Restraint, seclusion and time-out among children and youth in group homes and residential treatment centers: a latent profile analysis.
Children
Latent profile
Out-of-home care
Restraint
Seclusion
Time-out
Journal
Child abuse & neglect
ISSN: 1873-7757
Titre abrégé: Child Abuse Negl
Pays: England
ID NLM: 7801702
Informations de publication
Date de publication:
11 2020
11 2020
Historique:
received:
21
02
2020
revised:
21
07
2020
accepted:
18
08
2020
pubmed:
7
9
2020
medline:
13
7
2021
entrez:
6
9
2020
Statut:
ppublish
Résumé
Many children and youth living in residential units have experienced multiple traumas that may result in challenging behaviors. Among a range of professional responses, staff may use restraint, seclusion and time-out to manage these behaviors. To enhance our understanding of these restrictive interventions in residential units as a means of improving professional practices involving children and youth in out-of-home care. Administrative data were used. Restrictive intervention data for 324 children and youth (29 units) over a 6-month period were extracted. Latent profile analysis was used to identify subgroups of children and youth with distinct restrictive intervention profiles. Children and youth in these profiles were compared on individual (age, sex, ethnic group, length of stay in unit, reasons for services) and environmental characteristics (unit type, type of services, specialized designation). Restrictive interventions, especially time-outs, were frequent (5136 interventions; 69% time-outs), yet approximately half of the sample did not experience any. Restraints, seclusions and time-outs differed in frequency, duration and reason for use. A two-profile model was favored for children and youth who were subjected to restrictive interventions (classification accuracy = 94%). Children and youth in these two profiles differed from each other, and from those not subjected to restrictive interventions, on numerous individual and environmental characteristics. The use of restrictive interventions is frequent, and attention should be paid to individual and environmental risk factors identified in this study (i.e., being a boy, non-Caucasian, taken into care for neglect, and having a longer stay in unit).
Sections du résumé
BACKGROUND
Many children and youth living in residential units have experienced multiple traumas that may result in challenging behaviors. Among a range of professional responses, staff may use restraint, seclusion and time-out to manage these behaviors.
OBJECTIVE
To enhance our understanding of these restrictive interventions in residential units as a means of improving professional practices involving children and youth in out-of-home care.
PARTICIPANTS AND SETTING
Administrative data were used. Restrictive intervention data for 324 children and youth (29 units) over a 6-month period were extracted.
METHODS
Latent profile analysis was used to identify subgroups of children and youth with distinct restrictive intervention profiles. Children and youth in these profiles were compared on individual (age, sex, ethnic group, length of stay in unit, reasons for services) and environmental characteristics (unit type, type of services, specialized designation).
RESULTS
Restrictive interventions, especially time-outs, were frequent (5136 interventions; 69% time-outs), yet approximately half of the sample did not experience any. Restraints, seclusions and time-outs differed in frequency, duration and reason for use. A two-profile model was favored for children and youth who were subjected to restrictive interventions (classification accuracy = 94%). Children and youth in these two profiles differed from each other, and from those not subjected to restrictive interventions, on numerous individual and environmental characteristics.
CONCLUSION
The use of restrictive interventions is frequent, and attention should be paid to individual and environmental risk factors identified in this study (i.e., being a boy, non-Caucasian, taken into care for neglect, and having a longer stay in unit).
Identifiants
pubmed: 32891971
pii: S0145-2134(20)30357-4
doi: 10.1016/j.chiabu.2020.104702
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
104702Informations de copyright
Copyright © 2020 Elsevier Ltd. All rights reserved.