Who is treated using restrictive behavioral procedures? A population perspective

Considerable controversy surrounds the continued use of restrictive behavioral procedures in the treatment of destructive behaviors, such as self-injury, aggression, and property damage, displayed by some people with mental retardation. This study reports on the extent that pharmacological and behavioral consequences occur in response to these behaviors within a population of 31,000 people in one state's developmental services system. Data on these individuals are analyzed to determine the degree to which intellectual level, residential setting type, type and extent of problem behaviors, and age are related to the prescriptive use of pharmacologic and behavioral consequences. These variables appear to bear a significant relationship on the extent to which consequences are applied as part of treatment. Furthermore, although pharmacologic and several behavior consequences are applied at similar rates, it was found that generally timeout, as a specific treatment procedure, was applied at rates considerably less than those for psychoactive medication in each population sub-group that was examined.