

Dr. Arielle Silverman: 50:25

Excellent. So I'll just quickly go through kind of the rest of the ugly part of the cycle of escalation. And then then we'll talk about how to do better. Although I feel like most of the people who are here already know the answer to that. But well, we'll get to it. So what happens when teachers are responding either from a place of emotional stress or from problematic beliefs about behavior? What happens in that case, we see counter-responses from the teacher. So the student maybe is crying or they're not doing an assignment or they're running away, or they're saying I don't want to do the assignment or whatever it might be. And instead of supporting the student, the teacher might do things like yelling, repeating the request, and often doubling down on the request. I told you, I told you to do that assignment. reprimanding students for being non-compliant, you know, imposing threats or punishment or actual punishments, as I mentioned, which could be anything from taking away recess for the rest of the day, all the way to expulsion, or corporal punishment. Postures of power, or kind of physical maneuvers to try to regain control of the situation like physically carrying a student to where they want them to go or removing an item from the student. One thing just to emphasize quickly is that when teachers are reacting from a place of emotional reactivity, they can have the same challenges controlling that reaction as the student does because they're having a stress response too. But, for two reasons, teachers have a greater ability to take control of those stress responses. Firstly, teachers are adults. So if we're talking about a student who is not yet an adult, the teacher has a more mature brain and has had more life experience and more time to develop and test out and refine their coping skills. And secondly, the teacher has power in the situation even though sometimes teachers have limited power because they have limited support from the administration and so on. The teacher has access to tools and resources that almost by definition the student does not have. And so for those two reasons, it is incumbent on the teachers or whoever else it is who is holding power in the situation to take the lead in putting out the fire. Next slide. So returning to the question of why some students are more susceptible to restraint and seclusion than others. We've talked about some reasons why students with disabilities might be more reactive, they might experience more stress responses because they have more conflicts. And because those conflicts might elicit greater stress responses. We talked about students from different cultural backgrounds might also experience more conflicts and students who have trauma histories. We also see this, I would say, at least as much on the side of the teacher and how they interact. So we talked about how philosophies and how to interact with autistic students in particular, so formalized procedures, like applied behavior analysis, or positive behavior support are often used with all students but to a much more systematic degree, with students with disabilities, particularly autistic students, and generally, and I can say this from firsthand experiences while growing up as a blind person. The behavior of students with disabilities is surveilled far more than the behavior of students without disabilities, and we see examples of cases where a student with a disability is bullied in school. And instead of intervening with the bullies, the student with a disability who was bullied is the one who is assigned to receive social skills training. And that's just a really backward fact about our special education system. That's the student who is the target of bullying, who is expected to change their behavior instead of actually intervening with the bully. The other major issue is regarding implicit bias. And as a social psychologist, the professors that I studied under in graduate school that was their main area of focus was about implicit racial bias. And so we know that, in many ways, people have biases, for example, associating Black or African American people with danger or threat. And when a teacher is in a situation where they are relying on the emotional part of their brain, they're having a stress response, they're not using careful thinking, or they might be operating under time pressure. If they perceive that the student is behaving in a dangerous way, that will lead them counter-respond. And unfortunately, because of these deeply held implicit biases, teachers are more likely to react to certain types of students, particularly Black and African American students as if they were behaving in a dangerous way compared with white students. So