The effectiveness of contingent restraint on aggression, self‐injury, and property destruction of institutionalized mentally retarded persons

Abstract

This study was a retrospective evaluation of in place treatment procedures. Clinical data were reviewed from 45 cases in which contingent restraint was employed in an effort to modify the inappropriate behaviors of institutionalized mentally retarded persons. Statistically significant decrements in the rates of inappropriate behavior were detected over the 18 months of study. Clinically meaningful improvement in the rates of behavior were detected in 53% of the cases in which the target behavior was either aggression, selfinjury, or property destruction. The inclusion of less serious behaviors in the study did not substantially increase this rate. Effectiveness appeared to be more pronounced for males, younger persons, persons with short institutional tenures, and persons who were free from psychotropic medication during the course of treatment.Clinicians and administrators generally express the view that it is preferable to use reinforcement strategies to develop more appropriate alternates to the maladaptive behaviors. Unfortunately, such attempts alone are sometimes insufficient, and in lieu of allowing a person to continue injuring him/herself, clinicians often resort to the use of more aversive techniques to alter the rate of the behavior. Ideally, such aversive strategies are used to suppress the unacceptable behavior while more appropriate behaviors *Woodhaven Program is operated and funded under a contract between

Restraint Safety: an Analysis of Injuries Related to Restraint of People with Intellectual Disabilities

“…Restraint has been employed for many years in a variety of hospital and residential facilities as an intervention for people with mental disorders and intellectual disabilities to stop violent episodes or physical aggression toward self or others (Spreat & Stepansky 1986; Fisher 1994; Harris 1996). In facilities serving persons with intellectual disabilities, restraint has been used not just as an emergency or crisis‐intervention procedure to prevent injuries to self or others but has also been used as a component of behaviour intervention plans with many studies documenting its effectiveness along with other interventions in reducing target behaviours (Luiselli 1992; Van Houten et al.…”

Use of restraint for the management of challenging behaviour in children with intellectual disabilities

“…The commonest form of direct mechanical restraint in use is the restraining chair and/or belts for those who are mobile (Harris, 1996). Restraint can either last for a few minutes for the purpose of any haematological/physical investigations, or for longer, either in hospital or residential settings to prevent physical harm towards self or others (Spreat and Stepansky, 1986;Fisher et al, 1997;Emerson, 2002). In a series of studies conducted between 1994 and 2000, Emerson (2002) showed that 5 percent of children with intellectual disabilities who self injured were ''usually'' or ''sometimes'' managed by physical restraint.…”