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    HWDSBCommons
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    CARING AND SAFE SCHOOLS - MODULE 4 At times a student’s behaviour may pose a direct risk to self or to others. In these circumstances, staff intervention may need to take the form of physical intervention to respond to the behaviour of the disruptive student so that all students can benefit from their education. It should be noted that very few students will require this form of intervention.

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    CARING AND SAFE SCHOOLS - MODULE 4 At times a student’s behaviour may pose a direct risk to self or to others. In these circumstances, staff intervention may need to take the form of physical intervention to respond to the behaviour of the disruptive student so that all students can benefit from their education. It should be noted that very few students will require this form of intervention.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    868 views2 pages

    Safe Intervention Plan

    Uploaded by

    HWDSBCommons
    CARING AND SAFE SCHOOLS - MODULE 4 At times a student’s behaviour may pose a direct risk to self or to others. In these circumstances, staff intervention may need to take the form of physical intervention to respond to the behaviour of the disruptive student so that all students can benefit from their education. It should be noted that very few students will require this form of intervention.

    Copyright:

    Attribution Non-Commercial (BY-NC)
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    of 2

    SAFEINTERVENTIONPLAN

    StudentsName

    DateofBirth

    School
    Grade
    (year/month/day)

    Gender

    Male

    IEP

    Female

    ParentResponsetotheSafeInterventionPlan
    NameofStaffMember
    Assistinginthecreationofthe
    SafeInterventionPlan

    Position

    1.

    2.
    3.
    4.
    5.

    _________________________________________________________________________________
    _________________________________________________________________________________
    _________________________________________________________________________________
    _________________________________________________________________________________
    _________________________________________________________________________________

    ParentsSignature

    Date

    Date

    PrincipalsSignature

    ThisPlanmustbereviewedyearlyand/orascircumstanceschange.TheSafeInterventionPlan
    shouldbereviewedinconjunctionwithotherrelateddocuments(e.g.,IndividualEducationPlan
    IEP,BehaviourSupportPlanBSP).AcopyoftheSIPshouldbeplacedintheDocumentationFileof
    theStudentsOntarioSchoolRecord.TheinformationcontainedintheSIPshouldbemade
    availabletoallappropriatestaff.

    SAFEINTERVENTIONPLAN
    (page2)

    CRISISDEVELOPMENT

    STAFFRESPONSE

    STAGE1:

    Anxiety

    Supportive

    STAGE2:

    Defensive

    Directive

    STAGE3:

    ActingOut

    NonviolentPhysical
    CrisisIntervention

    STAGE4:

    TensionReduction

    TherapeuticRapport

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