CONFIDENTIAL

Safety Plan
Name:	School:
DOB:	Age:
Student #	Grade:
Ministry Designation:	School Year:

Date of Safety Plan:
Updated:

Placement:
Classroom Teacher:
Case Manager:

Objective: To ensure that staff working with Kid are aware of responses and safety procedures in place to maintain a safe, productive learning environment for Kid, other students and staff.

It is important that school support works towards a goal of Kid being able to adapt and adjust his behaviours across environments and contexts in order to meet social and community expectations for behaviours that are desirable, socially acceptable and which support learning.

Rationale: During phases of high-arousal in the context of Sensory Processing Disorder Kid may display the following behaviours; tantrums, cry, yell, kick, hit, charge at someone, try to bite, throw things, knock items off tables and shelves, tear up workbooks and worksheets, and become argumentative, non-compliant and/or defiant. These actions are often directed towards other children and supervising adults.

Based on Safety Plan and Template developed by Chris Castellarin, VSB administrator.

Key Understanding (Strengths) About This Student
(Provide a brief profile of this student)

intelligent, capable of verbal, written output
loves books and is a high level reader
displays good coordination, balance and strength
enjoys creative and imaginative play
likes to draw pictures
likes tactile objects
likes to be helpful when he is not experiencing stressful situations
at times he likes to be busy
responds well to deep pressure, and will at times lean on people
likes music
works well with routines, although will require time to adjust and accept routines

Key Understanding (Needs) For This Student
struggles with play integration, he wants to participate in games and activities but has difficulty with competitive situations
can easily become reliant on supervising adult for attention and regulation
at this point in time has great difficulty in regulating his behaviours/actions
requires consistent classroom routines and highly structured classroom
frequent specialized supports and staff support and redirection required
interventions to distract and interrupt
requires individualized programming, with explicit, direct instruction

Ministry Designation in Relation to Need for a Safety Plan
Kid has a Ministry designation of “D” for Sensory Processing Disorder. The over- stimulation that Kid can at times experience in his home and/or school environment on a daily basis results in behaviours that exhibit physical aggressiveness, non-compliance, defiance, bolting from the safety of the classroom and on a few separate occasions from the safety of the school grounds. This behaviour has at times put the safety of himself, his peers, support staff, and teachers at risk.

History/Diagnosis that Support the Designation and Need of a Safety Plan

See supporting documentation of Kid’s history and diagnosis included in the student’s file in the office and refer to the list below for quick reference.

Assessments: (available for review in student file)

Behaviour Observation Assessment Teaching Strategies  	
EdPsych Assessment  	
Functional Behaviour  	
Violent Incident Report(s)  	
Sensory Profile  	
OT Report(s)  	
SBT Notes	
Other  	

Problem Behaviour
(What specifically is the student doing?)

reacts physically (hits, scratches, kicks and pushes other children) when upset
has difficulty asking for help when he feels like striking out
will bolt from the classroom/workroom and run into playground or hallways
slams doors and appears to want support worker to chase him around the school and down hallways
will throw items and/or knock items off tables, desks and shelves (i.e. pencils, books, papers, containers), damages property
potential to place self and others at risk
ongoing anxiety/sensory overload and becomes at times easily overwhelmed by everyday life demands
has run out of school bounds and into neighbourhood house yards
will become argumentative and defiant towards the support worker and teacher(s)
has difficulty at times with sharing and taking turns
frequent difficulties with transitions
displays a restricted range of interests/activities which intrude on classroom functioning

Triggers/Stressors/Predictors
(What are the antecedents to the behaviour?)

change in routines, unexpected transitions
change in new/unfamiliar adults such as an EOC
large event that has occurred at home (weekend event or evening)
sleepy/tired, hungry, upset prior to school starting
fear that his work is not good enough
over-stimulation with too much noise, physically jostled, transitions
inflexibility - not wanting to stop/continue an activity
sitting/working for extended periods of time on one or multiple tasks, and/or having to listen to instruction or dialogue for too long without movement
uncertainty with other students (nervous to at first enter classroom settings)
proximity to other students if he thinks they are too close to him
peer-social interactions

Physical/Verbal Warning Signs
(Is there a chain of escalation?)

Voice level gets louder, increasing defiance/non-compliance with routines/ expectations, becomes visibly upset
Movement increases
Bolts from the classroom/workroom
Eyes wander from lesson/task, fidgets

What Need Is The Behaviour Meeting?
(control, attention, power, avoidance)
-	all of the above apply in conjunction with Kid’s diagnosis of Sensory Processing Disorder and/or depending on the individual situation/event of the occurrence(s)

Alternate Behaviour
(Is there another “acceptable” way for the child to meet this need?)
by offering Kid an opportunity to develop his own daily schedule with pre- planned “breaks” for sensory destimulation, preparation for transitions, “choices” for completed tasks using a tracking reward system such as a Star Chart and for opportunity to express his feelings through the Alert Program chart he is able to gain some control and power over his daily routines
modification to the expectations for Kid to complete certain tasks and within certain time constraints can be adjusted to accommodate behaviours of avoidance and allowing for Kid to complete a task using an alternative multimodal process (multiple intelligence) may also be of benefit

