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| Decreasing the Intrusiveness of Protective Physical Holds and Confinement Time-Out |
| Saturday, May 26, 2007 |
| 2:30 PM–3:50 PM |
| Ford AB |
| Area: DDA; Domain: Applied Research |
| Chair: Allen J. Karsina (New England Center for Children) |
| CE Instructor: Allen J. Karsina, M.S. |
| Abstract: Physically holding an individual and using confinement timeout are common procedures used with individuals who exhibit severe aggression and self injury to ensure that they do not hurt themselves or others. It is incumbent upon clinicians to make sure the intrusiveness of these procedures is minimized without compromizing safety. The presentations in this symposium involve emprical evaluations of decreasing the intrusiveness of protective procedures while taking into account the behavioral effects of these procedures. |
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| Reducing the Duration of Protective Hold Procedures. |
| NANCY A. PERHOT (New England Center for Children), Paula Ribeiro Braga-Kenyon (New England Center for Children), Jason C. Bourret (New England Center for Children), Allen J. Karsina (New England Center for Children) |
| Abstract: The effects of reducing the intrusiveness of a physical restraint procedure with a 10 year-old participant diagnosed with autism were examined. A functional analysis of the participant’s aggressions indicated that escape from demands maintained the participant’s aggressions. An extinction treatment package was implemented for the aggression; physical restraints were used to safely manage dangerous aggressions. Physical restraints were initially implemented for 5 minutes duration, then systematically reduced to 3 minutes in duration, and finally 2 minutes. The frequency of holds did not increase, nor did the frequency of aggressions. |
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| The Effects of Decreasing the Intrusiveness of Physical Interventions on the Rate of Intervention. |
| SHAWN E. KENYON (New England Center for Children), Paula Ribeiro Braga-Kenyon (New England Center for Children), Allen J. Karsina (New England Center for Children) |
| Abstract: The effects of reducing the intrusiveness of a physical restraint procedure with a 14 year-old participant with developmental disabilities were examined. A functional analysis of the participant’s self-injury indicated that the behavior was maintained by non-social variables. A multi-element treatment package was implemented for the self-injury; physical restraints were used to safely manage dangerous self-injury. Physical restraints were done on the floor and required multiple trained personnel to implement safely, and lasted between 2 to 4 minutes each. The intrusiveness of the restraint procedure was reduced by replacing the procedure with a sitting or standing hands-held procedure implemented by one person holding the hands and a second person protecting against bite attempts. The duration of the hands held procedure was 15 seconds. Frequency of holds decreased significantly immediately, and frequency of self-injury did not increase. |
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| Reducing Intrusiveness of Time-Out Procedures Used to Manage Dangerous Behavior. |
| MAGDA M. STROPNIK (New England Center for Children), Paula Ribeiro Braga-Kenyon (New England Center for Children), Jason C. Bourret (New England Center for Children), Jody M. Steinhilber (New England Center for Children), Allen J. Karsina (New England Center for Children) |
| Abstract: The effects of reducing the intrusiveness of a confinement time-out procedure with a 15 year-old participant diagnosed with autism were examined. A functional analysis of the participant’s aggressions yielded undifferentiated results, and confinement time-out was used to safely manage dangerous behavior while a multi-component treatment package was implemented. A ‘break’ area, similar in size to the confinement time-out room but without a door, was used in place of a confinement time-out sequentially across two settings. Frequency of aggression did not increase with implementation of the break area, and use of the confinement time-out room was decreased. |
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| Reducing the Frequency of Physically Guiding a Client to a Time-Out Room. |
| SARAH BUCKINGHAM (New England Center for Children), Britta Wehmann-Bell (New England Center for Children), Kimberly Keogh (New England Center for Children), Jason C. Bourret (New England Center for Children) |
| Abstract: The effects of reducing the frequency of physically guiding a 14 year old participant with developmental disabilities to a timeout room were examined. For this participant, physical restraint was often required to ensure his and staff safety during movement to timeout. Descriptive analysis data suggested that escape from demands and denied access to tangibles were related to the participant’s aggression and environmental destruction. A systematic treatment package was successful in increasing independent walking to timeout thus producing a decrease in manual guidance and physical restraint. |
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