PEEL DISTRICT SCHOOL BOARD

PROCEDURES FOR DEALING WITH STUDENTS SPECIAL EDUCATION EXHIBITING HIGH RISK BEHAVIOURAL DIFFICULTIES SUPPORT SERVICES 17

Section 1: Context Section 2: Responding To Students Demonstrating High Risk Behaviour Section 3: Responding To Threats

Section 4: Responding To Students Suspected Of Alcohol Or Substance Use Section 5: Responding To Non-Suicidal Self-Injury Section 6: Suicide Prevention, Intervention And Post-Vention References SECTION 1: CONTEXT Guiding Principals This operating procedure provides school personnel with background knowledge and recommendations to support students who demonstrate high-risk behaviour that may include aggressive behaviour and violence, threats, suspected alcohol or substance use, self-injury and suicidal ideation. All students and staff need to have a safe and caring environment for learning and working. School success plans focused on developing a positive climate for learning and working are the foundation of the creation of safe and caring learning environments. The collaborative approach outlined throughout this Operating Procedure is supported by Partners in Learning and Shared Solutions. The In School Review Committee (ISRC) is a foundational problem solving forum for school teams to meet the needs of students demonstrating challenging or high risk behaviour. The ISRC should refer to the ISRC checklist as well as the ISRC referral form. Guiding principles of this document are grounded in Board Policy 48: Safe Schools and include:

The Peel District School Board is dedicated to the well-being of our students and is committed to providing safe and caring environments for their development. Students who are struggling with mental health and/or behaviour concerns often reach out to a caring adult in order to seek help.

All members of our school communities have the responsibility to develop positive and caring relationships and to know each student’s profile in order that we can effectively meet their overall needs

Staff will work with families and community agencies to plan for student transitions and needs.

When a student expresses concern or presents behaviour that is concerning, all staff members have the responsibility to immediately share concerns for student well-being with administration and develop a support plan.

At the beginning of each year, school administration must:

Review this Operating Procedure with all staff and volunteers that may come in contact with students who have high risk behaviours

Access the list of ASIST (Applied Suicide Intervention Skills Training) trained staff members within the SIS module, print the list, post it on the Health and Safety bulletin board found in each school and review the membership at a staff meeting

Review safety plan protocol with all staff and volunteers that may come in contact with the student

Review risk assessment protocol Definition Of A Multi-Tiered Behaviour Intervention Approach

A multi-tiered approach to intervention should be adopted:

At the Universal: Good for All (Tier One) level schools must work to create a safe environment for all, with school-wide anti-bullying policies and programs, promotion of social problem solving, and non-violent conflict resolution. Focusing on the student’s profile will help to ensure effective problem solving.

At the Targeted: Necessary for Some (Tier Two) level, schools require professional development and students need to learn about and recognize the warning signs or clues associated with impending violence and/or aggression. Students need to know there are staff they can turn to if they are experiencing a crisis or know of another student in crisis.

At the Intensive: Essential for Few (Tier Three) level, schools may require a multi-disciplinary team, including community partners, to support a situation that has escalated and poses imminent danger. Students who demonstrate aggressive or violent behaviour have underlying needs that need to be identified and supported to ensure the safety of all members of our community.

Responses to incidents ideally should occur in sequence; however, student behaviour may necessitate a higher level response to a single incident. Interventions should proceed cumulatively. In other words, Tier Two intervention works within the context of Tier One intervention and Tier Three intervention works within the contexts of Tiers One and Two. The tiers represent the level of intervention provided not the student. Communication between community partners and all school personnel is efficiently achieved at a case conference. The case conference record should be used to develop a comprehensive program and document planning. A successful case conference will have a co-constructed agenda, be timed, have clear goals, list roles and responsibilities (case manager or principal/ principal’s designate) of follow up items and minutes recorded. Parents/guardians should participate as often as is practical and necessary to support planning and program implementation. The case conference should conclude with all attendees feeling that information has been professionally and positively shared and next steps are clear. It is critical that if members of the school team are not able to be present at the case conference, all relevant information (including recommendations and plans) is communicated to all members of the team. Violence and aggression need to be distinguished from each other. Aggressive behaviour may be a response to demands, stimuli and relationships in the school environment. Aggressive behaviours may indicate needs in communication, sensory, academic, physical, medical, social, impulse control or emotional regulation, or in a combination of these areas (Ministry of Education, 2010, p.22). In contrast, violence is the act of purposefully intending to or hurting someone. At times, students may exhibit violent behaviour that pose risks to self and/or others. External factors, outside a school’s control may also influence violent behaviour. Careful consideration must be given to students with developmental disabilities as aggressive behaviour can be a function of communication and is likely not violent. Members of the special education department can support ISRCs to review student profiles. This section of the operating procedure guides educators to ensure safety and to support the student’s underlying needs in order to minimize violence. Facts About Violence Violent behaviours towards self or others can result from several mitigating factors including but not be limited to:

Peer pressure

Need for attention or respect

Mental health

Substance abuse

Feelings of low self-worth

Family history

Witnessing violence at home, in the community or in the media

Access to weapons Tips for Addressing the Needs of Students Who Behave Aggressively or Violently Students demonstrate aggressive/violent behaviour for a variety of reasons, including to

communicate difficulty with academic demands. School teams should pay particular attention to analyzing the correlation of academic demand and demonstrated behaviour while problem solving. Intervention strategies may include, but are not limited to:

Check-ins from a caring adult (involve the student)

Reduction/modification of expectations

Chunking of instruction

Provision of activity choice

Use of alternative assessment methods

Reduction or elimination of transitions

Support of sensory needs

Use of preferred activities

Predictable and communicated routine

Implementation of non-verbal means of communication

Use of visual cues

Reduction of stimulation

Positive reinforcement

Menu of reinforcers

Social stories to provide predictability and routine

Change of program pathways (Academic, Applied, Vocational or Alternative) Using an Alternative Learning Environment An Alternative Learning Environment (ALE) can be any place in a school where a student is provided his/her educational experience. The ALEs are typically structured within classrooms or office areas where students can have a quiet space to separate them from regular class activities. Additionally, the Peel District School Board has Alternative Learning Environments that are separate rooms. There are two separate and distinct purposes for these rooms: sensory or calming. For students who regularly access these rooms, explicit use and supervision details must be documented as part of student’s positive behaviour intervention plan (PBIP) and/or safety plan. School teams should seek to support the student to the fullest extent possible in their school environment. Transferring a student to an alternative location should be a final consideration as often directing a student to an alternative placement negatively impacts student success and achievement. The creation, maintenance and effective use of sensory and calming rooms must be in consultation with Special Education Support Services Department and follow an approval process. School principals MUST contact the Coordinating Principal of Special Programs to discuss the creation of a sensory room at the school. All separate ALE rooms in Peel must comply with the following Peel Board building guidelines:

