Teachers Should Lift Up Disabled Students, Not Hold Them Down

A Teaching Aside

So, every once in a while I help out families that have to navigate the educational system with disabled children. Most often autistic or fragile X kids (once again this is a good time to note I am not a proponent of person first language). These phone calls tend to be very similar each time, and I find that sad. The school team is telling parents their children cannot succeed in anything other than a highly restrictive environment. Life skills classrooms rather than mild/moderate classrooms, self-contained rather than resource. Behavior units rather than a compassionate behavior plan… The school’s showing a complete lack of faith and belief in a child’s ability; contrasted with frustrated parents trying their best to advocate for their child’s abilities.

The theme of many of these phone calls are boiled down in this tweet:

This is what I am going to address in this post: How should schools approach the educational placement of disabled students.

Least Harmful Assumption

My approach in special education is to always favor what I call the least harmful assumption. The definition of least harmful assumption is as follows (paraphrased from this piece by Anne Donnelian and this conceptual extension from Zach Rossetti and Carol Tashie):

The Least Dangerous Assumption is the premise that, in the absence of evidence, we believe we have not yet found a way to make it so a child or adult with a disability can [learn], instead of believing he or she can’t [learn]

More colloquially, it is less harmful to the student to assume they can be taught how to succeed rather than assume they will never be able to accomplish.

Example(s)

(from Rossetti and Toshie – emphasis mine)

An example particularly applicable to my life (fishing)

…If I were to go fishing for a week and not catch any fish, there would be two assumptions that could be made.

First, I could say “there are no fish in the lake since I did not catch any, and I know what I am doing.”

Or, second, I could say simply that “I did not catch any fish that week, and I will keep on trying.” The first assumption seems rather arrogant, while the second one is more realistic and respectful.

(There is a third assumption that I could make which would be that I am not a good fisherman, but we won’t go there).

An example for disabled students in a school setting

Imagine a child who does not talk with the spoken word and moves around using a wheelchair. Her teachers have worked with her for a month and have not yet seen any evidence of what she understands. In fact, they wonder if she knows or is aware of anything at all.

These teachers can make one of two assumptions. They can assume that “what you see is what you get” and that this child does not know anything, that her brain is as empty as that lake. As such, they can educate her in a way that reflects those assumptions (perhaps segregated classes or regular classes with low or no expectations). Now imagine her as she graduates and uses a communication device to say, “Why did you treat me so poorly?!! I am smart and you wasted twelve years of my life!” A very dangerous assumption was made, with results that none of us would desire.

Now, consider the second assumption. These same teachers can recognize that her movement differences are differences and not deficiencies. They can assume that she knows lots and just isn’t currently able to show what she knows. Her brain is as full of knowledge and potential as that lake is of fish, but they just have not been able to reel anything in yet. As such, her schooling would reflect these high expectations and she would be considered and respected as a valued member of her school and classes. Now again, imagine her twelve years later at graduation, using her communication device to say, “Thank you from the bottom of my heart to all of my teachers who believed in me and made me feel as if I truly belonged and treated me like all of my classmates.” This is the least dangerous assumption, one that results in a young woman who can celebrate her full and fulfilling life.

But consider a third scenario as well. What if we never come up with a way for this young woman to communicate her intelligence? What if, after twelve years as a valued and respected student in all general education classes, we still do not know exactly what she has learned and knows? What harm was done? What was lost? Nothing. And that truly is the least dangerous assumption.

Lifting Up vs. Punching Down

When we look at a disabled individual, we have two choices. We can focus on their abilities and work on a plan to help them shine, or else we can prejudice ourselves and find ways to make sure our preconceptions are validated. In other words, we can lift them up and give them the chance for success, or we can punch them down and make sure they remain unable to do things.

This can be thought of as a form of Pygmalion effect, as diagrammed below. If we believe in them, they will conform to our belief and rise up. The same works if we constantly express a belief of inability. The student will conform to our expectations.


