Something urgent is happening
If someone is in immediate danger, call 911 now — or your local emergency
number. For suicidal statements, call or text 988 in the US.
This page tells you who to contact and what to write down. It deliberately does not tell you
what to do physically, and that is not an omission — see why below. For everyday situations that are not emergencies, see Situations; for what the codes require of you, see Ethics.
A caregiver asks you whether a medication is working or should change
A parent or caregiver asks your opinion about the learner's medication — whether it seems to be helping, whether the dose seems right, whether to skip it on session days, or whether a behavior you see could be a side effect. They ask because you see the learner often and they trust you.
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Nothing you say here should be medical advice. Tell the caregiver that questions about medication are for the prescriber, offer to share your objective session data with the medical team through your supervisor, and never suggest starting, stopping, skipping or changing anything.
Write down
- Record the question the caregiver asked and what you told them.
- Record any behavior change the caregiver attributes to medication, as objective observations only.
- Tell your supervisor the same day so that data can be shared with the medical team if the family wishes.
Advising on medication is outside the scope of a behavior technician and of a behavior analyst. Objective behavior data can be genuinely useful to a prescriber, and sharing them goes through the supervising analyst and the consent process.
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A learner is hurting themselves and there is a risk of injury
- Self-injury
- Medical emergency
During a session a learner begins behaving in a way that is causing, or is likely to cause, physical injury to themselves. You are worried about their safety right now.
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Make sure the person is safe and summon help from someone else on site immediately. Follow your own organization's crisis procedure and this learner's written plan, which are the only instructions that apply to this specific situation.
Write down
- Record what happened, when it started, and when it ended.
- Record exactly when you notified your supervisor and who else was present.
- Complete your organization's incident report before you leave for the day.
- Report any injury to the learner or to yourself the same day, however minor it looks.
What staff may and may not do in this situation is set by your employer's policy, your own certified training, and state law. Those rules differ by state and by setting, and they override any general guidance.
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The learner has a seizure, stops breathing normally, or collapses
During a session the learner has a seizure, has trouble breathing, chokes, faints, has a severe allergic reaction, or shows any other sign of a medical emergency. You may or may not know their medical history.
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Call emergency services, or have someone call while you stay with the learner, and follow the learner's medical or seizure plan if there is one and you have been trained in it. First aid is a certified skill; do what you are trained to do and no more, and let the dispatcher guide you.
Write down
- Record the time the event started and ended, and what you observed.
- Record when emergency services were called and when they arrived.
- Record who was present and who was notified.
- Complete the incident report the same day and tell your supervisor.
Medical response is governed by the learner's medical plan, your first-aid training and certification, and employer policy. A behavior plan never overrides a medical one.
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The learner has hit, bitten or kicked someone and there is an injury
- Aggression causing injury
During a session the learner strikes, bites, kicks or throws something at another person — you, a peer, a family member — and that person is hurt, or you cannot yet tell whether they are. The behavior may or may not be continuing.
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Get help from another adult immediately, attend to the injured person, and call emergency services if the injury could be serious. What staff may do to keep the learner and others safe is set by the learner's plan, your site's crisis procedure and your certified training, and by nothing else.
Write down
- Record what happened immediately before, what the learner did, and what happened immediately after, using objective language.
- Record every injury, to whom, and what care was given.
- Record who you contacted and when.
- Complete the incident report and any injury forms your employer requires before leaving for the day.
Physical management is governed by employer policy, certified training and state law. Any injury to a client or a staff member is reported to your supervisor the same day, however minor, and most employers require a written incident report.
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The learner runs off toward a road, a car park, or water
The learner has left the room, building or yard and is heading toward traffic, a car park, a pool or open water, or anywhere else where they could be seriously hurt. You may or may not be able to see them.
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Keep the learner in sight if you can, and call out for another adult immediately so that someone is with the learner and someone is calling for help. Your site's elopement procedure and the learner's own plan say what you may do next; those, not this app, are the instructions.
Write down
- Record the time you noticed the learner was gone and the time they were safe.
- Record who you contacted, when, and what each person did.
- Record what happened immediately before the learner left.
- Complete your organization's incident report before leaving for the day, and report to your supervisor the same day.
What staff may physically do to stop a person leaving is governed by your employer's policy, your certified training and state law, and it differs between a school, a clinic and a home. Those rules override any general guidance.
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The learner says they want to die or hurt themselves
A learner — of any age — says, writes, signs or otherwise communicates that they want to die, that they wish they were dead, or that they plan to hurt themselves. It may be said calmly or in distress, and it may be the first time or one of many.
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Take it seriously every time. Stay with the learner, listen without arguing or minimizing, and do not leave them alone. In the US, the 988 Suicide and Crisis Lifeline can be called or texted for guidance in the moment, and emergency services if there is immediate danger. Your organization's crisis procedure says who to call and in what order.
Write down
- Record what the learner communicated, in their own words as closely as you can, with the time.
- Record what was happening before, who was present, and how the learner seemed.
- Record who you contacted, when, and what they told you to do.
- Complete your organization's incident or critical-event report the same day.
Assessing risk is outside a technician's scope and outside this app's. The supervising analyst, the family, and where needed a qualified mental-health professional decide what happens next. Your employer's policy governs the steps you take.
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You suspect a learner is being abused or neglected
Something you have seen or heard makes you reasonably suspect that a learner is being physically, sexually or emotionally abused, or neglected — an unexplained injury, a disclosure, a pattern of fear, signs of not being fed or cared for. You are not certain, and you are not sure whether it is your place to say anything.
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If the learner is in immediate danger, call emergency services. Otherwise make the report to the protective-services agency for your state yourself, today, and then tell your supervisor. Do not investigate, confront the suspected person, or promise the learner you will keep it secret.
Mandated reporting
In most US states people who provide services to children or vulnerable adults are mandated reporters. The legal standard is reasonable suspicion, not proof, and the duty is personal: telling your supervisor or employer does not by itself satisfy it, and an employer may not stop you from reporting. Good-faith reports are protected.
Write down
- Write down exactly what you saw or heard, in the learner's words where there were words, with the date and time.
- Record the time you made the report, the agency you reported to, and any reference number you were given.
- Record when you informed your supervisor.
- Keep your notes factual and free of conclusions; describe, do not interpret.
Mandated-reporter duties, deadlines and hotlines are set by state law and differ by state. Your employer's policy will add steps but cannot remove the legal duty.
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Why this app will not tell you what to do physically
Physical management is a certified, hands-on competency — programs such as Safety-Care,
CPI, and PRO-ACT teach it in person and reassess it on a schedule. It cannot be learned
from a screen.
An app also cannot know whether you have been trained, what this person's plan authorizes,
or what your state permits. Restraint and seclusion are governed by state law and, in
schools, by federal guidance; the US Department of Education's position is that they should
never be used except where behavior poses an imminent danger of serious physical harm.
Survey research finds that a substantial share of technicians receive little or no training
for situations like these. That is a reason for employers to fix their training — not a
reason for a reference app to improvise instructions.
If you have not been trained in your employer's crisis procedure, tell your supervisor
before you are alone with someone who has a history of these situations.