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Journal cover: Advances in Mental Health and Intellectual Disabilities

Advances in Mental Health and Intellectual Disabilities

ISSN: 2044-1282
Previously published as: Advances in Mental Health and Learning Disabilities

Online from: 2010

Subject Area: Health and Social Care

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


Document Information:
Title:Use of restraint for the management of challenging behaviour in children with intellectual disabilities
Author(s):Krishna Menon, (Specialist Registrar in Child and Adolescent Psychiatry for South London and Maudsley NHS Foundation Trust, London, UK), Raghavendra Baburaj, (Specialist Registrar in Psychiatry of Learning Disability for Aneurin Bevan Health Board, Pontypool, UK), Sarah Bernard, (Consultant Psychiatrist in the Mental Health of Child and Adolescent Learning Disability Service, South London and Maudsley NHS Foundation Trust, London, UK)
Citation:Krishna Menon, Raghavendra Baburaj, Sarah Bernard, (2012) "Use of restraint for the management of challenging behaviour in children with intellectual disabilities", Advances in Mental Health and Intellectual Disabilities, Vol. 6 Iss: 2, pp.62 - 75
Keywords:Challenging behaviour, Chemical restraint, Children (age groups), Individual behaviour, Intellectual disabilities, Mechanical restraint, Personal restraint, Physical restraint, Restraint, Seclusion
Article type:Literature review
DOI:10.1108/20441281211208428 (Permanent URL)
Publisher:Emerald Group Publishing Limited
Abstract:

Purpose – This review seeks to provide an overview of the current research evidence on the use of restraint as an intervention in managing challenging behaviours in relation to children with intellectual disabilities. It also aims to discuss legal frameworks and ethical considerations that underpin the use of restraint in intellectually disabled children who present with challenging behaviours.

Design/methodology/approach – The authors conducted a search of existing literature primarily pertaining to the management of challenging behaviours in intellectual disability on PubMed, PsycInfo and Google Scholar using combinations of the following key words – children, intellectual disabilities, learning disability, mental retardation, challenging behaviour, restraint, seclusion, physical restraint, mechanical restraint, personal restraint, and chemical restraint. Since research on the use of such interventions in children has been hitherto scant, literature relating to their use in intellectually disabled adult populations as well as cognitively able children was also examined to ascertain whether the broad principles informing the use of restraint interventions could be generalised to their use in intellectually disabled children.

Findings – The review finds evidence to suggest that restraint interventions in their myriad forms are widely used to manage challenging behaviours in children with intellectual disabilities and outlines the evidence base, clinical scope, and the risks associated with the use of such interventions in children. It also helps highlight the current absence of comprehensive evidence based guidance that incorporates clinical, ethical, and legal aspects of the use of restraint interventions in children with intellectual disabilities and raises relevant questions in relation to their judicious use in this patient group.

Originality/value – The authors believe that the review completes the first in depth evaluation of the use of restraint interventions in children with intellectual disabilities and are confident that this would serve as useful guidance for professionals working with this patient group who may be considering using restraint interventions in their everyday clinical practice.



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