My approach in special education placement is to assume the student is able or can be taught to do whatever they need to know. I prefer general education over resource, resource over a self-contained special classroom, and I prefer a mild/moderate over severe/profound special classes, and I favor anything to a special school.

I have worked with students with Fragile X syndrome, and I have found the following to be true. If you work hard enough and/or give appropriate scaffolds, they can learn how to read. They can do basic math, especially if given a calculator. They can learn routines in a classroom and behaviorally fit in with the other students. They can mainstream for academic and nonacademic subjects. They can learn how to ask for help.  So, why would I immediately place them in a life skills class that assumes they cannot do the above things? Especially if I have a classroom that moved more slowly academically, but still has comparatively high expectations for the student.

With autistic students, I assume they can develop appropriate-enough of social skills to exist in a typical classroom. I assume they can self-regulate. I assume they can take care of their own sensory needs. I assume they can communicate effectively, be it by sign, speech, AAC, PECS, or whatever. I assume they can learn to cope. But they have to be taught. So why would I immediately place them in a classroom that is designed to prevent these kids from having the experiences necessary to learn the above skills? Why would I assume they will not be able to learn?

Later in this post I will give a specific example of a student with cerebral palsy. My assumption for people with cerebral palsy is that they have sharp minds but lack control over many functions of their bodies. Their physical disabilities are not indicative of a weak mind. In fact, the opposite is more reliably true in my experience. So why would I try to assign them to a special school that specializes in physical disabilities, but makes assumptions that include an incapacity for learning? Why would I do that to them?


This can be extended to any student with any challenge or disorder, be it mental, neurological, or physical. The U. S. educational system has a track record of making poor, even harmful assumptions about race, socio-economic status, learning disabilities, medical or psychiatric diagnoses, etc. If we could screw up our assumptions, we did. This was why the idea of a least dangerous/harmful assumption was formalized all the way back in 1984, and we still have difficulties consistently applying it.

My Experiences With a Least Dangerous Assumption

When I was in elementary school, my mother was a 1:1 paraeducator for a young woman with cerebral palsy in the junior high. This young woman used a wheelchair for mobility, required high levels of assistance for personal care, and her speech was very hard to understand. My mother’s job was to help: this student was the one doing all the work for her assignments, tests, etc.

I remember one day this young woman came to our house and was in the kitchen talking to my mother (by now I knew her well enough that I could understand her when she talked). Because I liked her, I drew her a picture of a red barn with a window. It was a typical young child picture of a barn. The perspective was awful, the windows were crooked, etc.

When I gave the picture to her, she commented that the barn would look better if the perspective were fixed and motioned with her arms how this l look. She also gave me a few more notes on how to improve the picture. To me this was not altogether unexpected feedback given her father was an art teacher at the high school.

In retrospect, I realize something  funny. I was not at all surprised that she gave me this feedback and did not even process at the time how some people would not be pleased to receive feedback on an art piece by a young woman with cerebral palsy. I took her notes and improved my drawings. I then sent them to school with my mother to give to her.


Fast forward to a year or so ago.

I worked with a student in 4th grade. There had been discussions by the school team about having this student go to a special school for profoundly disabled students because they have cerebral palsy and required a lot of assistance for their personal and communication needs.

This school had all the students use a computer program called Successmaker as part of their computer time because it gave the teachers data that could be used for progress monitoring. So I had daily data for reading and math for this student.  This student had a head mouse system involving a reflective dot on their nose that was picked up by a webcam on the computer monitor. The student hit a large button (think the “easy button” from Staples) to click the mouse.

Using this assistive technology, this student was consistently getting 60-75% of the grade level questions correct. Seeing this, I wondered why this student was in a full-time special education classroom placement. I felt that was holding this student back. So I made my own assumption and ran with it. I assumed they were a kid with a great brain but a body that was uncooperative.

