Effects of Behavior-Contingent and Fixed-Time Release Contingencies on Frequency and Duration of Therapeutic Restraint

Abstract

Reducing therapeutic restraint is a desirable outcome for programs that serve individuals who exhibit challenging behaviors. This study investigated the effects of modifying the criterion for release from therapeutic restraint on frequency and duration.Release from restraint was changed from a behavior-contingent criterion (restraint terminated when a specified duration of calm behavior was demonstrated) to a fixed-time criterion (restraint terminated when a predetermined duration elapsed independent of behavior) with one child and two adolescents with acquired brain injury and difficult-to-manage behaviors. For all three students, the duration of time they were exposed to therapeuticrestraint decreased with the fixed-time release criterion,whereas the frequency of restraint did not change. Practical implications of these results and future research opportunities are discussed.

Keywords

therapeutic restraint acquired brain injury contingent release

Get full access to this article

View all access options for this article.

References

Bean, A. W. , & Roberts, M. W. (1981). The effect of time-out release contingencies on changes in child noncompliance. Journal of Abnormal Child Psychology, 9, 95-105.

Donat, D. C. (1998). Impact of a mandatory behavioral consultation on seclusion/restraint utilization in a psychiatric hospital. Journal of Behavior Therapy & Experimental Psychiatry, 29, 13-19.

Favell, J. E. , McGimsey, J. F. , & Jones, M. L. (1978). The use of physical restraint in the treatment of self-injury and as positive reinforcement. Journal of Applied Behavior Analysis, 11, 225-241.

Favell, J. E. , McGimsey, J. F. , Jones, M. L. , & Cannon, P. R. (1981). Physical restraint as positive reinforcement. American Journal of Mental Deficiency, 85, 425-432.

Harris, J. (1996). Physical restraint procedures for managing challenging behaviors presented by mentallyretardedadultsandchildren. Research in DevelopmentalDisabilities, 17, 99-134.

Hill, J. , & Spreat, S. (1987). Staff injury rates associated with the implementation of contingent restraint. Mental Retardation, 25, 141-145.

Luiselli, J. K. , Treml, T. , Kane, A. , & Young, N. (2000). Behavioral intervention to reduce physical restraint of adolescents with developmental disabilities. Behavioral Interventions, 15, 317-330.

MacDonough, T. S. , & Forehand, R. (1973). Response-contingent time out: Important parameters in behavior modification with children. Journal of Behavior Therapy and Experimental Psychiatry, 4, 231-236.

Mace, F. C. , Page, T. J. , Ivancic, M. T. , & O'Brien, S. (1986). Effectiveness of brief time-out with and without contingent delay: A comparative analysis. Journal of Applied Behavior Analysis, 19, 79-86.

10.

Magee,S. K. , & Ellis, J. (2001). The detrimentaleffects of physical restraint as a consequencefor inappropriate classroom behavior. Journal of Applied Behavior Analysis, 34, 501-504.

11.

Matson, J. L. , & Keyes, J. (1988). Contingent reinforcement and contingent restraint to treat severe aggression and self-injury in mentally retarded and autistic adults. Journal of the Multihandicapped Person, 1, 141-153.

12.

Rapoff, M. A. , Altman, K. , & Christopherson, E. R. (1980). Elimination of a blind child's self-hitting by response contingent brief restraint. Education and Treatment of Children, 3, 231-236.

13.

Rolider, A. , Williams, L. , Cummings, A. , & Van Houten, R. (1991). The use of a brief movement restriction procedure to eliminate severe inappropriate behavior. Journal of Behavior Therapy & Experimental Psychiatry, 22, 23-30.

14.

Singh, N. N. , Singh, S. D. , Davis, C. M. , Latham, L. L. , & Ayers, J. G. (1999). Reconsidering the use of seclusion and restraints in inpatient child and adult psychiatry. Journal of Child and Family Studies, 8, 243-253.