Evidence-Based Practices for the Treatment of Challenging Behaviour in Intellectual and Developmental Disabilities: Recommendations for Caregivers, Practitioners, and Policy Makers.<\/a><\/p>\nThe best practice guidelines shared in the report address the most pressing questions facing clinicians in Ontario. The report identifies interventions that are evidence-based and effective, others that show promise, and several for which no evidence of effectiveness exists.<\/p>\n
\u201cThe treatment of challenging behaviour in Ontario is alarming,\u201d says Saini. \u201cOur report was designed to shape the future of health care in this area.\u201d<\/p>\n
Cox says it\u2019s when resources are stretched thin that the significance of best practices becomes clear. She recommends avoiding ineffective treatments in favour of those \u201cwhere there\u2019s a bigger bang for your buck.\u201d<\/p>\n
In a system where funding and human resources are in short supply, \u201cthe go-to is often restraints or sedation,\u201d says Cox. \u201cBut, there\u2019s a lot of good work that could be done before you need to rely on these more intrusive strategies.\u201d<\/p>\n
She finds the prevalence of medication as a treatment for challenging behaviour disheartening.<\/p>\n
\u201cIt\u2019s disappointing to me as a clinician because I feel that there are less intrusive approaches that could be tried first,\u201d she says, adding that clients want to be engaged in activities and behaviour analysts know how to make that happen.<\/p>\n
Cox uses the example of a client who requires multiple interactions with staff because he wanders.<\/p>\n
\u201cHe wanders because he doesn\u2019t know where his room is, so put a picture of him on his door or give him a rudimentary map of the space and teach him to refer to it,\u201d she says. \u201cThat might not be all that it takes, but those are some of the low-hanging fruit.\u201d<\/p>\n
The OSETF recommends that procedures such as psychotropic medication and restraint be considered as a last resort and only in combination with a skill-building program. Additionally, Cox says clinicians must respect their own limitations and call in experts when appropriate.<\/p>\n
The task force also recommends that the government register the profession of behaviour analysis. Practitioners are board-certified through an international body, but the certification doesn\u2019t offer the same rights or protections as being registered as a health practitioner.<\/p>\n
Currently in Ontario, anyone can set up a private practice claiming to treat challenging behaviours, Cox says, \u201cand there\u2019s nobody monitoring. There\u2019s no consumer protection.\u201d<\/p>\n
Saini adds that \u201cwithout proper oversight of the treatment of challenging behaviour and regulation of practitioners, the individuals being treated could be exposed to ineffective or even harmful interventions.\u201d<\/p>\n
That lack of oversight also means \u201cthere\u2019s no protection for the people who are very well trained and educated in that area,\u201d Cox says.<\/p>\n
Quality assurance measures developed by previous provincial ministries included a requirement that board-certified BA practitioners oversee intensive programming to treat challenging behaviours.<\/p>\n
While encouraged by these \u201cglimmers of recognition,\u201d Cox says, \u201cwe won\u2019t be able to do the best we can as certified clinicians if we don\u2019t have designation as registered health practitioners.\u201d<\/p>\n
The OSETF report was officially released in January through the Ontario Association for Behaviour Analysis (ONTABA), whose members include clinicians from education, nursing, health care and psychology. The authors also hope to sit down with representatives from the provincial government.<\/p>\n
Cox remains optimistic that \u201cit\u2019s just a matter of getting the right people in the right room talking about how we can move forward on these recommendations.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"
When an adult with developmental disabilities becomes aggressive or starts to self-harm, most people assume that professional caregivers know how best to handle such challenging behaviour. But what if the professionals aren\u2019t necessarily using the best treatments?<\/p>\n","protected":false},"author":50,"featured_media":56287,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[7484,3319,4052,1,4,5,38],"tags":[7580,244,7390,7576,522,7578,7577,7579],"_links":{"self":[{"href":"https:\/\/brocku.ca\/brock-news\/wp-json\/wp\/v2\/posts\/56283"}],"collection":[{"href":"https:\/\/brocku.ca\/brock-news\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/brocku.ca\/brock-news\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/brocku.ca\/brock-news\/wp-json\/wp\/v2\/users\/50"}],"replies":[{"embeddable":true,"href":"https:\/\/brocku.ca\/brock-news\/wp-json\/wp\/v2\/comments?post=56283"}],"version-history":[{"count":3,"href":"https:\/\/brocku.ca\/brock-news\/wp-json\/wp\/v2\/posts\/56283\/revisions"}],"predecessor-version":[{"id":56288,"href":"https:\/\/brocku.ca\/brock-news\/wp-json\/wp\/v2\/posts\/56283\/revisions\/56288"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/brocku.ca\/brock-news\/wp-json\/wp\/v2\/media\/56287"}],"wp:attachment":[{"href":"https:\/\/brocku.ca\/brock-news\/wp-json\/wp\/v2\/media?parent=56283"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/brocku.ca\/brock-news\/wp-json\/wp\/v2\/categories?post=56283"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/brocku.ca\/brock-news\/wp-json\/wp\/v2\/tags?post=56283"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}