I started by moving this student into a general education class for whole group reading and math. I figured since the student had a 1:1 paraeducator, they would be able to figure out how to survive the general education classroom. Well, apparently survival was not the question, it was participation. This student was able to complete assignments at grade level without any problems. She used an iPad to point to the numbers that were needed on the assignment and the paraeducator wrote them. With time, the student just got a better iPad program that let them just do the whole assignment themselves.

Reading showed similar success. When given choices or time to tap out answers using an adaptive keyboard, we saw grade level reading comprehension, meaning both the student was able to read the material and concurrently understand what they were reading. Now, even a significant number of non-disabled students struggle with this. Additionally, at this point the student also got the burr up their butt that they wanted to write. They wanted to type. They wanted to do the work themselves.  So the paraprofessional let them. For writing, the paraprofessional grabbed a pencil in her fist and stuck a thumb up. This student grabbed the para’s thumb and used it like a joystick to write. The para even would talk to me and actively  not pay any attention to what the student was doing to be sure not to influence any writing. The student also started using the adapted keyboard independently as well, even though it was extremely difficult.

The final hurdle took some more creativity. Communication. This student did not have the ability to speak. They did not have sufficient motor control to form the right sounds. However, this student was a social butterfly. They loved being in groups and always tried to be in the middle of things. We found out one day when there was a scheduling issue that put some physical therapy at the same time as recess. The student tried to communicate their displeasure using the iPad, but was ignored. They tried by yelling, but were ignored. So, to make their point, the student dumped their wheelchair started crawling outside without the para. Point made.

Our communication plan was simple: the student’s mother would program in a set of communication statements on the iPad connected to the button. In the morning, the paraeducator would have a typical beginning of day conversation with the student in the 10 minutes between arriving on the bus and class starting. Then the teacher started joining in. Then peers. After a while we programmed the iPad with some corny knock-knock jokes. It was constrained communication, but it was communication.

We also saw something interesting…the student started to vocalize more in the hallways and class to get our attention so they could communicate.  We even set up a few pre-determined questions for this student to answer so they could prepare and get the communication button set up with the answer during the lesson so the student could hit the button and participate in class.

In the end, by making the least dangerous assumption regarding a student with multiple disabilities, we helped a student succeed. They worked their way out of a special education unit. In fact, they do not receive any kind of academic special education services at all. They just have a 1:1 para for hygiene and mobility assistance.  On year-end testing they received a 3 out of 4 (which is “proficient”) for the English Language Arts testing and a 2 out of 4 (“approaching proficient”) for each the Math and Science testing. This student has friends that walk across the room talk to them and bask in a toothy grin. They hang out with a set peer group at recess. They communicate with teachers in class and in the hallway. They have it all.

All because we made the assumption that this student could do it. We never entertained the thought that they would fail. We challenged ourselves with the student’s success. And the student made it.

Conclusion

Kids can do amazing things if adults believe in them. They are also capable of spectacular failure if adults don’t. So, in a very real and tangible way, their success depends on our belief in their abilities.

To follow the least dangerous/harmful assumption there are things we can do:

  • Focus on who/what students are becoming, not what they are doing at the moment
    • It is the PROCESS, not the PRODUCT that matters
    • That Ah-Ha or Eureka moment may just be around the corner
  • Assume intentionality in communication
    • Always assume they are trying to communicate
    • If nothing else, you will teach them to intentionally communicate
  • See strengths
    • What can they do
    • Shape their strengths to compensate for any weaknesses
    • Always approach with the assumption of competence
  • Wait…Then Wait again
    • Rushing is not an effective way to identify skills and abilities, it often masks them
    • Patience is a virtue (give time for skills to develop)
    • Allow for a longer processing time (Getting the right answer eventually is still getting the right answer)
  • Use the right tools for the job
    • Assistive tech as needed to guide success (earlier post on AAC)
    • Teach how to use assistive tech (Teach them to fish, don’t just give them a fishing pole and walk away)
  • Focus on all pieces of the puzzle
    • Think critically about how to meet needs of the student
    • Treat IEPs and Placement decisions as an opportunity to challenge the student
  • Ignore nay-sayers
    • You do no harm when you make the least dangerous/harmful assumption
    • You may just raise the student up
    • Negative comments or naysayers are not helpful, so they can easily be ignored
  • Never give up
    • Never give up on yourself and your ability to teach the student
    • Never give up on the student’s ability to learn

 

One Cannot Prevent Meltdowns By Using Restraint

A Theoretical Aside

This post comes from my experiences the last few weeks. I have been working with a number of students that have been a danger to themselves and others. As such, I have had to use physical restraint to ensure maintained safety of students and others around them.

