Restrictive Practices Toward People with Intellectual and Developmental Disabilities

People with intellectual and developmental disabilities (IDD) frequently experience restrictive practices in various settings. The use of restrictive practices, such as restraint or seclusion, is controversial due to the risk of physical and psychological harm, as well as their impact on personal freedom and dignity. Therefore, the regulation and reduction of restrictive practices toward individuals with IDD has become a globally recognized imperative and human rights priority, leading to the implementation of several actions aimed at this goal. This chapter introduces the field of restrictive practices in three axes: (i) conceptual framework, (ii) ethical concerns, and (iii) strategies for the reduction of restrictive practices. First, a conceptual delineation of restrictive practices is provided, defining key practices such as restraint, seclusion, and blanket restrictions. Second, the main ethical concerns regarding physical and psychological safety and rights are discussed. Third, actions to reduce these practices, covering key regulatory principles and core elements of organizational approaches for their reduction, are highlighted.