intervention to close these gaps, and to reduce the restraint and seclusion of black students must address these implicit biases, in addition to addressing some of the other issues that we'll talk about that pertain to all students. Next slide. But what happens in the situation where there's been a conflict, there has been a stress response, the student had a stress response? And the teacher yelled at the student, punished the student, threatened the student, or took control in some other way. Then we get to step four, mutual escalation. This is kind of the ultimate meltdown stage. So in this stage, the teacher and the student are reacting to each other. And it's no longer about whatever it was about in the beginning, it's no longer about coming in from recess, or the room being too loud, those kinds of things. Now, there is this kind of proximal situation where the teacher is distressed and is reacting, and then the student is distressed is reacting. And we might see behaviors from the student along the lines of hitting, throwing objects, self-harm, and possibly also elopement. And the student is reacting to the teacher's reaction. And then the teacher is reacting to the student hitting or throwing objects and the teacher is feeling unsafe. And so once we've gotten to this point, is very difficult. It's not impossible, but it is a lot more difficult to stop the cycle of escalation from continuing to move forward. A person cannot control a meltdown in the middle of a meltdown, despite what that website said. Once someone is in the throes of that kind of meltdown, there's little to no voluntary control. You can't logic your way out of a meltdown. So it becomes much harder to intervene. And one thing that I will add is, I think there are there are times when this process plays out a little bit differently. Because sometimes students learn over many, many years through kind of traumatic behavioral control, that it's not safe for them to express their stress responses. And so instead of is when a student's in step two, instead of seeing the tears or the fighting or the running away, the student will bottle it all up, or hold it all in. And so from the teacher's perspective, it seems like everything's great. And the students coping well with the environment and the conflict situation, and everything's great. But what ends up happening is that the students holding it in and not expressing their distress, and are not being supported. And so even if the teacher isn't having a counter-response, because they think everything's fine, the stress is building up inside the student, and then the student will have an explosion at stage four. And this is where you get situations where teachers say, you know, everything was great, and then all of a sudden, the student came up and hit me, or the student started throwing a chair. But it didn't happen all of a sudden, there was a buildup, and oftentimes, there are many different conflicts that are all building up on top of each other, that the student might not be expressing, especially if they can't communicate in a way that is understood by others, or as was mentioned by one of the commenters if they're having a shutdown, and they can't even communicate non verbally and that stress can build up to the point of there being a stage four kind of situation. And then it's at this point, most commonly that the teacher will resort to restraint, seclusion, or worse as a means of trying to put a lid on what's happening. Next slide. And then we have step five, the aftermath. As you can see from this picture of a burned-down home, the fire may have burned itself out, but the consequences are permanent. People on both sides, the teacher and the student may feel shame or guilt. Traumatic Stress can result in the future. Related to the event I recall in Mona Delahooke's book, Beyond Behaviors, she wrote about a case of a little girl who had been subjected to seclusion and had been locked in a room at school. And it was reported that after that incident, not only was the little girl terrified to go to school, she became terrified of the sound of a door locking. So her mother took her to a department store, and they happen to hear the door of a fitting room being closed. And the child panicked because she was having a trauma response to her experience of being secluded. Damaged relational trust, of course, between the two individuals. And unfortunately, physical injuries can occur up to and including fatality, as we talked about in the beginning with Ethan Sailor. On the next slide, we're going to do a really brief thought exercise. I know we're running out of time. So I'll move quickly through the last few slides. But I wanted to pause and see if there are any questions or comments here.