Meet Fire Marshall and health and safety standards (School principals MUST contact the Coordinating Principal of Special Programs for specific guidelines)

Be supervised at all times

Provide the means by which staff can monitor the student, both visually and auditorily, at all times

Have adequate ventilation, lighting, and heat

Not contain items or fixtures that may be harmful to students

Have adequate space for students and staff as required

Be conducive to de-escalating inappropriate behaviour

Not be locked, latched, or secured in any way that would (in case of an emergency) prevent staff or student from entering or exiting the room

Have all exits clear of obstructions

Allow arrangements for the student to have food and toilet breaks, when appropriate

Sensory Rooms Sensory interventions have been shown to be effective in decreasing anxiety and agitation, and can be an effective strategy in reducing challenging behaviour, particularly for students with special needs. Depending on the student’s needs, sensory activities may be calming or activating, and may include activities addressing all senses: sight, sound, smell, touch, taste, proprioception (sense of body movement and position), and vestibular motion (sense of orientation and balance). Multisensory rooms may include, but are not limited to, Snoezelen rooms. Calming Rooms As educators, our first responsibility is to ensure that schools foster learning in a safe, non-threatening and healthy environment for all students and staff. A calming room may be used when a when a student needs to be temporarily separated from the classroom environment, primarily to ensure safety for students and staff. The purpose of a calming room is to provide a private space to assist a student in de-escalating unsafe behaviour. Use of a calming room is best practiced as a proactive strategy to support student self-monitoring, self-reflection and self-calming. It may be either teacher or student directed, as a means of calming within a safe and predictable environment. Using a calming room for a student is not a strategy to be used as punishment, or as a means of removing a student indefinitely from the classroom. Exemplary practice requires a comprehensive understanding of a student’s profile and history when considering environmental accommodations. The use of a calming room as a responsive behavioural intervention should only be employed within the context of a range of carefully considered, proactive and responsive interventions. These interventions and supervision plan will be developed collaboratively at an ISRC and captured within the student’s IEP, positive behaviour intervention plan (PBIP) and safety plan. The student’s IEP, PBIP and safety plan will be developed based on a thorough understanding of the student's background, history, strengths and needs and will include:

A range of both proactive and responsive behavioural interventions across all educational settings (including the playground, halls, bus, etc.)

An understanding of student frustrations, triggers and vulnerabilities (may require consultation with school-based speech and language pathologist, social worker and/or psycho-educational consultant)

Modification/accommodation as appropriate in all school environments where inappropriate behaviour is occurring

Written plan to teach, model and reinforce the skills that the student needs in order to demonstrate appropriate behaviour

May include a functional behavioural assessment

Involvement of the guardians/student in developing strategies as appropriate When using a calming room with a student, the following should be considered:

Does the student understand the reason for using the room?

Does the student have the ability, as well as the opportunity, to stop the disruptive behaviour and demonstrate appropriate behaviour?

Does the student have an opportunity to demonstrate responsibility for his/her own behaviour and have opportunities to practice self-control?

Does the student understand what the expectations are for a successful return to the classroom?

Does the student have an opportunity to debrief (if applicable)?

Is the seclusion space reasonable, safe, and respectful of the needs of all students?

Is data routinely collected and reviewed to evaluate the effectiveness of the room?

When a student self-directs or is staff-directed to the calming room, staff will document the student’s supervision, the antecedents, the student’s well-being and debriefing using the appropriate reporting form. The school principal will file the reporting form(s) within the student’s OSR at the conclusion of the year or at a time of student transition to a different school. If the principal deems the event was significant, the principal or designate will document the incident concurrently within SIS. Data on the use of the calming room with a particular student should be used by the ISRC to assess the effectiveness of behaviour support strategies. This data should also be communicated to the parent on a regular basis, or when requested. Registering and Transitioning Students Demonstrating High Risk Behaviour School teams should refer to the Operating Procedure LDSS 1, The Registration, Admission and Withdrawal of Students as a general guide for student admission. Students who demonstrate high risk behaviour require collaborative program planning to ensure successful transitions. There are a variety of means of notification that a student demonstrating high risk behaviour is registering at a school. For example, the family may visit the school directly, call Special Education Supports Services, call a trustee or make an appointment at one of the We Welcome the World Centres. If families are registering directly at the school, or through We Welcome the World, principals should contact the appropriate coordinator within the Special Education department.

Student Identification or Previous Placement

Contact Extension

ASD Coordinating Principal of Autism 2543

DD and ASD/DD Coordinating Principal of Special Programs

2320

Behaviour (may include coming from a treatment facility, or in the custody of CAS)

Coordinator of Behaviour Services 2323

Section 23 Coordinating Vice Principal of Section 23 2366

Case conferences should be scheduled to gather important student profile information so that a successful transition can be planned. School teams should refer to the document Critical Areas to Explore as a case conference planning document. Transitioning a Student Demonstrating High Risk Behaviours Between Schools

When a student transfers between Peel schools, a transition plan must be created in the student’s IEP. Modification of the school day may be necessary to create a more controlled entry and/or exit. Every effort should be made to ensure that all information gained about the student is shared with the new school team in a timely fashion through a case conference. This should be done in conjunction with the appropriate resource staff from Special Education Support Services. The transition form should be used to develop the comprehensive transition plan within the IEP.

Critical information regarding the behaviour of a student should never be removed from the OSR when a student is transferring (e.g. suspension letters, assessment reports, etc.). If special arrangements have been made to remove this material from the OSR, verbal information may be shared during the case conference. Reference: The Ontario Student Record (OSR) Guideline.