Fewer people were injured because I used restraint methods, but I still feel terrible for having to use MANDT restraints after my preventative strategies proved ineffective. I have found that school teams often have difficulty in understanding why I feel like an abject failure whenever I have to restrain students. To the untrained eye, the intervention worked-and it is hard to understand why I am so disappointed.

This post is my explanation.

The Escalation / Crisis Cycle

escalation

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I start with two diagrams to show that escalation is not an all or none phenomenon. We all go through several steps.

  1. Calm or Baseline Phase
  2. Triggered or Stimulation Phase
  3. Agitated/Acceleration or Escalation Phase
  4. Peak or Crisis
  5. De-Escalation Phase
  6. Recovery or Stabilization/Post Crisis Phase

The important components of this post are as follows:

The Calm or Baseline phase is not the same for everyone. In fact, in my experience, there are a surprisingly large number of children that do not have the luxury of having a true baseline level. If they have a hard home life, trauma in their past, or some conflict with and adult or other students, they may actually start the day at the Triggered phase.

The Triggered phase of the crisis cycle is deceptively named. For most people who start at a Calm baseline, the Triggered phase does not involve outward signs of agitation or stress. When a child is triggered, this sets the stage for responses to stimuli that are of a much greater amplitude than they would be had the student not been triggered.

The Agitated phase is when the child moves beyond simply being Triggered and begins to show outward signs of stress and annoyance. The child will become intolerant to stimuli they would otherwise tolerate. This is actually the phase most children are in when we erroneously say they have been Triggered.

The Acceleration phase is when the Agitated phase starts to self-perpetuate.

The Peak or Crisis stage is, in my opinion, by far the most  misunderstood stage. At this stage the child is disconsolate. Meaning there is NO WAY anyone can intervene to “bring them down” – and yet this is the stage most adults start to intervene.

The De-Escalation phase is deceptively tricky. Most adults do not  realize that a student fresh off a Crisis are very easy to re-escalate back into Crisis.  The De-Escalation Phase is oftentimes even closer to Crisis than the Acceleration phase.

Recovery is a refractory period between Crisis and Calm. It is only at this phase that it is appropriate for an adult to intervene and discuss the Crisis with the child.

How Should We Handle a Student in Crisis?

Optimally, we don’t let things escalate this far. We back off earlier in the escalation or crisis cycle, either by anticipating the Trigger or recognizing the Agitation phase for what it is.  The easiest way to do this is to back off. Give the child space. Most of the time your help is not actually  helpful at this point.

That said, backing off is not an option if a student uses violence or aggression during their Agitation, Acceleration, or De-Escalation phases. In these cases, intervention is unavoidable. Below I will explain how we can intervene. But first, I will cover how our interventions are often the coup de grace or straw that breaks the camel’s back that sends the child into full-blown crisis.

What Do We All Do Wrong

The diagram below describes the cycle that adults and children get into when there is a conflict. As adults, we often fail at taking the perceptions and feelings of others into account when we work with them.

why-conflicts-escalate

When a student is Agitated or in the Accelerating phase of the crisis cycle, they perceive intervention from an adult as a threat rather than as help. Because the child perceives a threat, the child either goes into a fight or flight mode or else they get angry. This means the student will react to the adult as an enemy rather than a friend-regardless their relationship 5 minutes or even 5 seconds earlier.

Well, because as the adult we fail to account for this side of the cycle, we react to the student’s reaction by getting escalated ourselves, and we go through the same behavioral cycle as the child. This turns into a vicious feedback cycle that results in both the adult and the child saying and doing things they will later regret and would not normally do.

