Physical intervention in schools: draft guidance

Prevention

23. It is recognised that for some children and young people, particularly those with complex additional support needs, some forms of physical intervention can play an important role in supporting their physical wellbeing. Examples include the provision of postural support, headrests and the use of moving and handling equipment such as hoists and mobility aids. In such cases, the form of physical intervention should be part of an agreed plan and efforts should focus on ensuring its use is always safe, proportionate and non-discriminatory, rather than preventing its use. Similarly, some forms of non-restrictive physical intervention play an important role in supporting children at an early stage of development. Examples include giving a young child a hug if they are upset or a helping hand if they have fallen over. Further advice on these considerations is included within the section on physical intervention.

24. Where physical intervention involves the use of any form of restraint, education providers must take active steps to minimise its use and eliminate its misuse. We explain what we mean by this type of physical intervention at paragraph 49 in this guidance. This section outlines how the use of preventative approaches can contribute towards this aim. The focus is on creating a positive whole school ethos that promotes positive relationships, behaviour and wellbeing, based on robust assessment and planning processes. An example of a school's journey away from the use of restraint is included on the national improvement hub^[20].

25. All behaviour is communication and distressed behaviour in a child or young person may indicate an unmet learning or wellbeing need or a child or young person experiencing a stressor too great for them to manage. Disabled children may display behaviours related to their disability over which they cannot exercise control. The purpose of preventative approaches is to understand their needs and, where possible, meet those needs. Preventative approaches form part of the provision that schools may be required to make for children and young people under "the 2004 Act" and/or reasonable adjustments under the 2010 Act. Where a child or young person is beginning to evidence distress in an educational context, an assessment of their needs should be undertaken with the aim of preventing the behaviours occurring over time.

Getting it right for every child and additional support for learning

26. The Getting it right for every child (GIRFEC) framework is central to the successful implementation of preventative approaches. Where there is a likelihood of a child or young person becoming distressed in their learning environment, or where that has previously occurred, schools should use the GIRFEC framework to put in place individual preventative support. In line with the current framework, agreed preventative approaches should feature in or link to any plan - Child's Plan, Coordinated Support Plan and/or an educational support plan (Personalised Learning Plan or an Individualised Educational Programme as part of additional support for learning provision).^[21] Where a Child's Plan is in place the Lead Professional will play an important role in agreeing preventative approaches. Where a Coordinated Support Plan is in place, specific text should usually be included setting out preventative measures as part of the support required for the child or young person. In these circumstances all agencies as well as children and young people, parents and carers should agree to the approach.

27. All support, including preventative support, should be kept under regular review to ensure its effectiveness.

28. Trauma-informed approaches are key to the success of preventative approaches as these are generally in keeping with whole school approaches, such as 'Nurture as a Whole School Approach'. They help to build an understanding of children and young people's development and how stress and adversity can impact on how they present and what they might need in an educational setting. Information on how schools might embed trauma-informed approaches are available on the national improvement hub^[22].

29. Preventative approaches in any Child's Plan should focus on what may be implemented with the goal of preventing distressed behaviour occurring, rather than focussing solely on approaches to be used when it does.

30. As outlined in the GIRFEC and additional support for learning policy frameworks, children and young people and their parents or carers should be actively involved in the development of preventative approaches to distressed behaviour. Schools can also draw upon specialist support through the input of educational psychologists and allied health partners such as counsellors, clinical psychologists, speech and language therapists, occupational therapists, Skills Development Scotland and the child or young person's social worker, where appropriate. Schools can also make formal requests for support to other agencies under the 2004 Act^[23]. Where such a request is made, it must be complied with by the other agency, except in limited circumstances.

31. The effectiveness of preventative approaches should be kept under constant review. Planned supports should be based on up-to-date risk assessments, an analysis of occurrences of distress and knowledge of the child or young person's additional support needs. It is expected that all staff working with a child or young person should be aware of, consistently apply and provide feedback on the agreed preventative approaches included within any Child's Plan.

32. In line with their duties^[24] to support children and young people's transitions, education authorities should share any agreed preventative approaches outlined in a child's plan with relevant staff, ahead of key transition points. This is particularly important following periods of home learning during the Covid-19 pandemic and in major transitions such as moving to primary and secondary schools. The Association for Real Change principles outline best practice in this area^[25].

