This concern about the potential risk to the individual who is making the
complaint is often the reason that complaints are not made. The threat of reprisal
is often a fear held by those who have experienced abuse or neglect or their
support people. This is particularly true for people who may not communicate
verbally and who are isolated.
VI. Quality Assurance Measures
The Policy Directive for Service Agencies also has a section on “Supporting
People with Challenging Behaviour”. This section outlines the requirements for
Behaviour Support Plans and the use of Behaviour Intervention Strategies. The
Directive states, “The Ministry’s position is that physical restraint should be used
solely as a last resort in crisis situations, unless otherwise identified in an
individual’s behaviour support plan.” The terms “physical restraints”^38 and “crisis
situations”^39 are both defined in the Directive. Each service provider is to have a
review committee made up of third parties, including one clinician who has
expertise in supporting adults who have been labelled with an intellectual
disability who have “challenging behaviours”. The review committee is to review
the Behaviour Support Plans and determine whether intrusive interventions are
ethical and appropriate for the individuals.
(^38) A “physical restraint”, as an example of a type of intrusive behaviour intervention in Ontario
regulation 299/10, includes “a holding technique to restrict the ability of the person with a
developmental disability to move freely, but does not include the restriction of movement,
physical redirection or physical prompting if the restriction of movement, physical redirection or
physical prompting is brief, gentle and part of a behaviour teaching program.”
(^39)
A “crisis situation” is defined in the regulation as “a circumstance where,
(a) a person with a developmental disability is displaying challenging behaviour that is new or
more intense than that which was displayed in the past and the person lacks a behaviour support
plan or the strategies outlined in the person’s behaviour support plan do not effectively address
the challenging behaviour
(b) the challenging behaviour places the person at immediate risk of harming themselves or
others or causing property damage, and
(c) attempts to de-escalate the situation have been ineffective.”