Evaluation of Restraint-Elimination Interventions for Students with Multiple Disabilities in a Pediatric Nursing Care Setting

Abstract

Mechanical restraint devices are sometimes used to prevent challenging behavior displayed by persons with disabilities. However, regulatory guidelines seek to prohibit or restrict the use of restraint in many residential programs. This research evaluated the implementation of restraint-elimination interventions with two students in a pediatric nursing care setting. Assessment and treatment procedures were developed and coordinated through a multidisciplinary, consultative team approach. Mechanical restraints were eliminated successfully with both students following application of individually designed treatment plans. Issues related to restraint-elimination programming and behavioral intervention within pediatric nursing care facilities are discussed.

Get full access to this article

View all access options for this article.

References

Ammerman, R. T. , Hersen, M. , Van Hasselt, V. B. , Forster, J. , & Simon, J. (1989). Behavioral and psychiatric consultation services for children with visual impairments and multiple disabilities in an educational setting: A program description. Journal of the Multihandicapped Person, 2, 225-240.

Favell, J. E. , McGimsey, J. F. , & Schell, R. M. (1982). Treatment of self-injury by providing alternative sensory activities. Analysis and Intervention in Developmental Disabilities, 2, 83-104.

Fuoco, F. J. , & Christian, W. P. (Eds.). (1986). Behavior analysis and therapy in residential program. New York: Van Nostrand Reinhold.

Green, C. W. , Reid, D. H. , White, L. K. , Halford, R. C. , Brittain, D. P. , & Gardner, S. M. (1988). Identifying reinforcers for persons with profound handicaps: Staff opinion versus systematic assessment of preferences. Journal of Applied Behavior Analysis, 21, 31-43.

Griffin, J. C. , Ricketts, R. W. , & Williams, D. E. (1986). Reaction to Richmond et al: Propriety of mechanical restraint and protective devices as tertiary techniques. In K. D. Gadow (Ed.), Advances in learning and behavioral disabilities (Vol. 5, pp. 109-116). Greenwich, CT: JAI.

Luiselli, J. K. (199la). Functional assessment and treatment of self-injury in a pediatric, nursing care resident. Behavioral Residential Treatment, 6, 311-319.

Luiselli, J. K. (1991b). Protective equipment. In J. K. Luiselli , J. L. Matson , & N. N. Singh (Eds.), Self-injurious behavior: Analysis, assessment, and treatment (pp. 235-268). New York: Springer-Verlag.

Pace, G. M. , Iwata, B. A. , Edwards, G. L. , & McCosh, K. C. (1986). Stimulus fading and transfer in treatment of self-restraint and self-injurious behavior. Journal of Applied Behavior Analysis, 19, 381-389.

Rincover, A. (1978). Sensory extinction: A procedure for eliminating self-stimulatory behavior in developmentally disabled children. Journal ofAbnormal Child Psychology, 6, 299-310.

10.

Rincover, A. , & Devany, J. (1982). The application of sensory extinction to self-injury. Analysis and Intervention in Developmental Disabilities, 2, 67-82.

11.

Sugai, D. , & Luiselli, J. K. (1989). Behavioral medicine consultation. In J. K. Luiselli (Ed.), Behavioral medicine and developmental disabilities (pp. 199-225). New York: Springer-Verlag.