The most recent positive behaviour intervention plan (PBIP) found within the student’s IEP should be reviewed and updated.

Arranging Transportation for a Student Demonstrating High Risk Behaviour

1. Transportation routes and vehicles assigned are established by the transportation department (STOPR). Ongoing communication with transportation personnel is important for effective program planning and implementation.

2. A behaviour plan for the bus ride may be part of the student's PBIP. Refer to the document When Bussing is a Challenge for suggested strategies.

3. Special requests for transportation require approval of the superintendent of education, in consultation with the superintendent of Special Education Support Services.

4. A request for specialized transportation arrangements should show evidence of an ongoing problem-solving process to address identified issues and concerns, as well as a plan for returning the student to a more typical arrangement.

SECTION 2: RESPONDING TO STUDENTS DEMONSTRATING HIGH RISK BEHAVIOUR Refer to section one, Definition Of A Multi-Tiered Behaviour Intervention Approach, for an overview of the multi-tiered approach. Many staff ask about the use of physical contact and when it is appropriate. If, in our professional judgment, a child is at imminent risk of danger to self or others it is our duty to respond as judicious parents in the least harmful, least intrusive manner. Universal: Good for All (Tier 1) At the Universal: Good for All (Tier One) level schools must work to create a safe environment for all, with school-wide anti-bullying policies and programs, promotion of social problem-solving, and non-violent conflict resolution. Focusing on the student’s profile will help to ensure effective problem solving.

Collaborative problem solving can be used to create a positive support plan and part of that plan could include physical supports. Physical supports may be applied to students using professional judgment and do not necessitate notation in a student’s IEP or a safety plan development. Here are some examples of contact that will support students behaviour and may not necessitate further planning or documentation.

When contact is appropriate

Why contact is appropriate

How contact is used

Transitioning in from recess

Student is distressed Holding hands

Walking through the hall Student is confused, unfamiliar with the environment

Gentle guiding on the back

Celebrating success Reinforcement High five, “props”

Task completion (sorting, cutting and pasting)

Direct instruction Hand over hand teaching

If a persistent pattern of challenging and non-injurious behaviours persist, the following best practice measures could support the student:

Employ Collaborative and Proactive Solution(CPS) strategies, as well as the COPING Model from the Crisis Prevention Institute (CPI) module in an attempt to get at the heart of what is causing the challenging behaviours.

Use a strengths-based approach whereby you utilize all that the student does well to leverage the challenging behaviours.

Targeted: Necessary for Some (Tier 2): PBIPs and Safety Plans Responses to incidents ideally should occur in sequence; however, student behaviour may necessitate a higher level response to a single incident. Interventions should proceed cumulatively. In other words, Tier Two intervention works within the context of

Tier One intervention and Tier Three intervention works within the contexts of Tiers One and Two. The tiers represent the level of intervention provided not the student. Definitions of PBIPs and Safety Plans Positive behaviour intervention plans (PBIPS) support student learning regarding self-regulation in a proactive manner. PBIPs include personalized and specific behaviour goals, instructional strategies, reinforcers and an assessment plan. Students demonstrating a persistent pattern of challenging behaviours that are not considered a safety risk to self or others (disruptive behaviour, verbal aggression) should have a PBIP. These students do not require a safety plan. Safety plans are an emergency response plan for staff. They provide direction to staff to ensure student and staff safety. They describe observable student behaviour so staff may recognize escalating behaviour and early warning signs in order to implement appropriate interventions that deescalate challenging behaviour. Emergency responses are clearly outlined if interventions are not successful. Students exhibiting a persistent pattern of externalizing, acting out behaviours (hitting, throwing, grabbing, biting, self-injurious behaviours, running into unsafe situations such as parking lot or traffic) must have a safety plan written in a timely manner. These students must also have a PBIP. Additional resources are outlined in the sections below. Creating a Positive Behaviour Intervention Plan

The PBIP must be developed in a timely manner to guide program delivery to a student demonstrating high risk and housed within the IEP. A team of people with particular behaviour expertise/interest should be involved in the planning process. In completing this plan school staff (administration, teachers and teaching assistants) may request assistance from the school-based speech and language pathologist, social worker and/or psycho-educational consultant. Support for school staff in developing a PBIP is also available through the the Special Education Resource Teacher- Behaviour or, where appropriate, the special programs consultant or the Autism resource team. Where practical, all members of the school team should participate in the creation of the PBIP. Resources to support developing a PBIP can be found on the Behaviour Services site.

A monthly review should be held to ensure all staff involved with the student are apprised of the student’s current needs.

Parent(s)/guardian(s) should be invited to provide input in the development and review of the PBIP. Parent(s)/guardians should be kept fully informed about all aspects of the student’s progress. Information shared with the parents/guardians should represent successes as well as challenges.

Creating a Safety Plan

A team of people with particular behaviour expertise should be involved in the safety planning process. Support for staff in developing a safety plan is available through the psycho-educational consultant and/or social worker and/or speech and language pathologist. The school psychoeducational consultant and/or social worker must sign that they have been involved in the development of a safety plan. Safety plans should be noted in the PBIP in the IEP. Where practical, all members of the school team should

participate in the creation of the safety plan. Resources to support developing a safety plan can be found on the Behaviour Services site.

A monthly review should be held to ensure all staff involved with the student are apprised of the student’s current needs.

Parent(s)/guardian(s) should be invited to provide input in the development and review of the safety plan. Parent(s)/guardians should be kept fully informed about all aspects of the student’s progress. Information shared with them should represent successes as well as challenges

Accessing the Intensive Support Team

The ISRC engages in problem solving and accesses supports that are available through the school-based BTA and school-based speech and language pathologist, social worker and/or psycho-educational consultant resources:

In-school staff (including Contact Program and school-based BTA) have collaborated to prepare and implement a plan for supporting the student’s learning and behaviour.

The school’s psycho-educational consultant, social worker and/or speech and language pathologist has been actively involved in the planning and has an open file with parent consent.

Consultation has occurred between any special education support staff involved.

The superintendent is aware of the significant and/or escalating behaviour concern and has consulted regarding the availability of additional BTA support.