Guy Stephens: 1:01:26

And I'll just let you know that you're fine on time, as long as you're okay. And just again, if you have a question or comment, feel free to put it in the chat. And we had a number of people responding with comments here. And I'll just share a couple of those and give you a second to take a break there and get a drink. Christina said exactly. This is why restraint seclusion should never be included in a student's BIP Behavior Intervention Plan. And also said that often the teacher in the classroom is a classroom aide, or one on one aide, somebody who often has not been trained at all. So just kind of sharing that point as well. So if anybody has any more questions, feel free to put those in the chat. But I think I don't see any popping up right at the second. So we'll let you go ahead and go on with the exercise.

Dr. Arielle Silverman: 1:02:14

All right, so this should be slide number 15. We'll just take about 45 seconds to think about these three questions, and they're pretty simple questions. So number one, and you don't have to share in the comments. This is just for your own consideration. Think about one thing that you're afraid of, could be something small, like a spider, it could be something big, like the loss of a loved one, something like that. Just anything that you're afraid of that you might have to deal with at some point. The second part, think about somebody who's your safe person, that could be your partner or your family member or friend. If you don't have a safe person, you can imagine someone who would be your safe person and what that person might look like or sound like. And then thirdly, visualize auditorily, or whatever to imagine that safe person being with you, while you have to face your fear and imagine specific things the person might say or do to support you while you're facing your fear. Take like 45 seconds

Guy Stephens: 1:03:19

And I had to share that the first thing that came here. to my mind was the spider. I am six foot one and afraid of spiders.

Dr. Arielle Silverman: 1:03:32

you had no choice?

Guy Stephens: 1:03:33

I'd want them to squish the spider. Of course, my son would actually get a cup and take the spider outside. So you know, but when I think about things beyond a spider and something or sometimes when I don't feel safe. I just want somebody beside me, somebody along with me. Knowing somebody understands me, right? Yeah, I think those are kind of the things that I feel and I want to support me. It is just having that person there that connects with you and knows you. And isn't making judgments about your intent, right?

Dr. Arielle Silverman: 1:04:21

Right. Yeah, so my example is one of my biggest fears is needles and medical procedures. And I had to get a procedure done a few years ago under local anesthesia so that not only to have to deal with the injection of the anesthetic, but then I had to be awake while somebody was actually cutting into my skin and like knowing that somebody was doing that. So I was pretty scared and I took my husband with me and he, you know, he sat next to me the whole time, and he held my hand while I was getting the shots and he distracted me when I was either anxious or there was one part where I got to Little bit dizzy, and I thought I was gonna faint. And there was another part when they were actually doing the operation, and he distracted me with silly jokes or talked to me about plans we had over the weekend and things like that. And so he, you know, you didn't have any special training, he wasn't using any special techniques, he was just there and was able to intervene in these really simple ways and didn't laugh at me, even though he doesn't have my phobia. You know, he made space for me to feel the way that I did. And we got through it.

Guy Stephens: 1:05:34

You know, my son, when he was very young had a lot of dental anxiety, which I can still relate to, but I remember going in with him while he was having some things done, and just kind of being there alongside of him. And just trying to talk in a real kind of calm, and, you know, we were like talking through stories and things we had done before. And, you know, like you said, just kind of trying to distract. I remember when he finished the one of the, you know, people that were working, I was like, we need you to come in with every patient. Now. It's just that a calm voice can make so much of a difference. We had a couple of people that shared here, Mickey said, understand and validate not dismiss, calming tone of voice. And that's so important.

Dr. Arielle Silverman: 1:06:20

Yeah, 100% that. So when we talk about intervention, I'm going to steal unfortunately, I don't remember the name of the presenter. There was a presenter on AASR live about six months ago. And she talked about primary, secondary, and tertiary prevention. She was working in, a mental health or residential facility. Do you know who?

Guy Stephens: 1:06:52

Ah, yeah, it's one of two people, and I'm trying to remember, was it Dr. Huckshorn or Kevin Huckshorn or it might have been? Oh, gosh, her name was just in my head and then went away. Out in Washington State, and it'll come back to

Dr. Arielle Silverman: 1:07:08

Yeah, I don't remember her name. But she me. talks about primary, secondary, and tertiary prevention. And basically, the way that I've conceptualized this is that primary prevention. Let's move to slide 16. Yep. So primary prevention is basically before there's been a conflict situation, preventing or reducing the impact of the conflict situation. And so Ross Greene and his Collaborative and Proactive Solutions, is really key for that. So he emphasizes that a lot of conflicts that lead to distress, that lead to what he calls unlucky behaviors are predictable. It's not like every trigger is it is a different trigger, you know, students that have those kinds of stress responses, oftentimes, you can learn what the triggers are, at least, or at least generally, with the types of things that can be triggering. So primary prevention is like basic fire safety, just recognizing what the conflicts might be, and collaborating with the student to find ways to either avoid the conflicts or reduce the impact of the conflict. So providing sensory supports, modifying the sensory environment, providing accommodations for academic tasks that might cause stress responses to occur, you know, providing choices, options, those are all just ways of preventing situations from starting in the first place. And so if there is a conflict that is inevitable, that has to happen, providing support so that the step two stress response is minimized. Next slide.

