Physical Interventions for Adults with Intellectual Disabilities: Survey of Use, Policy, Training and Monitoring

Abstract

Background Perceived problems around the use of physical intervention (PI) to manage challenging behaviour have led to UK initiatives to encourage policy development and accredited training. However, information on PI use and the impact of these initiatives remains limited. Method Adult residential services within an English region were sent a questionnaire regarding PI use, policy, staff training and monitoring ⁄ management. Results Physical intervention use was reported by 47% of the services. Of services using PI, 65% reported having a policy governing its use and 79% reported providing staff training. Where restrictive PI was used, comparable figures were 82% for policy and 84% for training. PI use was reported to be monitored in some way by 94% of services. Opinions offered supported the reduction of PI use. Conclusions Physical intervention use is widespread. National guidance on policy and training is widely followed though unimplemented by a minority. The time may be right to more explicitly aim for a reduction in PI use within services.

Frequency of Use and Characteristics of People with Intellectual Disabilities Subject to Physical Interventions

“…Current guidance, for example, acknowledges that 'there are occasions when the use of force is appropriate' (Department for Education and Skills ⁄ Department of Health, 2002, p. 4). The same guidance, however, has recommended that PIs only be used as 'exceptional methods of management' (p. 16) in situations where it is necessary to ensure the safety of either the service user or others, that is, PI should only be used as a last resort (Lyon & Pimor 2004;Deveau & McGill 2009). The extent of use described in the current study is inconsistent with such a position.…”

Can sensory integration have a role in multi‐element behavioural intervention? An evaluation of factors associated with the management of challenging behaviour in community adult learning disability services

“…Lundstrom et al () assert the use of restraint is still an issue in practice. This would indicate there is a disparity between policy and practice in the management of CB (Deveau & Mc Gill, ; Feldman, Atkinson, Foti‐Gervais, & Condillac, ; Rickard, Chan, & Merriman, ). As discussed by Webber, Richardson, Lambrick, and Fester (), restrictive intervention ought to be a least restrictive approach and should only be used as a last resort following preventative proactive strategies (Deveau & Mc Donnell, ).…”

Reducing challenging behaviour of adults with intellectual disabilities in supported accommodation: A cluster randomized controlled trial of setting-wide positive behaviour support

“…Department of Health, 2007). Almost half of residential services use restrictive responses such as physical intervention (Deveau & McGill, 2009). Challenging behaviour is associated with placement breakdown (Phillips & Rose, 2010) removal of individuals to more restrictive, out-of-area settings (Goodman, Nix, & Ritchie, 2006).…”