A case manager is established. The case manager is either the speech and language pathologist, psycho-educational consultant or social worker who may have already been involved in case planning.

When the student’s behaviour continues to escalate or remains significantly elevated, the ISRC may consider a referral for additional support with the IS team:

A SIS referral form is completed by the case manager in collaboration with the school’s ISSP teacher at the elementary level or the school’s head of Special Education at the secondary level.

One of the K-12 behaviour consultants in Special Education receives the IS referral and contacts the case manager to schedule a presentation date with the Intensive Support Planning Committee.

The case manager consults with the behaviour SERT at the elementary

level or the Special Education consultant at the secondary level to review presentation information in preparation for the Intensive Support Planning Committee date.

Following the presentation, the Intensive Support Planning Committee determines the IS allocation.

After IS support is allocated: The case manager facilitates scheduling a school case conference with

the IS teacher and BTA to review and identify specific directions for IS support.

Specific goals and a predictable schedule for the IS support time period is established.

The case manager provides clinical guidance to the IS casework during the IS support period.

A SIS demission statement is completed by the case manager, in collaboration with the IS teacher, at the end of the IS support period. Demission from IS support occurs after 8 weeks or earlier if the goals that were set out in the plan are achieved.

Intensive: Essential for Few (Tier 3): Supporting Students with Physical Contact up to and Including Physical Restraint The concept of tiered intervention guides staff to understand when, why and how physical contact is used to support students. These physical supports to students should be noted in a student’s IEP. Responses to incidents ideally should occur in sequence; however, student behaviour may necessitate a higher level response to a single incident. Interventions should proceed cumulatively. In other words, Tier Two intervention works within the context of Tier One intervention and Tier Three intervention works within the contexts of Tiers One and Two. The tiers represent the level of intervention provided not the student. Accessing Safety Training When a Student Demonstrates a Safety Concern When student safety concerns persist beyond the work of the ISRC and its use of the ISRC checklist, the ISRC must refer for safety training using the following codes as appropriate: SIS code 210 Safety training for a student with behaviour needs SIS code 214 Safety training for a student with Autism or Developmental Disability The referral will be responded to by the coordinator of behaviour services (code 210) or the coordinator of integrated services (code 214). The coordinator will assign support staff from the Special Education Support Services department who are trained in Non-Violent Crisis Intervention to work collaboratively with the school team and provide a range of appropriate safety training, ranging from Level 1 De-escalation training to Level 2 Student-Specific Crisis Training. All staff who support the student must receive safety training (lunchroom supervisors, teaching assistants, volunteers, teachers, etc.) The appropriate training will be selected by the specialized staff from Special Education Support Services. All crisis intervention training in the Peel Board is provided by instructors who are certified in Non-Violent Crisis Intervention by the Crisis Prevention Institute. The purpose of crisis intervention is to enable school staff to maintain a safe environment at school for all students and staff.

Essential Information About the Use of Physical Intervention Physical intervention should be identified in a safety plan and considered only when:

The student is an immediate danger to self or others.

Other ways of managing the student’s dangerous behaviour have failed.

Staff are trained in the proper use of physical intervention by members of the Special Education Support Services department.

Every opportunity should be provided for the student to control his/her own behaviour before physical intervention is used.

Physical intervention should not be used as a punishment, as a method of convenience to staff, for issues of behaviour compliance, or as a means to inflict pain.

Physical intervention on students should only be used as a temporary emergency measure until the student has regained control of their behaviour and/or they are no longer a danger to self or others.

Using physical intervention:

Physical intervention training may only be provided by staff trained by specialized members of the Special Education Support Services department using the methods of the Crisis Prevention Institute.

Physical intervention is when a person’s freedom of movement or physical activity is restricted by physical intervention. The purpose of using physical intervention is to maintain the safety of self or others.

Students have the right to the least intrusive interventions to address their at-risk behaviour.

Physical intervention is to be used in the least restrictive manner possible.

Teamwork should be used whenever possible during a physical intervention.

All use of physical intervention will involve some possibility of injury to students and/or staff and therefore should be used with extreme caution. Staff who have been trained in physical intervention should have regular review of that training with a certified CPI Peel Board instructor.

All information (eg, diagnoses, medical conditions) related to a student and his/her safety must be reviewed as part of the student’s safety training and communicated to all employees.

A Checklist for When Tier Three Physical Intervention or Restraint has Been Used

Step One: Ensure Safety Check in with all members of the team and seek medical attention if required. Step Two: Communicate Notify parents/guardians of the incident. If injuries were sustained, notify the superintendent of schools and the School Services Department. At the earliest convenience, administrators should make the school-based speech and language pathologist, social worker and/or psycho-educational consultant aware of the incident so that program planning may be reviewed.

Step Three: Document During the incident requiring physical intervention or restraint, school teams must complete the incident report using the student observation sheet found within the safety plan. Administrators should make a plan that enables the school team to easily access this student observation sheet. Administrators must ensure that the observation sheets are filed in the student’s OSR upon transfer to a new class or school. The student observation sheet provides a high level of detail of the incident. Additionally, administration must create a note within SIS using the Use of Physical Intervention field. If injuries were sustained, administration must file an accident report within SIS and follow the accident reporting protocol. Step Four: Reduce Tension Following a physical intervention, the administration must ensure that the emotional impact on all those involved is dealt with in a supportive, reassuring manner through a discussion and review of the incident. Step Five: Reflection Administrators should discuss the incident at the ISRC so that the student’s program can be reviewed and additional support may be requested if necessary to mitigate further incidents from occurring. Step Six: Monitor Administrators must monitor the student’s progress and continue to problem solve at the ISRC to promote student success and safety.

Modifying a Student’s Length of Day

All students are entitled to 300 minutes of instruction daily. Modification of the school day may be necessary to create a more controlled entry and/or exit. Students demonstrating high risk behaviour may require accommodation to their length of day to support their success. When school teams are considering accommodating the needs of a student by modifying the length of their day, the student’s profile must be reviewed at the ISRC. A referral to the school based speech and language pathologist, psycho-educational consultant and/or social worker is recommended.