School Support Team consisting of the Principal, Vice Principal/Case Manager, Classroom Teacher , Student Support Workers , District Behavioural/Inclusion Consultant , Occupational Therapist(s) , Parent



Support Services in Place
SSA support Full Time (100%) -



ACTION PLAN

Behaviour Goals:
teach/model for Kid social/emotional communication skills
provide him with self-regulation tools/skills
teach Kid to express his feelings, and to learn when and how to ask for help
integrate Kid into games, and activities with other students
have Kid learn to follow routines in the class, and rules of games
teach/model the Code of Conduct demonstrating a respectful, Polite, Accountable, Welcoming and Safe (P.A.W.S.) mannerism during his daily school routines

Role Modeling:
Redirection

Positive Reinforcement Key routines

Plan:
Staff working with Kid will read and sign this safety plan.

Setting Events:

Setting Events

Problem behaviours are more likely to occur in the presence of certain/specific setting events.

Strategy

sleepy/tired, hungry, upset prior to school starting

Check in with Kid. Ask him how he feels. Encourage him to use the Alert Program coloured wheel to indicate his level of arousal on the gray, green, red zone.

transitions and change of routine/ Talk and build with him the plan for the day. This may

program

need to be broken into smaller sections such as morning to recess, recess to lunch ad afternoon. This can also be broken into smaller portions such as First and Next. Review visual schedule as the day progresses.

transitions and change of routine/ Establish key routines for transitions. When covering

program

noisy environment in hallways/ class

noisy environment in hallways/ class

proximity to other students if he thinks they are too close to him

coffee and lunch breaks have the transition occur in the middle of an activity as opposed to during a transition in activity.

Forewarn Kid of any loud noises before they occur for example bells, alarms, (fire drills), noisy musical performances, games that will allow for acceptable increased noise levels, etc.

Offer a quiet space when the environment noises overwhelm. Such as the “Chill Out Zone” tent located in the classroom or a separate resource room, The Den room, or a space outside such as the courtyard, playground or garden area. Offer an alternative to Gym activities when needed.

If Kid is exhibiting stress from noise, proximity to other students or tactile defensiveness allow him to stand at the end of the line, or come in before or after the class has reached its destination (i.e. classroom, library, computer lab). Arrange the classroom seating plan to minimize the risk of him being jostled or bumped by classmates and have his desk positioned near the doorway of the classroom to allow him easy access and departure from the room.

Antecedents:
Be aware of situations and events that are immediate triggers for the escalation of behaviour.

Antecedent

Strategy

Unstructured times

Inflexibility - not wanting to stop/continue an activity

Negative feelings being voiced

Fear that his work is not good enough

Sitting/working for extended periods of time on one or multiple tasks

Uncertainty with other students Peer-social interactions

Structured recess/lunch breaks with a friend and adult. Allow for lunch to be eaten outside of the noisy lunch room and in a quieter place such as the classroom/ resource room

Make use of visual supports, and a Time Timer clock/ timer. Make use of “First - Next (Then)”, visual schedule and countdown strip.

Verbal Praise and reinforcement: give Kid positive feedback when he is calm and/or working well in class or workroom. Compliment him on his progress while he is working and make use of a Star Chart visual reward record.
Positive self-talk: remind Kid to keep his self-talk positive. Give him examples of turning negative self- talk into positive self-talk if possible. Remind him that trying his best is what is important.

Offer motivating incentives: such as compliments “good job”, “give me a high five” and offer choice activities after success work tasks/sessions. “Choice cards should be used in a limited manner (once per day) and then placed into an envelope to indicate that the choice is not an option a second time. For example, choices may consist of time on the computer, playing with a toy, making an item out of plastercine, playing an activity outside of the classroom with a friend and an adult. Incorporate a classmate into Kid’s “choice” activities to develop peer relationships and familiarity

Sitting too long in one place with Active learning/instruction, using different modalities

no movement and listening for too long

Transitions from one place to another where a break is needed Transitions – changing tasks/

for his learning (make use of multiple intelligences). Kid enjoys listening to stories, watching videos, listening to music, drawing and participating in creative play. Incorporate these whenever possible.

Schedule breaks as part of the daily routine as well as when needed. Ensure that a “break” is separate from a “choice” activity. The support worker should remove

activities where a break is needed Kid from the classroom for a short period of energizing
or calming activities depending on what is needed. These could consist of using the small trampoline

Crisis Response Plan (staff responses to student’s behaviour)

Precursor Behaviours (What you see)

Designated staff (First team: Second team: Other support members will implement the following crisis management plan when necessary.

Staff Responses (What you do)

Anxiety - Noticeable increase or Be supportive (empathetic, non-judgmental responses) change in:

Voice level gets louder, increasing defiance/non- compliance with routines/ expectations

and/or

Movement increases

Eyes wander from lesson/task

Offer a “break” outside of the classroom/workroom. Ensure that a “break” is separate from a “choice” activity. The support worker should remove Kid from the classroom for a short period of energizing or calming activities depending on what is needed. These could consist of using the Rebounder, doing some heavy lifting, stretching a Thera-Band, using the weighted turtle, vest, etc, applying deep pressure to the shoulders, or a body hug, getting a drink from the water fountain, using the washroom, relaxing in the hallway, going for a walk outside in the garden area, or doing some running outside.