How Do We Do It Right?

I distinguish the above cycle of conflict of serial reactions to stimuli from an adult taking a step back and responding appropriately. My operational definitions for these words are reaction = acting upon stimulus without prior thoughts. Response = acting upon stimulus with prior consideration of multiple options and antecedents.

When we find a student that has been Triggered, we need to take a step back and ask ourselves some questions.

  • Did I just do something that triggered the student?
  • Did something happen to the student at school today that might have triggered them?
  • Did something happen in the student’s home life that might have triggered them?

If we do not know the answer, there are two things we can do. We can – I know this is revolutionary – ASK THE STUDENT how they are feeling. If they are unable or unwilling to answer, that is why we have phones. Reach out and communicate with the child’s family or other teachers/paraprofessionals that may have some information.


If this proves fruitless, we move onto the next step. If the student is triggered or agitated, we can still engage them in a dialogue. Importantly, the adult must take care to not take a dictatorial tone. The adult is on a fact finding mission, not on a quest to solve any problems. In fact, if an adult tries to impose a solution on the child at this point, it will likely be interpreted as either unfair, controlling, or demanding…and the child will escalate toward the Accelerating phase.

If, however, we let the student talk (and this does often involve a fair amount of cursing and swearing), they often can de-escalate themselves or else discover their own trigger. Since they are in control, they can be receptive to an adult guiding them to a Calm state. Letting the child express themselves in a free and safe environment will often naturally guide them into a Calm state, but if you, as the adult, impose yourself and try to correct their language or minimize the child’s emotions, you are not recognizing how the child feels and they will likely escalate.


Let us assume we cannot help at the Agitation phase. If a student is at the Accelerating phase (or the De-Escalation phase as they are handled the same way), BACK OFF. Literally. BACK OFF. Give the child as much space as possible and do not bother them. You can only make things worse at this point. Even proximity will result in further acceleration toward a crisis.

Sometimes body blocking is necessary, so we do it. But it is obligatory we KEEP OUR MOUTHS SHUT. If we have to take something away from the student, we do so SILENTLY or just say with a flat affect, “Not an option”. Nothing more. Even this runs a major risk of driving a student toward crisis. We cannot give any emotional fuel to the hell fire in potentia.

If the student has an option of a safe space, dark spot, or quiet corner, this is a good time to remind a student (REMIND, never demand), that they have the option of separating themselves into their special space. Again, if we demand the student do this or tell them to go over there to cool off, we probably just ticked them off. The Accelerating phase is typified by a defiant attitude and self-preservation – not taking advice.


Now to the hard part. Crisis. What do we do when there is crisis. I wish I could say, “Run away”, but that is not always an option.

monty-python-run-away-o

So, if running away and giving oodles of space fails, we are left with one of the hardest things we can do. KEEPING A CHILD IN CRISIS SAFE. Most of the time this takes the form of clearing the classroom or else getting the student to a safe space where they cannot hurt anyone.

Amazingly, that is the easy part.


If the above fails, we have another responsibility-and this is the hardest bit-we have to make sure the student does not hurt themselves or others. This is where restraint methods come in. And the probability of both the adult and the child getting seriously hurt goes off the scale.

Restraint is not to be taken lightly and is the absolute last resort in any crisis situation. Touching a student in crisis is often not a great idea and is almost always dangerous, both to the adults and to the child. This is why every other option needs to be employed prior to even considering restraint. In fact, even grabbing a student’s hand or using an arm to prevent an elopement can cause problems.

I say backing off and letting the kid blow off steam is the easy part because it does not involve a physical interaction, Whenever a child is escalated, even if they are in the Accelerating or De-Escalating phase, touch will often send them from 0-100 in a microsecond.