Positive relationships, behaviour and wellbeing

33. Building positive relationships is one of the fundamental values and skills expected of teachers. This is reflected within the General Teaching Council for Scotland's (GTCS) Professional Standards^[26]. The value placed on building positive, respectful and supportive relationships between all members of the school community will also play an important role in shaping a school's culture and children and young people's experience of learning. Building positive relationships forms a key part of curricular learning in health and wellbeing and existing strategies to promote school connectedness, resilience, inclusive culture and the development of children and young people's social and emotional competences.

34. The ability to build and maintain relationships to support wellbeing and learning are part of the GTCS, Scottish Social Services Council and CLD Standards Council Scotland professional standards. A number of resources that teachers and school staff can use to build positive relationships and support children and young people's mental wellbeing are available on the National Improvement Hub^[27].

35. The process of child or young person participation in decision making is important for building respectful and trusting relationships and a culture where their views are listened to and acted upon. It also helps to develop, through practice, children and young people's capacity for decision making in general, and aid learner participation in decisions about their wellbeing and life choices. It is important to allow children and young people to make decisions, as far as possible, about their environment, their support and any preventative approaches. Children and young people will often be able to offer a unique insight and perspective into the types of preventative approaches and tools, which best assist them when they are distressed.

36. Children and young people with specific communication support needs may require a range of appropriate evidence-based approaches to enable them to become actively involved in decision making. This may involve the use of visual supports, the benefits of which are discussed in the 'Can Scotland be Brave? Incorporating UNCRC Article 12 in Practice' report^[28]. The Lundy Checklist of Participation^[29] may be a helpful starting point in assessing approaches for participation.

37. It is recognised that children and young people can build strong and trusting relationships with individual members of staff, who can help them during times of distress. The names of any preferred contact (and where possible, substitute support) should be included in any Child's Plan. Leadership teams should continue to be alert to the potential for distress caused by the absence of any staff member who normally supports a child or young person. For children and young people at risk of significant distress, schools should work towards having a small number of adults that the child or young person progresses to feeling safe with. This will help reduce dependency on one member staff and help with continuity of support.

38. Where distress has led to a relationship breaking down, or following the use of restraint, restorative approaches; where implemented well, and where all of those involved are in a state to be able to engage in this, can be used to help repair this rupture. It is important that restorative approaches only take place at a time when the child or young person feels able to engage in them. This is not usually immediately following the use of restraint.

Leadership and culture of a school

39. A school's culture, ethos and values are fundamental to promoting positive relationships, behaviour and wellbeing^[30]. An inclusive ethos where everyone's contribution is valued and encouraged should be promoted. The review of additional support for learning implementation (2020) found that positive school cultures develop where the key conditions for implementation are in place:

• values-driven leadership;
• an open and robust culture of communication, support and challenge - underpinned by trust, respect and positive relationships;
• resource alignment, including time for communication and planning processes; and
• methodology for delivery of knowledge learning and practice development, which incorporates time for coaching, mentoring, reflection and embedding into practice^[31].

40. It is recognised that these conditions are evident in many schools. Nevertheless, all schools may benefit from considering their individual culture and ethos in light of the above points; in particular, reflecting on whether there are any remaining barriers to achieving or maintaining the key conditions set out above.

41. Highly effective leadership at all levels is key to ensuring the highest possible standards and expectations around the use of preventative approaches and restraint reduction are shared across schools. Highly effective leaders are best placed to improve outcomes for children and young people. They can drive further improvement, by ensuring that key information on preventative approaches and restraint reduction is cascaded throughout the school, by working collegiately with staff and collaborating across boundaries to engage positively the entire learning community.

42. The information gathered in the standard dataset for recording and monitoring physical intervention at school and education authority level, in combination with the 'How Good is Our School? (4^th edition) self-evaluation framework'^[32], will support reflective discussion and constructive challenge of current practice.

Assessment

43. As part of a Getting it right for every child approach, care is required in order to proactively meet children and young people's physical, neurodevelopmental, sensory, emotional and communication needs. This is particularly important where additional support is required with speech and language communication or where a child or young person cannot communicate what they want or need verbally. In such circumstances, extra care and assessment is required to develop an effective non-verbal method of communication with the child or young person to allow learning, and the learning environment, to be tailored to meet their individual needs.

44. If a child or young person can communicate (verbally or non-verbally) and their physical, neurodevelopmental, sensory and emotional needs can be met, distressed behaviour is less likely to occur. In addition, when children are extremely stressed, their ability to express themselves appropriately diminishes, and those supporting them need to be mindful of trying to understand what the behaviour is communicating in that moment. For example, defiance and refusal may be a function of anxiety due to an over-stimulating learning environment or a fear of a change.

