Applied Behaviour Analysis (ABA), is a widely used and effective, evidence-based approach for supporting children with autism. While ABA has shown tremendous promise in helping children develop essential skills and reach their full potential, it’s equally important to emphasise the need for ethical and responsible practices within ABA therapy and that includes the elimination of restrictive practices.
In this blog, we will break down why eliminating restrictive practices is not just about following the rules of the NDIS Quality and Safeguards Framework – it’s crucial for the well-being and growth of children too.
What are restrictive practices?
A restrictive practice is any type of practice that limits a person with disability and their freedom of movement or their rights, for example when a person is unable to leave a room, receives medication to change their behaviour, or feels intimidated into doing something. (Source: www.disabilitysupportguide.com.au)
“Under the NDIS rules, certain restrictive practices are regulated. These include seclusion, chemical restraint, mechanical restraint, physical restraint and environmental restraint“ (Source:www.health.nsw.gov.au)
Ethical considerations should be paramount in any intervention program. The use of restrictive practices, raise serious ethical concerns, and according to the NDIS Quality and Safeguards Commission, when used inappropriately, may constitute abuse and neglect. They can infringe upon a child’s rights, autonomy, and dignity, potentially causing physical and psychological harm. Early intervention ABA should always prioritise the child’s well-being and safeguard their rights.
Compliance with legal and regulatory standards
The UN Convention on the rights of the child emphasises the principle that the best interests of the child should always be a primary consideration when decisions affecting children are made. This principle is fundamental and underpins many child welfare and disability support frameworks worldwide, including the NDIS. It emphasises the need to prioritise the well-being, safety, and best interests of children when making decisions that affect them.
Governments have a responsibility to ensure that children are protected from all forms of physical and mental violence, abuse, neglect, and exploitation. This includes children with disabilities who are often vulnerable to mistreatment. In the context of the NDIS, this means that when restrictive practices are considered, they must be used with extreme caution and in strict accordance with the law to prevent any harm, abuse, or neglect of the child.
It’s important for ABA professionals, as well as other caregivers and service providers, to be aware of these principles and regulations and to work in a manner that prioritises the safety and well-being of the child while respecting their rights and dignity. This includes using positive behaviour support strategies.
Promotes a positive learning environment
The core philosophy of ABA is to create a positive and nurturing learning environment that encourages building skills while minimising the occurrence of behaviours of concern. Restrictive practices run counter to this philosophy as they rely on control and containment rather than active teaching and positive reinforcement, that increase the child’s capacity using a strengths-based approach.
Strengthening Therapeutic Alliance
A successful ABA program depends on a strong therapeutic alliance between the child, their family, and the therapy team. The use of restrictive practices can strain this partnership, eroding trust and communication. By avoiding such practices, the therapeutic relationship can flourish, ensuring a more effective intervention.
Respect for individual differences
Each child is unique, and their developmental path is a highly individualised journey. Restrictive practices do not respect these individual differences, often leading to one-size-fits-all solutions. A non-restrictive approach acknowledges the unique needs and challenges of each child, allowing for a more tailored and effective intervention.