Abstract

This chapter reviews the use of interventions based on applied behavior analysis to reduce the use of restraint. Strategies include interventions to reduce the target behavior that calls for the use of restraint. These interventions for people with intellectual disabilities and autism include function-based interventions to teach skills and reduce challenging behavior such as tantrums, aggression, self-injury, and pica that often occasion the use of restraint. In addition, several applied behavior analytic interventions directly target the reduction of restraint, including increasing positive reinforcement, modification of antecedent stimuli, restraint fading, analysis of the least intrusive and most effective degree of restraint, and systematic desensitization for some forms of chronic self-injury. Other examples include the reduction of restraint for thumb sucking, noncontingent restraint during dental treatment. The chapter concludes that although applied behavior analytic interventions can be highly effective in reducing and eliminating restraint, behavioral services are often weak and poorly implemented.

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