An Analysis of the Distribution and Social Antecedents of Restrictive Behavioural Practices in a Community Day Service for Adults with Intellectual Disabilities

Background Community service providers strive to reduce the use of restrictive behavioural procedures, but little is known about their use in community services. Therefore, this study analysed the distribution among service users and antecedents to the use of restrictive procedures. Materials The authors analysed records of the use of restrictive behavioural procedures for 81 adults with intellectual disabilities, behavioural and mental health challenges who attended a community day programme. The authors obtained data from one quarter in each of three consecutive years. The authors analysed the frequency of restrictive procedures by individual and the frequency of antecedents to the use of restrictive procedures. Results A small proportion of service users accounted for all use of restrictive procedures. This was true for all three data sets. We coded antecedents to the use of restrictive procedures reliably. The most common antecedents were transitions and seatwork. Conclusion Restrictive behavioural procedures are concentrated among a small proportion of service users and occasions. Efforts to reduce the use of restrictive procedures should first identify these service users and occasions and then focus efforts to reduce restrictive procedures there. Information concerning the antecedents of restrictive behavioural procedures may be useful as part of a descriptive assessment to design individual interventions to reduce restrictive procedures.