Therapeutic Restraint and Protective Holding

Social Validity Assessment of Physical Restraint Intervention by Care Providers of Adults with Intellectual and Developmental Disabilities

“…In this case, PR is reserved for select target behaviors within contextually specific conditions. Contemporary standards demand that emergency and planned PR require specialized training of care providers, routine supervision, outcome evaluation, and monitoring of procedural integrity (Luiselli 2011;Reed et al 2013b).…”

Parent-Guardian Evaluation of Physical Restraint Among Adults with Intellectual Disability: a Social Validity Assessment

“…The habilitation services program had comprehensive policies and procedures for implementing PR that were derived from evidencebased practices (Luiselli 2011;Reed et al 2013). All care-providers completed pre-service training in physical intervention, applying approved methods of PR, crisis management, and de-escalation strategies.…”

“…Implementation of PR should only be considered if (a) less restrictive procedures have been ineffective, (b) there is clinical justification for its use, (c) the emphasis of intervention is on positive behavior support, (d) careproviders receive comprehensive training, (e) treatment effects are continuously evaluated, and (f) PR reduction and elimination are therapeutic objectives (Lennox et al 2011;Reed et al 2013;Sturmey 2009) Notably, PR is not easy to implement, can cause injury, and even death (Chan et al 2012;Spreat et al 1986;Tilli and Spreat 2009), and may function as positive reinforcement (Favell et al 1978;Magee and Ellis 1988). However, as articulated by Chan and colleagues (Chan et al 2012(Chan et al , 2014Rickard et al 2013), perhaps the most critical concerns about PR are the vulnerability of people with ID to restrictive procedures, their freedom from potentially abusive treatment, and the protection of fundamental human rights as declared in the United Nations Convention on the Rights of Persons with Disabilities (CRPD) (United Nations 2006).…”

Effects of Fixed-Time Release Fading on Frequency and Duration of Aggression-Contingent Physical Restraint (Protective Holding) in a Child With Autism

“…Physical restraint is sometimes required with children and adults who have developmental disabilities; display challenging behaviors such as aggression, self-injury, and property destruction; and are unresponsive to less restrictive intervention procedures (Harris, 1996; Luiselli, 2011; Reed, Luiselli, Miller, & Kaplan, 2013). Concerning the acceptable use of physical restraint, virtually all regulatory agencies and professional organizations specify that it be reserved solely for behaviors that are harmful to self, others, and the environment (American Psychological Association, 1994; Association of Professional Behavior Analysts, 2010; Ryan, Robbins, Peterson, & Rozalski, 2009).…”

“…Our therapeutic objectives were to reduce physical restraint applications to the lowest duration possible while monitoring collateral changes in restraint frequency. Hence, we report another potentially effective strategy for reducing and eliminating physical restraint of people who have developmental disabilities and require intensive interventions for treating high-risk challenging behaviors (Luiselli, 2011; Reed, Luiselli, Miller, & Kaplan, 2013).…”