Positive behavioral support of adults with developmental disabilities: assessment of long-term adjustment and habilitation following restrictive treatment histories

Abstract

The long-term maintenance of behavioral treatment effects is an important measure of clinical significance but is not reported with regularity in the published literature. The present report concerned therapeutic maintenance by evaluating five adults with developmental disabilities who had been exposed to multiple, restrictive procedures (food deprivation, mechanical restraint, electric shock) in a prior residential treatment facility and were transitioned to a new habilitation setting where these procedures were terminated in favor of alternative methods of behavior support. As revealed through a 24-month follow-up period, all of the participants were able to maintain clinically acceptable levels of challenging behaviors following the removal of the restrictive treatment procedures. Quality of life measures also revealed that the participants experienced greater independence, reduced supervision, and increased diversity in their living and work environments. These findings add to the limited studies on extended maintenance outcomes from behavioral intervention for serious clinical disorders in adults with developmental disabilities by demonstrating that positive adjustment can be sustained in the long-term without the continuation of restrictive treatment procedures.