Administration should hold a case conference together with the school-based speech and language pathologist, social worker and/or psycho-educational consultant, parents/guardians and outside agencies to develop a comprehensive program plan for the student. The consideration of a modified day as an accommodation should be raised at the case conference to understand the impact of this decision on the family.

Administration must seek the approval of the superintendent of schools. The superintendent of schools will collaborate with the superintendent of Special Education to create awareness of the situation.

After consultation, the decision to accommodate a student through a modified day must be made through the ISRC. Goals for the student will be identified and monitored regularly with the intention of increasing the length of day to best support the student.

Excluding a Student In rare circumstances, a student may pose such a significant risk to the safety of self and others that exclusion (as defined by the Education Act and PPM 145) is the only means possible to ensure safety. This decision is usually made after a significant series of accommodations and modifications have been put into place and safety concerns persist. Before exclusion is considered, administration must review the student’s profile at ISRC and follow the ISRC checklist to create a program that is closely aligned to the student profile. A referral to the school-based speech and language pathologist, psycho-educational consultant and/or social worker for case management must be made to coordinate community support and to gather clinical information regarding the student. The Intensive Support team may be called upon to provide support to the school based team. Safety training must requested through the ISRC. If safety concerns persist, administration must consult with the superintendent of education. The superintendent of education will collaborate with the superintendent of Special Education. The superintendent of education and the school team will review the student profile together with the Tier Three Review Committee made up of senior leaders within the Special Education Support Services Department. Best practices would indicate that the decision of exclusion is made collaboratively at the T3RC and an exclusion letter will be issued. The exclusion letter will outline next steps to be taken to provide support for the student and the support plan will be monitored regularly with the intention of returning the student to an educational setting as soon as possible. The exclusion will be documented in SIS.

SECTION 3: RESPONDING TO THREATS

Guiding Principals All threats expressed in words (oral, written, electronic), drawings or gestures must be taken seriously and must be reported to the principal. Please ensure you are following Board Policy 48: Safe Schools at all times. Facts About Threats A threat is an expression of intent to harm self or others.

Threats may be spoken, written or expressed in some other way, such as through gesture (Cornell & Sheras, 2006, p. 1).

Threats could be made directly to the intended victim, communicated to third parties or expressed in private writings, possibly through social media.

Any object could be considered a potential weapon, based on the threat of injury it poses to others.

There are two primary categories of threats:

1. A transient threat is a statement that does not express a lasting intent to harm someone and may be resolved by an apology or an explanation. The statement reflects a feeling that dissipates rapidly when the issuer considers what s/he has said.

2. A substantive threat is a statement that represents a sustained intent to harm

someone beyond the immediate situation where the threat was made.

Most threats are transient and can be investigated and managed at the school level by understanding the context of the threat and using progressive discipline and a restorative approach to ensure a safe and caring environment is restored. Substantive threats require further investigation. The response to the substantive threat should be made in collaboration with school superintendent and School Support Services. Substantive threats are serious in the sense that they represent a sustained intent to harm someone beyond the immediate situation where the threat was made. In case of doubt, treat the threat as substantive. Possible indicators of a substantive threat:

The threat has specific plausible details.

The threat has been repeated over time or related to multiple persons.

There is physical evidence of intent to carry out the threat, such as a weapon, a map or written plan or a list of intended victims.

The threat is reported as a plausible plan, or planning has taken place.

The student has recruited accomplices or has invited an audience to observe the threat being carried out.

None of the five indicators are absolute. Any one of the indicators may lead the administrator to believe a threat is substantive. Tips for Communicating with Students Who Have Issued a Threat All threats must be investigated by the school principal or vice principal to determine whether the threat is transient or substantive. No threat is acceptable. However, threats may reflect ineffective coping strategies in response to stress and may not pose a danger. The following tips will be useful when speaking to a student who has issued a threat in word, drawing or gesture.

Speak to the student regarding the threat they made when they are calm and the conversation can be private. Whenever possible, a second adult should be present.

Seek to engage the student in an authentic conversation regarding the threat. Refrain from being judgmental but instead ask questions to understand the student’s motivation, intent and mitigating circumstances. Students may offer an explanation of their drawn, gestured or articulated threat.

Conduct an investigation. The school administrator will seek to understand the student’s intention in making the threat, the motivation behind the threat, the student’s perceived impact of their actions and the student’s future plans for acting out the threat. Sample questions to ask include:

Do you know why I wanted to talk to you? Can you tell me why? What did you mean by what you said? Why did you say what you did? Why did you make that gesture? How do you think you made others feel by saying or doing what you

did? What was the reason you said or did that?

Students who have issued threats should be supported to use appropriate coping strategies. The school team will support the principal to determine appropriate supports and consequences for the student.

School Response to a Substantive Threat Issued by a Student After consultation with the school superintendent and School Support Services, the administration will determine the severity of the substantive threat and the appropriate response. Consultation should extend to the school school-based social worker, psycho-educational consultant and/or speech and language pathologist to ensure a comprehensive support plan is created. The student should be referred to ISRC to develop a support plan, review the event and analyze the school’s response to the student’s needs. The support plan may include:

Check-ins with a supportive adult

Modified timetabling

Case conferences

The development of a Positive Behaviour Intervention Plan (PBIP)

The development of a Safety Plan

Skill training

Consultation with the parent

Referral to community agencies

In extreme circumstances, students who have issued substantive threats require a higher degree of support to ensure their safety and the safety of others. The plan for the student is created in collaboration with the school principal, superintendent, School Support Services and school-based speech and language pathologist, social worker and/or psycho-educational consultant. The support plan, in extreme circumstances, may include a combination of the following:

School transfer

Police involvement

Placement in an alternative education setting

Home instruction

Risk assessment SECTION 4: RESPONDING TO STUDENTS SUSPECTED OF ALCOHOL OR SUBSTANCE USE Facts About Substance Use

About 12% of students in grades 9 and 10 report intoxication at school at least once in the past year. This statistic increases to about 18% for students in grades 11 and 12 (Centre for Addiction and Mental Health, 2013).

Substance abuse and mental health problems have common risk and protective factors.

Substance abuse can trigger mental health problems.

Substance use can be a reflection of ineffective coping and stress management strategies (attempt to self-medicate).

