Developmental Services - Behavioral Regulations/Three Person Committee

Involuntary Exclusion From Community Activities

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Sometimes a person is prevented from attending previously scheduled activities in the community because the person has exhibited target behavior or other objectionable conduct. The most common name for this intervention is “grounding”, but sometimes it is also called “in home stabilization” and even “house arrest”. Although the person’s physical movement is restricted, the intervention is not seclusion as defined by the behavior regulations because the person is not restricted to a single room. The person still has access to any pleasurable or reinforcing activities that might be available in the building (usually the residence) where the grounding/stabilization is taking place. For the purposes of the regulations the intervention is a form of fining, “the forfeiture of …. participation in an event when an individual engages in target or maladaptive behavior”.

Grounding/stabilization may be both an emergency and a programmatic intervention. As an emergency intervention, it can only be imposed “during (the) emergency, and for the duration of the emergency”. It cannot “be employed as a punishment, for staff convenience or as a substitute for planned behavioral interventions.” (Section (3)(B)(1)) An “emergency” is “a situation in which there is risk of imminent harm or danger to the individual or others.” “Imminent” describes a “situation or event that is about to occur at any moment.” So, absent a program, as soon as the risk of harm or danger to the individual or others has passed the grounding of the person should cease and the person should be eligible to participate in the community event.

In a program grounding requires all of the safeguards of a moderate level behavior modification plan. Although it is not mandated by the regulations, it is recommended that the program set out in addition to the target behavior the objective indicators staff can use to evaluate when the target behavior has ceased, and criteria by which staff will judge the period of grounding to be over. It is best not to leave this decision purely to the discretion of the staff, because it is likely that staff will change and the decision will be made according to the personal standards and level of tolerance of the particular staff on duty at the time. The use of some objective criteria, determined in the planning process, allows for a more consistent message to be communicated to the person.
Consistent with the requirements of Section 4(D)(5) of the behavior regulations, any use of this intervention should be recorded so that the person’s PCP team may know how often the technique is used, and for how long the person was grounded or held in stabilization. The PCP team may require additional information in order to determine the effectiveness of the intervention.