Guy Stephens: 1:08:59

I was just going to add it here. I mean, so often when we find individuals, when looking at schools, and as an example of when we find individuals that are being restrained or secluded, really what is below the surface is an individual that is not having their needs appropriately met. And so much of this is preventable when we really understand and are meeting the needs of individuals.

Dr. Arielle Silverman: 1:09:28

Yeah. And it could be that needs aren't met in one setting, and the outward manifestations of that might appear in a different setting in some cases. So on slide 17, I want to just take a couple of minutes to go over this quote from Greg Santucci that AASR shared a couple of weeks ago. So he says imagine how many restraints and seclusions could be avoided If we lead with validation and compassion when a child demonstrates a stress response, so this is secondary prevention, this is step two, there's been a situation, and we're starting to see those sparks there, we're starting to see that the student is having a hard time. And they're showing some sort of fight, flight or freeze response. And so Greg was actually talking about a situation that he had with a student, where, and this was a non-speaking student. And he was talking about how he made a joke, or what he thought was a joke when the student was stimming, playing with the light, and turning the lights on and off. And he kind of jokingly said, Good morning when the student turned the lights on, but it wasn't morning, it was later in the day. And he said the student reacted to that by coming at him and scratching his arm. So the student showed kind of an initial fight response. And Greg said that you know, instead of reacting instead of saying, it's not okay to scratch me, instead of, you know, acknowledging the aggression. Instead, he took a step back and you said, No, you're right. I'm sorry, I shouldn't have said good morning. It's not morning. And then he said that the student kind of just leaned against him and took a few minutes to reregulate. And then they had a great session after that. And when I was reading, so of course, what it says about validation and compassion is right on. It also occurred to me that we don't necessarily know at least from the information we have, we don't necessarily know if the reason for the stress reaction was Greg making a bad joke, it could have been something totally different. It could have been, you know, the student might have been dealing with something in the class before he went to Greg's room, that he was still processing, for example. And because, you know, the student was non-speaking, presumably, they didn't necessarily communicate what the trigger was. But we do know that when Greg took a step back and validated his feelings and said, You're right, and I'm sorry, the student was able to reregulate. And so this kind of demonstrates that in many ways, it's more about the emotional connection and the validation. From this bottom-up perspective, it's more about that than necessarily kind of logically responding to what the issue is. And it's funny, when you think about validation because it really doesn't make any sense. From like, a psycho-psychological perspective, or thinking logically, it doesn't really make sense why we feel so much safer when somebody agrees with us, or when somebody acknowledges that the distress that we're experiencing is real, you know, if somebody is being chased by a bear, having somebody else say, Oh, wow, that bear is huge, that bear is really scary like that, that shouldn't really help the situation, but it does. And I mean, we've all had experiences when, you know, got upset, and we reached out to a friend or family member and vented and expressed our feelings. And we always felt better when the person, first of all, listened to us, second of all, kind of provided emotional support. And third of all, we often feel even better when they agree with us. And the only reason I can think of why that's so effective is I think the validation is kind of a proxy signal for when somebody says, I hear you, and I understand what you're saying, or even I agree with what you're saying. It's kind of a proxy for I've got your back, and I'll fight for you. And perhaps there was a time in our evolutionary history when the types of people who backed us up emotionally also backed us up physically, when we were under physical threat. You know, in the great hunter-gatherer days or whenever it was, so there's something really powerful on a bottom-up level on this basic emotional level of stepping back and sitting with the person who's having a stress response and saying, Wow, I hear I hear you, and I understand what you're saying. I understand what you're communicating. That can be a very potent force of de-escalation. Next slide. So I wrote in my book about this stop, ask, listen formula, which is really just a basic description of how we can intervene on the secondary level. So when somebody is having a stress response, first thing we want to do is stop our whatever our instinct is telling us to do next, if our instinct is telling us to yell or to punish or to double