Indicators of Alcohol or Substance Use There are a number of indicators related to possible substance or alcohol use. It is important to know that these indicators do not necessarily mean that the student has used alcohol or drugs or that the student has a substance abuse problem. Any of these indicators require follow-up action or exploration (refer to Board Policy 48: Safe Schools for guidelines). Indicators of alcohol or substance use may include:

Odour of alcohol on the person

Slurred speech

Difficulty with coordination, balance or walking

Inability to speak coherently or make sensible sentences

Agitated or violent behaviour

Lapses into unconsciousness

Inability to focus physically or mentally on a simple task

Severe signs of physical distress: difficulty breathing, chest pains

Dilated pupils Supporting Students who Engage in Substance Use The school staff observing an indicator of suspected alcohol or substance use initiates the following process to further understand the behaviour: The guidance counselor or school administrator, in conjunction with a trusted adult (eg- contact or SST teacher), should have a confidential conversation with the student regarding the student’s presenting symptoms to understand the observed behaviours. It is strongly recommended that staff include a second adult in the room to support the conversation. This approach recognizes that there may be other mitigating factors

besides alcohol or substance use for the observed indicators. When alcohol or substance use is confirmed, a student support plan should be developed that considers mitigating circumstances and reflects progressive discipline and/or supports. Students who present with these behaviours should be closely monitored, as substance use issues can be a sign of other concerns. School Response to a Student Presenting with Suspected Alcohol or Substance Use

Immediately make administration aware if a student appears to be under the influence of alcohol or drugs.

Where necessary, contact emergency services.

Contact the parent/guardian to develop a plan for the student to leave the school premises safely.

Special care should be given to the consideration that the student may have driven to school.

Provide supervision/monitoring of the student until the student has safely left the building.

Provide follow up with a designated school staff to review the incident at the ISRC and facilitate appropriate supports as required, based on frequency and intensity of suspected alcohol or substance use (example, referral to social work).

SECTION 5: RESPONDING TO NON-SUICIDAL SELF-INJURY Non-suicidal self-injury (NSSI) is the deliberate and direct destruction of one’s body tissue, without suicidal intent and for reasons not socially sanctioned. Every situation involving non-suicidal self-injury (NSSI) is unique. This definition excludes tattooing or piercing, and indirect injury such as substance abuse or eating disorders. NSSI should also be distinguished from self-injurious behaviour (SIB) that is commonly seen among youth with intellectual and developmental disabilities (e.g. repetitive stereotyped head-banging). Self-Injury Methods The most common methods of NSSI include cutting, burning, scratching and bruising. These injuries can range from superficial to moderate. Facts About Non-Suicidal Self-Injury

Although anyone at any age may begin to engage in NSSI, the most common age of onset for NSSI is early adolescence.

Between 14% to 24% of adolescents and about 4% of adults in the community report engaging in NSSI at least once in their life. This range is between 60% and 80% in clinical samples (Heath & Lewis, 2013).

Recent research indicates that there is little to no sex difference in prevalence of NSSI in community samples. However, NSSI is more prevalent in females in clinical samples.

Individuals who engage in NSSI may injure themselves repetitively, with increasing severity, and may use different methods over time.

The behaviour can also occur on a more episodic basis with repetitions occurring during high stress periods.

Indicators of Non Suicidal Self Injury Here are a few possible signs of self-injury that are important to be aware of:

Unexplained cuts, burns or bruises; these typically occur on the arms, legs and stomach.

Possession of razors, shards of glass, knives, thumb tacks or other items that teens may use to self-injure (keep in mind that any sharp object may be used to injure; e.g., paper clips, ends of pencils).

Continually wearing clothing that is inappropriate for the weather or the situation (e.g., bulky, long-sleeved clothing in hot weather or gym class).

Noticing evidence of, or references to, self-injury in a student’s creative writing, journals or art projects.

It is important to note that if staff see these signs in a student, it does not necessarily mean that the student is engaging in NSSI. Tips for Communicating with Students Who Self Injure

Once it is known that a student is engaging in NSSI or when a student discloses these behaviours, staff initial response is very important; it will likely influence the student’s willingness to seek help in the future.

Staff may feel uncomfortable with the idea of talking with a student about NSSI. Some people feel shocked, or even horrified by NSSI; these are normal reactions to have.

A school staff member may be the first person that a student talks to about NSSI; the student is likely to be scared and nervous.

By being prepared, staff can monitor their own reactions to help the student feel more comfortable and to increase the likelihood of them seeking further help.

Staff need to know that they cannot stop NSSI and that their primary role is to discretely make the principal or vice principal aware of any student who they suspect is engaging in this behaviour.

DO

Communicate with the student in a calm and caring way.

Let the student know that there are people who care about him/her and that s/he is not alone and that other youth self-injure.

Understand that this is a way for the student to cope with the pain that s/he is feeling.

Use the student’s language for self-injury when talking about self-injury (e.g., if a student calls it ‘cutting’ or ‘self-harm’ use that term in your discussion).

Listen to the student in order to better understand his/her behaviour.

Use non-judgmental language and demeanour.

DO NOT

Do not tell the student that you won’t tell anyone about their self-injury.

Do not be overly reactive; this could alienate the student.

Do not respond with panic, revulsion, shock or averted gaze.

Do not try to stop the self-injury behaviour with threats or ultimatums.

Do not show excessive interest in the details of the student’s self-injury (e.g., what exactly was done).

Do not permit the student to relive or describe the experience of self-injury in detail as this may trigger the desire to engage in self-injury again.

Do not talk about the student’s behaviour in front of the class or around peers as this increases the likelihood of contagion.

Do not engage in discussions about self-injury with your class. School Response to Self-Injury

Step One: Communicate Immediately make the principal and/or vice principal aware that you are involved with a student who has self-injured.

