The Ohio Association of Adult Services has been
a partner in the review of behavior support practices for many
years. In keeping with the Association's mission to provide
leadership and promote quality services that are responsive to
the needs and
choices of individuals served, we have continuously sought
to improve upon the methods used to support individuals to manage
behavior in a safe and growth-enhancing environment. Tremendous
progress has been made in the field and particularly, in Ohio.
In this evolution, we have realized the true benefit of positive
behavior supports and are now prepared to move to the next
level. That is, the eventual elimination of certain types of
The following is the Ohio Association of Adult Services Position
Statement on Prolonged and Horizontal Behavior Restraints.
- The need for restraint should be considered the result of
unsuccessful treatments, strategies or interventions
rather than the methods themselves are approved treatments, strategies
As such, it should be the last approach or tactic for
individuals from serious risk of harm.
- There are no approved
or generally accepted methods for safely restraining
persons who have developmental disabilities,
there a system for direct monitoring and oversight
of such restraints.
- The prevalence and use of restraints are not
monitored in aggregate, nor are the results of such applications
crucial data, the risks from the use of restraints
cannot be evaluated empirically.
- There is a significant risk that a person may experience
severe emotional, psychological, health and physical
problems when restrained.
Additionally, the application of restraints may result
in increased agitation and restlessness when movement
- The use of restraints except in life threatening
emergencies is prohibited in all systems of community-based
care excluding services for persons who have developmental
disabilities and the elderly. Moreover, the standards for the
of force and restraint in prison settings are elevated,
even for those who have committed the most heinous of crimes,
and such applications
monitored by human rights organizations.
- There is no evidence
that continuing to “hold” a
person beyond the time needed to redirect to an alternative
activity promotes the acquisition of greater coping
and management skills
for persons who have developmental disabilities.
On the contrary, persons who are being held may resist
time and may become dependent on the external control
of their behavior.
- The risk of injury to the person and those
applying the restraint increases correspondingly to the
length of time
that the person
is being restrained.
- Risks of
prolonged restraint and restraint in a horizontal
Elimination Problems – bowel and
Injury – Soft tissue damage and fractures
(resistance, falls and misapplication)
Lung Problems – Choking, breathing, pneumonia, infection
Emotional Problems – Depression and anxiety, particular
for persons who feel they are being punished or triggering
to previous abuse
Nutritional Problems – Hydration, consumption and digestive
Physical – Blood flow and clots, muscle deterioration
The OAAS remains committed to its principle objective to provide
support to its membership as the profession seeks to improve
the quality of services provided to persons who have disabilities.
Accordingly, OAAS will continue to solicit and advance best practice
resources, particularly including behavioral assessment and positive
The Ohio Association of Adult Services joins the following leaders
in advocating for the elimination of aversive behavior supports:
The ARC, AAMR, TASH, MANDT System, The American Psychiatric Association,
The Autism Society, Advocates for Children in Therapy, and The
General Conference of the United Methodist Church.