down and insist that we're right and they're wrong. We want to stop that as quickly as we can. And so that means engaging in self-regulation strategies, which will differ for every person. Secondly, ask, to check in with the person. See if the person is able to communicate what the source of the stress response is, sometimes people can communicate that. And sometimes you might be able to provide a solution. So ask the person what is causing the stress and then listen to what they say and validate. And provide support or provide a solution, if you're able, sometimes the cause of the stress is something that can't necessarily be fixed on the outside, but making space for the person to express how they feel and to be heard and to be validated, might be all that's necessary to turn things around. And just really quickly, I'll share a student that I worked with a few years ago, who was a neurodivergent student, and sometimes in group situations, if he was having a stress response, he would walk out of the room. And there was one time when this happened. And so I went outside and found him and sat next to him and asked him what was going on. And he told me that he felt that the way that another staff member had spoken to him was what had been causing him stress. And so, you know, instead of defending my coworker, instead of saying, you know, you need to listen to him, and so on. I listened to what the student had to say, and I said, you know, actually, this person, this other staff member, I said, he's a good guy. But he sometimes gets really excited about things. And just between you and me, sometimes he stresses me out a little bit, too. And I remember when I said that to the student, he, I hear, so I can't see his body language. But I could hear that he was kind of adjusting himself in his chair. He was adjusting his posture and his voice, the tone of his voice became just so much less stressed, so much more calm. And he was able to kind of open up to me about some other things that had been causing him stress. And then it only took maybe a couple of minutes, and he was back to his old self. And then he said to me, you know, Arielle really helped me out a lot when you told me that sometimes you have a hard time with the other staff member. And that always really stuck with me that he was able to articulate how much being validated actually helped him regulate in that situation and something that has always stuck with me. And I think a lot of working with teenagers and young adults, especially who are really seeking autonomy and independence, and mastery over their environment, and over their identities being validated is so so important. Next slide. So we're almost done here. I'll just mention the last phase of prevention, which is tertiary prevention. And so this is after things have gotten to step four. So even sometimes our best efforts to prevent at step one, step two, or step three, may not always work for one reason or another. Whether it's a case where the student has been kind of internalizing their stress, and then it all blows out in step four, or, you know, we make mistakes, sometimes we miss the early signs of stress, or sometimes we lapse, and we might react in a way that unintentionally escalates things. So if we got to step four, where the student is actually to the point of more kind of over Fight, fight or flight behavior. Ross Green says, What can we do in that situation, we can't do as much as we could do in the earlier steps, but what we can do is diffuse, de-escalate, keep everyone safe, and figure out what just happened, so it doesn't happen again. So if a student has a history of experiencing frequent stress responses, like in the classroom, for example, they should have a safety plan. And you can identify sometimes maybe with the help of an occupational therapist, you can identify sensory inputs that can help the student feel safe when they're in a dysregulated state, because that will be different for every single person. So ideally, you will have that information and be able to implement whether it be music or visuals or giving them objects to use for regulation or, you know certain words or certain phrases that on the emotional level because at this point, logic has gone out the window. But on an emotional level, you can support them through that state of heightened dysregulation until it turns around.

Guy Stephens: 1:20:05

Arielle, I was just gonna add that, all too often we see things like restraint and seclusion in a safety plan, which, of course, is not something to help somebody to feel safe or something and help somebody to feel, you know, help somebody to get regulated. And I think that's so important. I mean, you know what you're talking about, when you talk about safety plan, it's really, how do we help the individual to feel safe. And it's only when we feel safe, that we can return back to, at some point, feeling regulated where our prefrontal cortex will then again, be available. So I think it's just so important to realize that a lot of people think about safety planning, and they think, Oh, well, this is about physical safety. And that's not necessarily what we're talking about.