Step Two: Respond Pathway 1 (Emergency)- If the student has an injury that requires immediate attention (e.g., concerning tissue damage, burn injury, severe bruising), the situation is a medical emergency. The principal or designate will call 911 (ask for an ambulance) and the parent or guardian, regardless of the student’s age. Ask for a school-based certified first aid responder to attend. Pathway 2 (Non-urgent)- If the student has self-injured and the injury does not require immediate medical attention, the situation is of concern and requires further evaluation. The principal will immediately contact the parent or guardian, make them aware of the injury and request a meeting at the school. The principal will also contact the social worker and/or psycho-educational consultant to request their support with this parent/student meeting. Step Three: Collaborative Planning With Parents/ Guardians Parents/ guardians may be unaware of the self-injury and the information shared may be shocking, overwhelming and cause a sense of denial or immobilization. Like our students, parents/guardians may need time to process information. At the same time, school teams may feel a sense of urgency to support a student in crisis. The school-based social worker and psychologist are a valuable support to families, students and schools at such times.

The goal of the initial meeting will be to plan for next steps which should include a referral to the school-based social worker and/or psycho-educational consultant. Additional resources include contact with the family doctor*, and a referral to a community partner to aid in developing a support plan for the student at school and home.

Parents/guardians of a student who has self-injured should always be given the opportunity to respond appropriately to their child’s need. In discussion with

parents, school teams must feel confident that parents/guardians are following through on the recommendations for support (examples may include: making an appointment with the family doctor, calling the Peel Children’s Centre Crisis Team, going to the emergency department). If the parent/guardian refuses or is reluctant to follow the recommended steps outlined by the school team, the principal will ask the school social worker and/or psycho-educational consultant to reinforce with the parent/guardian the necessity of an immediate response and our duty to report children in need of protection. If the student is under age 16, a report must be made to the Children’s Aid Society when the parent refuses or is unlikely to access appropriate mental health support for the student.

When the parents/guardians of a student over 16 years of age who has self-injured are reluctant or refuse to access community supports, the principal will discuss with the student the possibility of contacting another significant adult for support. Principals should make their Superintendent aware of the situation.

*In some situations it is appropriate to ask the parents/guardians to sign a consent form which will enable you to consult with the doctor or the mental health facility.

Step Four: Outreach The school, student, his/her family and community partners will collaborate to support the student’s needs. Support may include but is not limited to actions such as:

Counseling

Community case conferences

Creation of a holistic crisis plan

Creation of a safety plan

Step Five: Staff Check-in The principal will convene a meeting to check in with the staff’s emotional well-being, give support and encouragement. Step Six: Reflection The student should be referred to ISRC to review the event and analyze the school’s response to the student’s needs. Step Seven: Monitor The school, student, his/her family and community partners will collaborate to support the student’s needs. Support may include but is not limited to actions such as:

Daily check-ins

Implementation and/or review of the safety plan

Modifying the timetable

Involvement of community partners

A psychiatric referral

Referral to a Mental Health and Addiction Nurse

SECTION 6: SUICIDE PREVENTION, INTERVENTION AND POST-VENTION Guiding Principles

Any student may be at risk of demonstrating mental health needs.

Any student may be suicidal.

All thoughts of suicide must be taken seriously.

Students who disclose suicidal ideation will be treated with dignity and respect. The disclosure of potential self-harm must be shared immediately with the school principal, vice principal and guidance counselor (if the school is staffed with guidance personnel). Student safety overrides the usual practice of confidentiality; however, at all times, student privacy must be respected while supports are implemented.

The school administrative team will immediately consult with the school-based social worker and/or psycho-educational consultant, and/or the school’s ASIST trained member (Applied Suicide Intervention Skills Training).

Facts About Suicide

Suicide is the second leading cause of death for Canadians between the ages of 10 and 24.

Studies indicate that more than 90 percent of suicide victims have a diagnosable psychiatric illness, and suicide is the most common cause of death for people with schizophrenia.

Men die by suicide at a rate four times higher than that of women. Women, however, make 3 to 4 times more suicide attempts than men do, and women are hospitalized in general hospitals for attempted suicide at 1.5 times the rate of men.

Canadian Mental Health Association, http://toronto.cmha.ca/mental_health/suicide-statistics/ Indicators of Suicide Risk School staff members often have significant connections with students and may become aware that something is seriously wrong in the life of a student. Staff may be alerted to a student’s potential self-harm or suicide in a variety of manners. These indicators do not necessarily mean imminent risk of suicide, but require follow-up action or exploration:

Suicidal communication such as talking, writing, drawing or texting (including jokes)

Noticeable change in behaviour, mood, withdrawal of interest or loss of motivation

Sleeplessness

Loss of appetite

Change in routine

Report by others (friends, family) of suicidal thought/intent

Reckless behaviour (risk taking/substance, drug use)

Expressions of helplessness, hopelessness, feeling trapped, worthlessness, loneliness

Sudden drop in grades, school performance, decline in attendance

Giving away personal belongings

Tips for Communicating with Vulnerable Youth Staff learn about a student’s vulnerability primarily through conversation. The following framework will be useful to staff when speaking to a youth who may be vulnerable:

DO:

Find a quiet and private place to talk.

Obtain input from the youth about how you can support him or her.

Take time to hear the student. This may mean making alternate arrangements to take care of other responsibilities.

Be genuine. It is better to say less to a youth than to try to say things that one does not genuinely believe.

Remain calm and demonstrate a caring manner.

Establish rapport with your words and body language. Convey warmth, caring and a willingness to hear youth speak about a variety of topics.

Promise privacy but not confidentiality. You must inform someone if there is potential risk to the student or others. You cannot keep suicidal thoughts or behaviours a secret.

Listen carefully and avoid interrupting the student. Listen for the feelings behind the words.

Paraphrase what the student is trying to say to indicate your understanding.

Acknowledge the youth’s thoughts and feelings. It is not necessary to agree with the youth’s thoughts and feelings, but it is helpful to recognize them.

Offer your own feelings and thoughts on the matter. The best time to do this is after you have listened carefully and acknowledge the youth’s perspective. These would include sentences such as, “I like the way you handled the situation,” or “I am concerned about what you’re saying happened.” These kinds of statements convey a personal and genuine interest.

Allow for periods of silence.

Allow time for the student to process your questions. S/he may have communication difficulties.

Keep the student’s perspective in mind (no matter how unrealistic). It is the student’s perception that is most important to understand his/her thoughts and feelings.

