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Restraint, seclusion and medication

This page addresses issues of restraint and seclusion, and medication. Read about what these issues are, and the related activities the CBF has been involved in.

Jump to: Restraint and seclusion Medication 

Restraint and seclusion

We are working together with a group of families to bring key national organisations together to develop a strategy to tackle the issue of restrictive interventions against children and young people across the UK.  Our aim is to Reduce Restrictive Interventions and Safeguard Children (RRISC). 

What are restrictive interventions?

When we refer to restrictive intervention with children, we mean: 

  • Physical restraint (direct physical contact between the carer and person, including being pinned to the floor);
  • Seclusion (supervised containment or isolation away from others in a room the child is prevented from leaving);
  • Mechanical restraint (materials or equipment used to restrict or prevent movement);
  • Blanket restrictions (including lack of access to certain places or activities);
  • Chemical restraint (the use of medication in response to someone’s behaviour).

Latest activity

Restrictive Intervention of children and young people with SEN and disabilities during the pandemic: Results of Family Carer and School Staff Surveys

This report sets out the findings of two small scale surveys of families and schools which took place in the autumn of 2020 during the covid-19 pandemic.  The aim was to try and gather some information about any impact of the pandemic (and associated restrictions) on disabled children’s experiences of restrictive interventions, such as physical restraint and seclusion. 48 family carers and 12 school staff responded.

    • Almost half of respondents received no behaviour support from the NHS or their local authority.
    • More than 1 in 3 families reported that their child had experienced restrictive interventions at school since the pandemic began in March 2020.

Although the results are not nationally representative, they point to worrying trends which require further scrutiny.

Read the full report here: Pandemic survey report

And the data supplement here: Data supplement

In February 2020, we published an updatereportjointly produced by the Challenging Behaviour Foundation (CBF) and Positive and Active Behaviour Support Scotland (PABSS) and supported by the Reducing Restrictive Interventions and Safeguarding Children groupRRISC. This report is an update to our January 2019 report ‘Reducing Restrictive Interventions and Safeguarding children’ and provides further analysis on additional case study data.  

Reducing Restrictive Intervention of Children and Young People – update report

Our 2019 and 2020 reports shared family carers’ shocking accounts of their children’s experiences of restrictive intervention, shared through a survey and case studies.  We found children are being injured physically and emotionally through the use of restraint, seclusion and other restrictive practices in schoolsYou can read the original 2019 reporthere. 

2020 Report Launch event at the House of Lords

We launched our update report at an event at the House of Lords on 10th February 2020 hosted by Baroness Sheila Hollins. The aim of the event was to raise awareness about this hidden issue and encourage different organisations, researchers and stakeholders across the UK to pledge to action to reduce restrictive interventions of children and young people. 

Baroness Sheila Hollins opened the event by thanking all the families who shared their experiences for this report. The Baroness said: “I know it is traumatic to have to go over what happened, and we appreciate your bravery in bringing this issue to light.” 

Elly Chapple, a family-carer whose daughter Ella lost her sight as a result of the traumatic impact of restrictive interventions, spoke about this life changing experience and how we should view children differently.  Elly is also a founder member of the RRISC group and has worked in partnership with the CBF and PABSS to bring this issue to light. 

Read Elly’s presentation here

Richard Hastings is the Cerebra Chair of Family Research and a Professor of Psychology and Education at the University of Warwick. He explained the research background and highlighted the findings of the report and the key recommendations. 

Read Richard’s presentation here

Nick Hobbs, Head of Advice and Investigations at the office of the Children and Young People’s Commissioner Scotland (CYPCS), gave the final presentation. Nick explained the importance of focusing on restraint and seclusion as human rights issues and spoke about the current work taking place in Scotland 

Read Nick’s presentation here

A key feature of the day was when three parents described their experiences, the impact of Restrictive interventions and how we can support children well. You can see the short film here: 

Pledges

We asked all invitees to make a pledge to reduce restrictive intervention of children through a specific action. Pledges made at the launch begin to address all of the four main recommendations in the report.

Read all the pledges made here

Baroness Hollins closed the launch event highlighting the need to continue to ensure that the voices of families are heard

I hope we will look back on today as the start of a real process of change – Baroness Hollins

Family carer film

At a meeting of the RRISC group we filmed three parents talking about restrictive intervention experienced by their children, and the impact on the whole family. You can watch the short film we made:

A blog of one family’s experience, shared at our first meeting, can be found on the Paving The Way website.

Read the blog

Key messages 

The RRISC group have produced a series of key messages about the issues. The list includes five key asks that we believe, if carried out, will reduce the use of restrictive intervention on children and young people. 

Read the key messageshere 

The key messages have been endorsed by the CBF, Positive and Active Behaviour Support Scotland, The Council for Disabled Children, National Association of Special Schools, Mencap, and NSPCC. 

Parliamentary debate 25th April 2019  

The CBF produced a briefing paper for the parliamentary debate on restrictive intervention of children and young people, held on Thursday 25th April 2019.

Read the briefing paper here

DfE Consultation on Restraint in Mainstream Settings and Alternative Provision   

The RRISC group wrote to Michelle Donelan MP in October 2019, regarding the consultation on Restraint in Mainstream Settings and Alternative Provision.

You can read the RRISC group response here  

We are still waiting for the outcome of this consultation to be published.   

Medication

The CBF are concerned about ongoing issues of over-medication and inappropriate use of medication for children, young people and adults with learning disabilities. Antipsychotic medications are often prescribed for individuals with learning disabilities or autistic people when there is no related diagnostic reason for them, and may be prescribed for behavioural reasons. 

STOMP/STAMP 

The CBF were pleased to see the introduction of NHS programmes STOMP (Stopping Over Medication of People with a learning disability, autism or both) and STAMP (Supporting Treatment and Appropriate Medication in Paediatrics) in 2015, and have heard from families that, when applied as intended, these programmes have made a great difference for their relatives. However, we also head from many families to whom the programmes have had frustratingly slow progress. The experiences of families in touch with the CBF have been collected in our report. 

Read the report: STOMP – A family carer perspective

There is also a risk of STOMP/STAMP being treated with diminished importance, and no longer appearing a policy priority for healthcare bodies. Since the introduction of the programmes in 2015, there has been limited distribution of information and training programmes, and safeguards to ensure that concerns are addressed has been limited. The CBF are committed to ensuring that addressing over medication and inappropriate medication remain on the health policy agenda. 

To see what the CBF are doing to promote the STOMP/STAMP initiatives and to address overmedication and inappropriate medication, please visit the projects section of our website. This page includes information on our medication pathway resource, involvement with the development of training programmes, and our reports.  

Medication briefing paper  

Medication used in response to someone’s behaviour can be a form of restraint. In June 2019 the CBF put together a briefing paper on medication, including background information about medication use and why it is important to avoid inappropriate medication.

Read the briefing paper 

 

Family Support Service

Family Support Service

The Family Support Service can provide information and support about the needs of your family member with a severe learning disability. Our support is confidential, and we won’t judge you or tell you what to do.

Safeguarding

Safeguarding

This information page answers four questions about what to do if you are worried about the safety of someone with a learning disability, and who you should tell. It also describes what happens when child and adult protection referrals are made.

Projects and research

Projects and research

The CBF aims to improve lives for individuals with severe learning disabilities who display behaviour that challenges through our project work, using new approaches and encouraging others to learn from this work and improve their practices.