South Dakota Advocacy Services - Seclusion/Restraint Questionnaire

Parent/Guardian Survey on Seclusion/Restraint

Many states have codified the definition and use of seclusion and restraint in school settings. South Dakota does not have administrative rules or statutory language that specifically regulates the use of seclusion or restraint in school settings. There is, however…

•A reference to schools and the use of “physical force when reasonable and necessary” to control students on school premises (See S.D.C.L. 13-32-1)
•A definition of seclusion within the statutory framework pertaining to people with developmental disabilities. The statute references schools who receive public funds cannot engage in the practice of secluding a person with a developmental disability. Seclusion in this statute is defined as a “placement of a person alone in a room or other area from which egress is prevented…” (See S.D.C.L. 27B-8-41)
•School district policies which may describe the use of seclusion and restraint.

South Dakota Advocacy Services (SDAS) is conducting this survey to find out how prevalent the use of seclusion and restraint is in South Dakota schools, and whether there is a need for state laws and rules to regulate the use of seclusion and restraint. We are looking for information from parents/guardians whose child was/is on an Individualized Education Program (IEP), and the child was/is restrained and /or placed in seclusion.

This survey has 10 questions and should take approximately 10-15 minutes to complete.

We thank you for your time in completing this survey. Please contact SDAS if you have any questions at 1-800-658-4782 (toll free in-state) or 605-224-8294

Question Title

* 1. Please list your name and contact information. If you want to remain anonymous, skip to Question 2.

Name

Phone Number

Child's School District

Question Title

* 2. I found out about this survey from ...

South Dakota Advocacy Services

South Dakota Parent Connection

USD-Center for Disabilities

State Division or Agency

A community mental health center

A community support provider

South Dakota United for Hope and Recovery

National Alliance on Mental Illness-South Dakota

A friend or other parent

Other (please specify)

Question Title

* 3. Please fill out the following information regarding the restraint/seclusion incident.

Child's age when incident occurred.

Child's grade when incident occurred.

Year that incident occurred.

Question Title

* 4. What is your child's disability (mark all that apply)

Autism Spectrum Disorders (ASD)

Emotional or Behavior Disorders

Deaf or Deaf-Blind

Developmental Cognitive Disability

Intellectual Disability

Other Health Disability

Physical Disability

Severe Multiple Disability

Specific Learning Disability

Speech/Language

Visual Impairment

Hearing Impairment

Traumatic Brain Injury

Developmental Delay

Other

Please specify

Question Title

* 5. Please mark all that apply to your child:

My child was restrained by adults at school because of his or her behavior.

My child was placed in prone restraint at school because of his or her behavior.

My child was held by straps or other devices at school because of his or her behavior.

My child was placed in a room alone in school because of his or her behavior.

Question Title

* 6. If you child was placed alone in a room (seclusion), please indicate all that apply

	Yes	No
Could your child leave the room if he/she wanted to?	Could your child leave the room if he/she wanted to? Yes	Could your child leave the room if he/she wanted to? No
Was the door locked or held shut?	Was the door locked or held shut? Yes	Was the door locked or held shut? No
Was someone monitoring your child in the room?	Was someone monitoring your child in the room? Yes	Was someone monitoring your child in the room? No
Was the room ventilated, lit, and clean?	Was the room ventilated, lit, and clean? Yes	Was the room ventilated, lit, and clean? No
Was there a way to visually monitor the child?	Was there a way to visually monitor the child? Yes	Was there a way to visually monitor the child? No

Question Title

* 7. If your child was placed alone in a room (seclusion), please indicate about how many minutes.

About 0 - 5 minutes

6 - 10 minutes

11 - 15 minutes

16 - 20 minutes

21 - 25 minutes

26 - 30 minutes

30 - 60 minutes

More than one hour

Question Title

* 8. Has your child been injured at school because of seclusion or restraint?

Yes - because of seclusion

Yes - because of restraint

Yes - because of seclusion and restraint

Please tell us what happened.

Question Title

* 9. How did you find out about the seclusion or restraint incident?

Written notice from the school

My child told me

Phone call from the school

Email from the school

Other (please specify)

Question Title

* 10. Is seclusion and/or restraint written into your child's IEP or some type of behavior plan?

Yes