Take charge with respect to asking pointed questions or making arrangements for student safety. Ask the question outright if the student does not mention suicidal thoughts (e.g. “Are you having thoughts of suicide?).

DO NOT:

Do not hesitate to call the school office if you feel it could escalate quickly.

Do not judge what the student says in terms of moral or adult standards.

Do not debate whether suicide is right or wrong or whether life is valuable.

Do not make promises or remarks that might be unrealistic.

Do not argue about suicidal behaviour.

Do not panic if the student admits to suicidal thoughts or behaviour.

Do not ignore the student’s need to talk.

Do not allow yourself to be sworn to secrecy; this becomes a safety issue for the student.

Do not assume that the person isn’t the suicidal type; anyone can be suicidal.

Do not discount the student’s problems or distress as minor or suggest s/he will get over it or that everything will be alright.

Do not give up if the student just shrugs or is uncommunicative. S/he may say more given additional time. You may want to offer a drink or a small snack.

(King, Ewell Foster & Rogalski, 2013)

School Response to a Suicidal Student Follow these fundamental elements when supporting students who have disclosed suicidal thoughts or demonstrated suicidal behaviours:

Suicidal and self-harm gestures and comments must be taken seriously and responded to immediately.

Do not leave the student alone.

Always inform and work with the administration. Never deal with a potentially suicidal student without support.

Do not rely on email or voicemail to communicate urgent needs.

Recognize that students under stress and those with communication/ language needs require simple language, extra time to process, repetition and rewording.

Step One: Communicate Immediately make the school principal and/or vice principal aware that you are involved with a potentially suicidal student. Step Two: Respond Pathway 1 (Medical Emergency)- If the student is actively attempting suicide (e.g., the student has disclosed an overdose), the situation is a medical emergency. The principal or designate will call 911 (ask for an ambulance) and call the parent or guardian, regardless of the student’s age. The administration or designate will alert the school psychologist and/or social worker regarding the event when the emergency has been stabilized.

Pathway 2 (Crisis Requiring Intervention)- If the student expresses current suicidal ideation, the situation is a crisis. The principal will contact the parents/guardians and request that they come to the school immediately. The principal or designate will contact the ASIST trained team member within the building or the ASIST trained school-based social worker and/or psycho-educational consultant to come to the school.

Step Three: Collaborate With Parents/Guardians The Principal or designate will phone the parent/guardian and share the information that the student is actively attempting suicide or expressed suicidal ideation. Parents/guardians may be unaware of the suicidal ideation expressed by the student

and the information shared may be shocking, overwhelming and cause a sense of denial or immobilization. Like our students, parents/guardians may need time to process information. At the same time, school teams may feel a sense of urgency to support a student in crisis. School-based social workers and/or psycho-educational consultants are valuable support to families and schools at such times. After the nature of the self-harming behaviour or the disclosure of suicidal intent is shared with the parents/guardians, the parents/guardians, student and school team will work together to establish next steps. If the parents/guardians are unable to come to the school the principal or designate may consider transporting the student to the hospital for assessment. There should always be two adults in the vehicle transporting the student.

If the student and parents/guardians agree to a safety plan with an ASIST trained staff member there may be no need to go immediately to the doctor or emergency department.

If the student and/or parent do not agree to a safety plan, then the parent and student should be directed for further assessment, either with the family doctor or the nearest emergency department at the hospital.

Parents/guardians of students considered at risk of suicide must always be given the opportunity to respond appropriately to their child’s need. In discussion with parents, school teams must feel confident that parents/guardians are following through on our recommendations for support (examples may include: making an appointment with the family doctor, calling the Peel Children’s Centre Crisis Team, going to the emergency department). Occasionally, a parent refuses or is reluctant to follow the recommended steps outlined by the school team. In this case, the principal will ask the school social worker and/or psycho-educational consultant to reinforce with the parent the necessity of an immediate response and our duty to report children in need of protection. If the student is under age 16, a report must be made to the Children’s Aid Society when the parent refuses or is unlikely to access appropriate mental health support for the student. When the parents/guardians of a suicidal student over 16 are reluctant or refuse to access community supports the principal will discuss with the student the possibility of contacting another significant adult for support. If another adult is not available, two staff members will accompany the student to the family doctor or hospital. In some situations it is appropriate to ask the parents/guardians to sign a consent form which will enable you to consult with the doctor or the mental health facility. Step Four: Outreach The school, student, his/her family and community partners will collaborate to support the student’s needs. Support may include but is not limited to actions such as:

Counseling

Community case conferences

Creation of a safety plan

Admission to the hospital

Step Five: Staff Check in The principal will convene a meeting to check in with the staff’s emotional well-being, give support and encouragement. Schools can turn to the Special Education Support Services for assistance. The Employee Assistance Program is available for those staff who wish additional support. Step Six: Reflection The student should be referred to ISRC to review the event and analyze the school’s response to the student’s needs. Step Seven: Monitor The school, student, his/her family and community partners will collaborate to support the student’s needs. The school team should review the student at the ISRC and create minutes. Support may include but is not limited to actions such as:

Daily check-ins

Implementation and/or review of the safety plan

Modifying the timetable

Involvement of community partners

A psychiatric referral

Referral to a Mental Health and Addiction Nurse

REFERENCES Canadian Mental Health Association, http://toronto.cmha.ca/mental_health/suicide-

statistics/ Centre for Addiction and Mental Health. (2013). Drug Use Among Ontario Students.

Toronto: Centre for Addiction and Mental Health. Cornell, D., & Sheras, P. (2006). Guidelines for Responding to Student Threats of

Violence. Longmont, CO: Sopris West. Crisis Prevention Institute. http://www.crisisprevention.com/ Heath, N., & Lewis, S.P. (2013). A Guide for Mental Health Professionals. Montreal:

McGill University Press. King, C.A., Ewell Foster, C., & Rogalski, K.M. (2013). Teen Suicide Risk: A Practitioner

Guide to Screening, Assessment and Management. New York: The Guilford Press.

Ministry of Education. Caring and Safe Schools: Supporting Students with Special Education Needs Through Progressive Discipline Kindergarten-Grade 12. Toronto: Queen’s Printer for Ontario.

Board Policy 48 06 09 27 16 09 27 Revised