Dr. Arielle Silverman: 1:20:50

Right. No, that's an excellent point. So I don't know if there's a phrasing that signifies that it's more about kind of person-specific. Regulating strategies that don't involve control?

Guy Stephens: 1:21:08

Yeah, I think the wording is fine. I think the shift that needs to happen is how people think about what is needed and the safety plan. Because again, I mean, if we're able to help someone, if we're able to help them to feel safe, whatever other danger might be there is going to dissipate. So, you know, I think it's just the reframing and hopefully one that people will begin to think about.

Dr. Arielle Silverman: 1:21:34

Right, and I mean, needless to say, restraint and seclusion are not safe. You know, it's temporary control of the acts, but all too often it creates more danger, either for the student or the person who's doing the restraining

Guy Stephens: 1:21:48

Right, Yeah. But both in the short term and in the long term. I mean, people often say that they need restraint and seclusion to keep everybody safe. But the truth is the most likely injuries occur when people are using physical interventions like restraint and seclusion. And then of course, we know that due to the trauma of the restraint and seclusion, trauma changes, the brain, kids are more likely to be hyper-vigilant in the future, are more likely to have distressed behavior. So it creates a cycle where it's happening more and more, not less.

Dr. Arielle Silverman: 1:22:20

Yeah, I'm curious if the OCR has captured, and they probably don't capture this. But has anybody captured out of the number of students who have been restrained and secluded? How many repeats?

Guy Stephens: 1:22:30

Yeah, I mean, there are some average. Yeah, there is some data around that. And of course, one of the things that OCR says in there, they issued a guidance back in 2016, and in the form of a Dear Colleague letter, and they essentially said in that dear colleague letter that if you're repeatedly restraining and secluding the same child, we would likely not find in your favor that it's reasonable, because you know, that point you're talking about a plan intervention, but very often, these things do become planned interventions, they end up in safety plans, they end up in IEP s, and they end up out of the places where we see them happening repeatedly to kids. And of course, you know, the more you're doing it, the more you're going to see it. So I don't recall if it's in the OCR data source, but I know, other data sources that I've looked at, have included in I'm trying to remember the way it's been phrased, but the number of individuals and then the number of instances that are unique, so that you can kind of calculate what the rate was on certain individuals.

Dr. Arielle Silverman: 1:23:36

Yeah. Right. But the fact that it's planned ahead of time and not even urgently is very concerning.

Guy Stephens: 1:23:45

Oh, absolutely. Absolutely. In fact, you know, we had an issue here in Maryland, where at one point they wanted to include restraint seclusion in the IEP. And what we found is once it was an IEP, it was far more likely to happen. Once you talk about something in the context of a plan, it becomes much more likely and of course, the intent and I would say misguided intent is that restraint and seclusion. I don't feel that seclusion is ever an appropriate intervention. I think restraint should be exceedingly rare and only in a situation that truly was life-threatening, but the data and what we find is that once something like that is planned for that. It will happen repeatedly.

Dr. Arielle Silverman: 1:24:28

Yeah. Yeah, absolutely.

Guy Stephens: 1:24:32

Are you ready for me to move on? I'm sorry.

Dr. Arielle Silverman: 1:24:35

Yeah, so I'm, I'm actually done. But the last two slides here are just resources. And I think many of these viewers will already be familiar with Ross Greene and Mona Delahooke. I don't have Alfie Kohn on here, but I've only read one of his books so far. I should join this book club and learn about Some of the other books that I haven't read.