This video below shows one of my behaviorist heroes, Cesar Milan, making a mistake of touching an animal in crisis. Everyone was safe until he touched the dog. Cesar carefully took the dog through the escalation cycle from Calm, to Triggered, to Agitated, to Acceleration, to Crisis, and to De-escalating phases. However, even though it was during the De-escalating phase, as soon as Cesar touched the dog, everything became complicated. I particularly like this video because it explains the dog behavior along the Escalation/Crisis cycle.

I Feel Terrible When I Lose Control Of The Situation

Whenever I restrain a student, I lose. They lose. We all lose. The student ends up a sweaty mess of emotions and snot, and I often end up bruised and bitten. I have to use restraint, I feel like Cesar in the above video explaining to the people around him how he screwed up and missed something. Then Cesar had to walk away and lick his wounds. Additionally, the dog learned nothing from the experience other than he was able to bite Cesar (which will increase the probability of it happening again).

I feel terrible for all the reasons displayed in this video. Cesar missed something because he was distracted and it resulted in injury to himself and complete loss of control of a situation. I always ask myself, “What did I miss? What could I have done to prevent this? Where did I screw up?” immediately followed by an, “is the student okay? Are they hurt? Are they still freaking out? DO they understand what just happened?”. Then I ruminate and perseverate on the experience for a few hours.

EVERY. SINGLE. TIME. I have to use restraint methods I am able to find something that I missed during the escalation/crisis cycle that would have prevented further escalation. There is always something I did not notice. Some tone of voice I missed. Some frustration I accidentally projected.  Some accidental sarcasm on my part. An eye roll. A smirk. A mistake. An oversight. A lack of control over my surroundings that resulted in an additional trigger.

How Do I Do Better?

I have spent a lot of time mulling over in my mind what I can do better to help de-escalate kids when they are not in control of themselves. By applying my background as a behaviorist to the situation, I have a few notes for myself – and I hope they will be helpful to others. When one has to restrain or seclude students for their own or other’s physical safety:

  • Never invalidate a student’s emotions. They are feeling what they are feeling, there is no point telling them they are wrong or shouldn’t feel a certain way.
  • Never hover over a student. If a student is on the floor or in a chair, do not use your mass to intimidate them. It is intimidating.
  • Never repeatedly bring up a student’s mistake. Move on. You are only going to make them self-conscious and reduce their self-esteem.
  • If a student asks for space, GIVE IT TO THEM so long as it is safe.
  • Do not chase/run after a student if they elope. Follow SLOWLY and at a distance. Catching the student does not earn any prizes.
  • Watch your tone of voice. The student is paying attention. They know if your tone is aggressive they are unsafe.
  • Never use sarcasm. If words do not match the tone of voice, you are confusing the student.
  • Never dictate terms. The student will balk at orders when escalated and become defiant on principle.
  • Never lie to the student. They will call you on it. They will remember. They will hate you for it.
  • Never talk about the student in a negative way in front of them to another teacher. In fact, this is NOT the time to give an update on behavior unless you are handing off responsibility for the student to a specialist.
  • Never give ultimatum. These never work, less so when a child is escalated.
  • Never give an emotional response to swearing or physical aggression. The student is not entirely in control of themselves and trying to get the adult to move away from them, by whatever means necessary.
  • Never argue with the student. They will contradict and defy you. Don’t take the bait.
  • In fact, Never try to start a conversation. This will not end well. There is nothing you can say that will fix the situation.
  • Never touch the student to calm them down (pat on back, etc.). This will be misinterpreted.
  • Never distract yourself with a phone, etc. You will miss important signs.
  • Never show frustration, anger, etc. Your emotions are not helpful. They do not contribute anything other than fuel to the already highly combustible situation.
  • Never, Ever, under any circumstances retaliate against any of the violence committed by a student being restrained. I wish this went without saying. It doesn’t. I am saying it. We are the adult. We MUST act like it.

Some of these may seem counterintuitive, but they are all important. The best advice I can have for anyone is to avoid restraint or seclusion as consequences for behavior.

The solution is for us to focus on prevention instead. Help the student meet their needs before we turn the escalation cycle into an escalation spiral.