Provide the Kid with the opportunity to work standing at his desk, or make use of a sensory cushion (wedge cushion) or allow him to work on the floor in a prone- on-elbows position (on stomach). Provide the use of fidgets and/or a Thera-Band wrapped around the chair legs to provide sensory input to assist Kid in remaining seated longer.

Make use of visual supports, and a Time Timer clock/ timer. Make use of “First - Next (Then)”, visual schedule and countdown strip. Make use of Star Chart rewards. Use Alert Program visual. Acknowledge his feelings and behaviour. Use humour. Distract/re-direct to task or move to a new task/activity offer choices, or break. *Note “Breaks” and “Choices” should be separate and not the same activities.

Verbal Praise and reinforcement: give Kid positive feedback when he is calm and/or working well in class or workroom. Compliment him on his progress while he is working and make use of a Star Chart visual reward record.
Positive self-talk: remind Kid to keep his self-talk positive. Give him examples of turning negative self- talk into positive self-talk if possible. Remind him that trying his best is what is important.

Defensive (cues that this students is beginning to lose the ability to think or process information)
Anxiety – Noticeable increase or change in (what you see – precursor)
Increased physical
movement
Louder voice
Defiance, non- compliance	Be Directive
Redirect
Set simple, clear enforceable limits
Reduce language – 2 or 3 word directives
Offer choices or breaks
Disengage – calm, neutral voice, no eye contact
Approach slowly from the side, not from behind or in a rushing manner from the front
Use protocol in place for assistance
Remove Kid to a quiet space	
Acting Out (risk to self or others)	Crisis Intervention Plan * (injury prevention)

Make use of Code Purple Protocol if needed by removing all peers from the classroom/workroom for their safety. Send a student to the office to report on situation. Use the walkie-talkies to obtain support of team member(s).
Keep a safe distance.
Clear the area (rather than remove the child) make the area safe
Assign one adult to direct the actions of intervening adults
Physical restraint strategies as a last resort when there is a clear and immediate danger to self/others. Never restrain a child to the floor. Best practice is to restrain the child by both wrists. Follow CPI (Crisis Prevention Institute)
protocol.	
Tension Reduction (cues that
this student is calm)	Therapeutic Rapport (re-establish rapport – do not
recriminate)	

Post Incident Debriefing (ensure all involved employees are included)

SSA(s), Classroom Teacher(s), Case Manager, Administrator

Other means to minimize risk to staff (i.e. clothing, earrings, etc…)

Do not try to carry or move Kid – risk of physical injury to adult and escalation of behaviour.

Do not restrain in the form of pinning a child (Kid) to the ground, use calm voice, keep a safe distance if he is kicking and if needed restrain by holding him by the wrists.

Criteria for Calling Home

If Kid hits, kicks, scratches, and/or tries to bite anyone deliberately If he is sick or overly tired
If he demonstrates very unsafe behaviour such as running off the school grounds, and/or putting himself or others deliberately in danger
If he continues to not respond to strategies – non compliance, defiance







Parents will be contacted by a school administrator (or designate) – such as classroom teacher and/or case manager in the following cases:

Reintegration Plan (if required - following a suspension)

Conduct a follow up meeting with parent and/or staff if required

Gradual entry - shorter times at school - i.e. morning until recess, build up to lunch and increase to full day once Kid demonstrates acceptable success with his daily school routines.

It may be worthwhile to reassess the use of gradual entry during extended times away from school such as the start of the school year in September, return from Winter holidays in January and return from the Spring Break.

This plan will be reviewed

Regularly by the Administrator, or designate, the classroom teacher(s) and support worker(s), and any district staff working with Kid such as Occupational Therapist(s), Area Counselor or home support workers
If any change in behaviour occurs such that the risk of violence is different
and/or incidence of violence occurs
It is required by the employer that staff complete a Violent Incident Report when an incident results in injury to a staff member (classroom teacher, resource teacher, support worker, supervision aid or other staff member). Violent Incidence Reports need to be reviewed by the administrator, and

staff representative and will be faxed to the office of the Health and Safety Staff Support at 604-713-

Review Date: should be on a weekly and/or as required need

Evaluation:

To be completed year-end or as required.

A safety plan meeting will be convened
The Principal, Vice Principal and/or Case Manager and/or designate will call a Safety Plan review meeting if new information indicates that the Safety Plan needs to be reviewed and/or modified.

I have read the Safety Plan as it applies to Kid and I am aware of safety procedures and protocols to be followed when working and interacting with Kid.

Name:	Signature:	Position/Title:	Date:

Once approved, this document cannot be altered from its original form without the expressed consent of the Administrator and/or Case Manager. Additions, modifications, deletions and changes will be discussed at a Safety Plan meeting and included with the document. A change in staffing will require updates and new signatures to this document.

Based on Safety Plan and Template developed by Chris Castellarin, VSB administrator.