Introduction: Features of intellectual disability (ID) and/or autism spectrum disorder (ASD) may hinder responsiveness to interventions typically used during psychiatric hospitalization to manage severely disruptive behavior, and could increase the likelihood of experiencing restraint and/or seclusion (R/S). This study investigated the occurrence of R/S in psychiatrically hospitalized children rated by their treatment team as having ID and/or ASD and those who were rated as having neither.

Methods: Pre-adolescents (N = 777; M = 9.71; SD = 2.71; Range 5–12) consecutively admitted to an acute psychiatric hospital during a one-year period were assigned a consensus DSM-5 diagnosis of ID (n = 295), ASD (n = 48), Both (n = 77), or Neither (n = 361). R/S occurrences were recorded in terms of their frequency and duration.

Results:52% of patients experienced at least one R/S while hospitalized. The modal number of R/S events for this sample was 0, and for children who experienced any R/S, the mode was 2. Comparisons (ID, ASD, Both, Neither) showed statistically significant differences (p <.001) in R/S events. Children rated as meeting diagnostic criteria for ID (68%; M = 13.9), or Both ID and ASD (78%; M = 18.2), had elevated rates of R/S events compared to cases with Neither diagnosis (35%; M = 7.3). ASD alone (50%; M = 10.0) was not associated with an increase in R/S compared to cases with Neither diagnosis. Data on the duration of these events completely paralleled the frequency results.

Conclusion: Children who met DSM-5 criteria for ID had a greater risk of experiencing R/S during psychiatric hospitalization. To reduce the occurrence of R/S, interventions must be refined and staff specially trained to address the complexities of treating children with ID.

简介：智障（ID）和/或自闭症谱系障碍（ASD）的特征可能会妨碍对通常在精神病院住院期间用于处理严重破坏性行为的干预措施的反应，并且可能会增加出现束缚和/或隔离的可能性（R / S ）。这项研究调查了由治疗小组评定为具有ID和/或ASD的精神病住院儿童以及被评定为没有ID和/或ASD的精神病住院儿童中R / S的发生情况。

方法：在一年期间连续入读急性精神病医院的青少年前期患者（N = 777； M = 9.71； SD = 2.71；范围5-12）被分配为一致同意的DSM-5 ID诊断（n = 295） ），ASD（n = 48），两者（n = 77）或都不（n = 361）。R / S发生的频率和持续时间被记录下来。

结果：52％的患者在住院期间经历了至少一项R / S。此样本的R / S事件的模态数为0，而经历过任何R / S的儿童的模态数为2。比较（ID，ASD，二者，均不显示）在统计上有显着差异（p <.001） R / S事件。符合ID诊断标准的儿童（68％; M = 13.9）或ID和ASD都达到标准（78％; M = 18.2），与未诊断的病例（35％; M = 7.3）。与没有诊断的病例相比，单独的ASD（50％； M = 10.0）与R / S的增加无关。这些事件持续时间的数据与频率结果完全平行。

结论：符合DSM-5 ID标准的儿童在精神病院住院期间发生R / S的风险更大。为了减少R / S的发生，必须改进干预措施，并对员工进行专门培训，以解决治疗ID患儿的复杂性。