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快速约束分析的进一步研究。

Further investigation of a rapid restraint analysis.

作者信息

Deshais Meghan A, Fisher Alyssa B, Hausman Nicole L, Kahng SungWoo

机构信息

KENNEDY KRIEGER INSTITUTE.

UNIVERSITY OF MISSOURI.

出版信息

J Appl Behav Anal. 2015 Dec;48(4):845-59. doi: 10.1002/jaba.251. Epub 2015 Sep 28.

Abstract

Research related to the use of mechanical restraint devices (e.g., arm splints) has been limited despite the frequency with which they are used in the clinical treatment of severe and dangerous self-injurious behavior (SIB). Wallace, Iwata, Zhou, and Goff () used a rapid restraint analysis (RRA) to evaluate the effects of different levels of arm-splint flexion on rates of hand-to-head SIB and adaptive behavior. The goal of the current study was 3-fold: (a) to extend previous research on RRA by reporting RRA results for 10 participants and investigating post-RRA outcomes, (b) to investigate whether the RRA might have the potential to eliminate the need for restraint fading altogether for some individuals, and (c) to investigate whether the RRA might help to identify a starting point for restraint fading for individuals for whom fading is necessary. Results suggested that the RRA helped to eliminate the need for restraint fading for 6 participants. With respect to the identification of a starting point for restraint fading, results were mixed. Overall, 8 of the 10 participants were discharged from the inpatient unit at a less restrictive level of flexion or at the same level of flexion identified by the RRA. Implications for adoption of the RRA are discussed.

摘要

尽管机械约束装置(如手臂夹板)在严重危险的自伤行为(SIB)临床治疗中的使用频率很高,但与之相关的研究却很有限。华莱士、伊瓦塔、周和戈夫(年份未给出)使用快速约束分析(RRA)来评估不同程度的手臂夹板弯曲对手部至头部自伤行为发生率和适应性行为的影响。本研究的目标有三个:(a)通过报告10名参与者的RRA结果并调查RRA后的结果来扩展先前关于RRA的研究,(b)调查RRA是否有可能完全消除某些个体对约束渐消的需求,以及(c)调查RRA是否有助于为需要渐消的个体确定约束渐消的起点。结果表明,RRA有助于消除6名参与者对约束渐消的需求。关于确定约束渐消起点的问题,结果喜忧参半。总体而言,10名参与者中有8名在住院单元出院时的弯曲限制程度较低,或处于RRA确定的相同弯曲水平。文中讨论了采用RRA的意义。

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