Guy Stephens: 1:25:01

We haven't done one of his books, but his books are amongst my favorite, of course, Punished by Rewards is an excellent book, and always a great read. And you have here your contact information as well, including your email and website. So I'll give people a minute to grab that if they'd like to. And of course, if you have any questions, I know we've gone a little bit longer, but if you have any final questions, please feel free to put those in the chat. And we'll see if we can get to a couple of them. And I'm gonna go ahead and remove this screen here. So it'll just be back to you and I and we've had a great, this has been fantastic. Arielle, you know, I really appreciate how well I really appreciate the way that you talked about all of this. And you're so right on with all that you shared with us today. And there's a lot of change, it's needed to move things in a better direction. I'm seeing a lot of thank yous beginning to show up here in the chat, and we've had a really nice, engaged audience, and they've been really, you know, here, putting in a lot of comments as we've been going. This is fantastic. And I really appreciate you sharing this. I do want to because of course you you were diving into, you know, restraint and seclusion in your presentation. But, if you would be willing to give us a little bit of background on your book, Just Human. You know, as I mentioned, as we got started here, I think we'll probably get this scheduled for books study in the future. So would you mind telling people a little bit about your book? And we'll give people a moment to put any questions they have. And then we'll wrap up here.

Dr. Arielle Silverman: 1:26:47

Yeah, of course. So most of my book is so that the title is Just Human, the quest for disability, wisdom, respect and inclusion. And most of it is a memoir about me and my life growing up as a blind person, and kind of understanding ableism and understanding that people didn't always see blindness the way that I did. Because for me, it was a very natural way of existing, and I never really felt like I was deficient in any way. But other people saw me very differently. It's written so that each chapter is based around different parts of my life. But then it also has some kind of broader lessons either, including nuggets from disability scholarship, disability history, or social psychological research. So for example, there's a chapter in there about an experience I had as a preteen being bullied by a friend and being rescued by a boy that I had a crush on. And so that's a fun story to read. But it's also has this lesson about kind of the power of one, the power of just having one person stick up for you being being really powerful, which, of course, is backed up also by social psychological evidence. So most of the book is kind of a personal memoir, but it moves as you get later on in the book, it moves a little bit more toward this kind of collective fantasy vision of a world where everyone is kind of radically accepted for who they are. So a lot of ideas about neurodiversity. And in chapter 15, is where I talk about the five steps of escalation. And then kind of ending with thinking about what things might look like and how we might all work toward a world where everyone is accepted for who they are.

Guy Stephens: 1:28:45

Let's hope that's not a fantasy. Let's hope that, like the people in our audience, and you and others, we've got to keep pushing for things to get better.

Dr. Arielle Silverman: 1:28:55

I was just going to add that just a housekeeping thing. So the the link that was shared for my book, that was probably the Amazon link. So that's probably the easiest way to get it. That's the easiest way to get it in paperback or as an ebook. There are a couple of other formats that can be purchased directly from me, including an audio version that's $15, you can buy directly from me and some other versions. So if you're interested in a different version of the book, like a digital PDF, or an audio version, you can go to my website and all the information is there about all the different ways to find it.

Guy Stephens: 1:29:28

Fantastic. And I just put that link in the chat as well. And I think the link we linked to earlier today on our Facebook well on our social media, was that link also. So great. I appreciate you doing that. Well. I want to share with you a couple of the thank yous here real quickly, and then we'll wrap up. Let's see. Bridget said Thank you, Dr. Silverman. Thank you for an excellent conversation. Christina said this was excellent. Thank you. Mickey said it was super duper. Thank you In the bonus a great program. Yes, let's hear it for change. Thank you, Arielle. Cassie said thank you, thank you for being out there making these important things known this is valuable. And already somebody's ordering your book. So that's great. That's great. So and I really appreciate all of you that have been on with us. I mean, you know, it's hard in our days, the fine, you know, an hour and a half to sit down and do something. But I noticed that the people that started with us here had been on for the whole time and really appreciate that. This has been amazing Arielle, is there anything else that you would like to share with our audience before we wrap up and say goodbye to everybody.