39. In order to best understand whether a child or young person may be experiencing sensory integration difficulties, a trauma trigger or, for example, stress due to the cognitive load of the task being too high, a functional analysis of the distressed behaviour(s) should form a part of the assessment of the child or young person's additional support needs.

40. Parents and carers, who are likely to have years of experience of effective communication with their child are a valuable source of advice. The communication passport^[33] can be a useful tool in recording and sharing parental views and experience in communicating with their child. Visiting health professionals and partner services often hold valuable information and can help staff build positive and effective communication with children and young people.

Positive learning environments

41. When considering preventative approaches, thought should be given to the potential impact of the physical learning environment. As part of a nurturing approach to practice, the learning environment offers a safe base. Careful consideration should be given to ways in which the school estate aids the delivery of a positive learning environment; one that supports child or young person's learning and wellbeing, engenders a sense of safety, encourages participation and reduces stress. In particular, consideration should be given to:

• classrooms and common areas that are not over-stimulating;

• spaces that children and young people can choose to access themselves if they find this helpful (including an individualised safe space), which may also include safe opportunities to move freely around, should this be supportive to the child or young person. This should not include lockable spaces such as toilets;
• quieter spaces that can be used to facilitate positive child or young person participation and decision making or where additional communication support may be required;
• spaces that can facilitate both low- and high-stimulus activity to support any specific sensory needs; and
• in line with the development and implementation of accessibility strategies, any safe spaces that may become associated with physical intervention should be assessed to ensure they do not increase, rather than reduce, the stress levels of children and young people and associations of shame or stigma.

Co-regulation to de-escalate in the moment

42. In the context of whole school approaches to relationships and behaviour and the practice outline above, there will still be situations where a child or young person requires support from adults to regulate their emotions, behaviours and stresses. Some children, over time and with support, will be able to self-regulate when they are distressed, but some children and young people with complex additional support needs, and younger children, will require support from adults to "co-regulate". Both approaches are closely linked and share the same aim of de-escalating emotions, behaviours or stresses in the moment.

43. Children and young people, their parents or carers and all staff involved in supporting them should be actively involved in agreeing de-escalation and co-regulation approaches, which should be subject to regular review. All staff working with the child or young person, including pupil support assistants and supply teachers, should be informed of the approaches agreed in the plan to enable them to respond appropriately.

44. The same stages of individualised needs-based assessment, planning, implementation and review should be followed when agreeing de-escalation and co-regulation strategies. These may differ greatly from child to child, in response to assessed need, but the principles outlined below are likely to be helpful.

45. The least restrictive approach to supporting a child or young person whose stress levels are rising is to use de-escalation strategies. The use of de-escalation should always be considered as a first response. De-escalation is most effective when planned and tailored to the individual child or young person. However, de-escalation strategies can still be used when unplanned. Principles of de-escalation include:

• communicating in a calm, non-judgemental and non-threatening manner;
• maintaining a quiet sensory environment by speaking in a quiet voice, reducing the number of people present, noise and if possible, reducing lighting;
• giving the child or young person time to de-stress;
• distraction in the moment where this is helpful to the child or young person;
• an activity or movement break that supports self-regulation;
• time with a trusted adult or time alone, with an adult in close proximity (within sight and hearing) if the child or young person identifies that this is helpful to them;
• respecting their personal space at all times, by maintaining a suitable distance;
• being mindful of open and engaged body language, facial expressions and tone of voice (and not speaking, when appropriate);
• identifying what would be most helpful to them; and
• accommodating, where possible, any previously agreed strategies or unplanned requests that de-escalate, including a pupil-led withdrawal.

46. More information on de-escalation is available on the National Improvement Hub^[34].

47. The use and effectiveness of de-escalation should be kept under review and any child's plan must be promptly updated following any incident with what was found to be helpful.

Unplanned use and duty of care

48. It is recognised that despite the most thorough planning, distressed or unsafe behaviour may still occur unexpectedly, with no plan in place. In such circumstances, staff should use the least restrictive option available to them to support the child or young person to regulate their emotions or behaviour and reduce any risk of injury (see duty of care, Annex C). Knowledge of the Principles of de-escalation (para 45 above) will assist staff to respond. The use of unplanned de-escalation or co-regulation should be reviewed and recorded within any child's plan to inform the assessment, planning and implementation of agreed preventative approaches in future.