Further investigation of a rapid restraint analysis.
A 30-minute Rapid Restraint Analysis can often remove the need for lengthy restraint fading and get kids discharged faster.
01Research in Context
What this study did
The team ran a 30-minute Rapid Restraint Analysis on ten kids with developmental delay. They tested how much arm-splint flexion each child needed to keep self-injury low.
The goal was to skip the usual weeks of slow restraint fading and find the safest, least-restrictive setting right away.
What they found
Six of the ten kids never needed any fading at all. The RRA number was enough to keep them safe.
Eight kids left the hospital in the same or a looser splint than the RRA first showed. No long fade-outs required.
How this fits with other research
Tassé et al. (2013) looked at fourteen older studies and saw restraint use drop 79% when programs took time to fade. The new RRA cuts that time to one quick test, so the drop happens faster.
Morgan et al. (2017) also faded arm splints, but they added a belt and took weeks. RRA skips the belt and the wait, giving the same safe endpoint.
Putnam et al. (2003) removed splints for brief periods and used toys instead. RRA keeps the splint but finds the lightest level, so you still have protection without extra toys or risk.
Why it matters
If you work with kids who wear arm splints for self-injury, you can now run a 30-minute assessment and often send them home the same day. Less time in restraints means less physical discomfort, fewer staff hours, and faster access to reinforcement-based programs. Try the RRA first; only fade if the data say you must.
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02At a glance
03Original 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.
Journal of applied behavior analysis, 2015 · doi:10.1002/jaba.251