Restraint interventions widely used in children with learning disabilities despite absence of evidence based guidance

autism children holding hands

The term ‘physical interventions’ refers to ‘any method of responding to challenging behaviour which involves some degree of direct physical force to limit or restrict movement or mobility’

The authors of this literature review set out to look at the current evidence on the use of restraint as an intervention in managing challenging behaviours in to children with learning disabilities. They also looked at the legal frameworks and ethical considerations underpinning the use of restraint in such children.

They reviewed literature from a search of electronic databases using a combination of keywords. Because of the relatively small number of studies in this area, they also used studies from adult with and cognitively able children to try to come to a view on whether broad principles underpinning the use of restraint interventions could be generalised to their use in children with learning disabilities.

They found evidence suggesting restraint interventions in were widely used to manage challenging behaviours in children with learning disabilities. They outline the risks associated with the use of such interventions and the current absence of evidence based guidance incorporating clinical, ethical, and legal aspects of their use.

The authors suggest that the review finding could constitute guidance for professionals working with children with learning disabilities and challenging behaviour considering using restraint interventions in their clinical practice.

Use of restraint for the management of challenging behaviour in children with intellectual disabilities, Menon K et al in Advances in Mental Health and Intellectual Disabilities,  6 2, 62 – 75

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John Northfield

After qualifying as a social worker, John worked in community learning disability teams before getting involved in a number of long-stay hospital closure programmes, working to develop individual plans for people moving into their own homes. He worked for BILD, helping to develop the Quality Network and was editorial lead for the NHS electronic library learning disabilities specialist collection. This led him to found the Learning Disabilities Elf site with Andre Tomlin as a way of making the evidence accessible to practitioners in health and social care. Most recently he has worked as part of Mencap's national quality team and also been involved in a number of national website developments, including the General Medical Council's learning disabilities site.

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