Vittone, T. (Interviewer) & Ghobrial, R. (Interviewee). (2016). De-escalation Tale #4. Retrieved from Yammer: CPI Instructor community website: https://www.yammer.com/cpiinstructorcommunity/#/Threads/show?threadId=768981320
Ghobrial, R. (2016, June). General format. Retrieved from https://www.crisisprevention.com/Blog/June-2016/haptics
The Use of Touch: Haptics & Students With Special Needs
“How much touch can I use to support student behaviour?”
“When is it OK to restrain my student?”
“Should I be touching in order to garner compliance?”
“I can’t touch him; my union says I’m not allowed!”
These are some of the many quandaries I’m asked to weigh in on during my school visits and CPI training sessions.
In the last six years as a CPI Certified Instructor, I’ve trained many teachers and teaching assistants and have helped them recognize the difference between touch used to de-escalate student behaviour and touch that can derail a student. I also help staff recognize how their efforts, when people are running on fumes, have supported a situation that could have gone awry.
I get teams to think about and practice eliciting productive responses, as detailed in the Staff Fear and Anxiety unit in Nonviolent Crisis Intervention® training. This discussion helps teams figure out the best possible response in a situation that they anticipate as tension-inducing.
In addition, I reinforce that using a team approach really does make a difference when it comes to managing student escalation.
Here’s the nugget:
There is way too much pressure on adults to theorize what’s going on for a child. Rather, our jaw-dropping moments should come from unassuming information gathering: Asking other teams who have worked with the student, asking medical practitioners, and of course, asking the student’s parent(s) or guardian(s).
The truth of the matter is that people in numbers do things incredibly better than they do in solo interventions.
THE QUESTION OF HAPTICS
Haptics, or touch, can generate different messages in different situations. As a result, the question of hands-on or hands-off can be a quandary for staff.
Within our board, our rule of thumb is that physical contact starts with knowing your student and using sound judgement. Physical restraint, for instance, is only to be used as a very last resort when the risk of the student’s behavior outweighs the risk of the intervention.
In terms of supportive touch, I always ask teams to ponder whether it’s used for sensory and/or communicative purposes. In other words, does the student need to be touched to help them manage their sensory world? Or does the child need to communicate something through their own physical contact with staff, but can only do so in a maladaptive way (biting, hitting, etc.)?
This leads to a great group problem-solving discussion, and it helps teams assess their use of sound judgement when it comes to student behaviour, a student’s use of touch, and staff’s use of touch.
HELPING TEAMS TROUBLESHOOT
Everything starts with knowing your student.
When we’re troubleshooting, my first inclination is to review what the student’s day looks like and what was going on when he exhibited a challenging behaviour. We also consider:
- Has something changed medically or biologically?
- Has the child been ill or visited the doctor recently?
- Has the child been prescribed medication? If so, do we understand the side effects of the medication?
- Is there a larger sensory need? If there are underlying sensory needs manifesting in a challenging behaviour, has the child been seen by a registered occupational therapist?
Until fruitful information is gathered, it’s great to have a list of options to use with the student. Individualized efforts might include:
- If we know that the student is looking for touch for sensory purposes, then perhaps we can replace touch with something else—a blanket, a stuffed toy, a ball, etc.
- Trying calming activities (taking a walk, jumping on a trampoline, rocking on a rocking chair).
- Preferred choice activities (eating, puzzles, books).
- Incentives: A favorite toy or some sensory objects can certainly be among our incentives, but incentives should probably not be the sole thing on our list.
If we don’t have a great list for the student to begin with, then one of our structured activities during the child’s day could be to try different things and see what works and expand our list. This kind of testing and learning can be done at a time when the child is calm and happy.
HOW DO WE GIVE KIDS SKILLS TO HANDLE CHALLENGES?
This is an important question, especially if the behavior is an attempt to communicate.
As opposed to imposing punitive and adversarial consequences to the behavior, such as physical restraint procedures, we need to consider how we’re teaching the child to communicate in adaptive ways.
For instance, if the child is biting or hitting in order to communicate, then we need to figure out how to help them communicate and teach them in an adaptive way—possibly through visual supports or objects. Communication supports for the child may include a personal visual schedule along with a First–Next board, a visual timer, and a 5, 4, 3, 2, 1 board, which will need to be taught and reinforced, so that the student can have some predictability in their day.
We should bear in mind that the student’s time at school is to control stimulation overload and to allow us to structure a more suitable day that should include a variety of tasks at a suitable pace. Certainly having the student access a quieter environment allows us to have greater control over all those variables—and we can then begin to teach the student some greater self-control within some of those variables.
PREPARING THE STUDENT FOR THE FUTURE
In addition to our day-to-day supports, we are always prepping our students for what lies ahead—high school, post-secondary education, workplace, etc. We need to ensure they understand what they should be doing or should not be doing in those domains when it comes to physical proximity/touch. We wouldn’t want an adult with special learning needs to go up to a stranger and grab their arm or hand!
An important approach involves modeling touch in a way that can be appropriately and adaptively reciprocated. For instance, we talk about holding a child’s hand as the easiest transition from touch to no-touch. And certainly if a student attempts to hold our hand, it’s touch that we can reciprocate.
MEETING THE ULTIMATE GOAL
The plan is for our students to be calm during their day, to become used to coming to school and engaging in activities, to be able to successfully complete a limited number of transitions, and to begin to engage in effective communication.
If our inclination is that the classroom is too stimulating an environment for the student and they become triggered throughout the day to engage in unsafe activities that threaten their well-being, and the well-being of peers and staff, then we may need to use our professional judgement and experience to find a calming space.
Ideally, in the student’s world, they will have a safe space that is not overly stimulating for them to calm, to receive appropriate programming, and to act as a base from which they can transition to the class in a limited way that we have control over.
Rania Ghobrial works as an Autism Resource Team Facilitator for the Peel District School Board. Rania facilitates CPI training during professional development days and regularly encourages her participants to re-examine the ways touch is used to de-escalate and manage acting-out behaviour. She frequently shares the CPI Verbal Escalation Continuum℠ with teaching teams to help them shed light on the behaviours that can occur at each stage of a crisis and the most supportive, non-judgemental responses to use. Rania is delighted to share information about students’ sensory, communicative, and self-regulation needs.