In his book, Challenging Behaviour, Eric Emerson defines challenging behaviour as:
“Culturally abnormal behaviour(s) of such an intensity, frequency or duration that the physical safety of the person or others is likely to be placed in serious jeopardy, or behaviour which is likely to seriously limit use of, or result in the person being denied access to, ordinary community facilities”
Between 5-15% of people with learning disabilities show behaviours which present a significant challenge for those caring for them.
Such behaviours may include aggression, destructive behaviours or self-injury. People with specific syndromes (for example, Lesch-Nyhan syndrome, Rett syndrome or Cornelia de Lange syndrome), people with more severe disabilities, and those with additional disabilities such as sensory impairments and communication disorders are more likely to demonstrate challenging behaviour.
Many forms of challenging behaviour are thought of as being functional and adaptive responses to challenging situations, in that they serve as a method of communication with the people with whom they interact (e.g. stopping unwanted attention, attracting attention or attempting to explain they are experiencing pain).
Some forms of challenging behaviour may be linked to mental health problems, such as depression.
- The most important element in the reduction of challenging behaviour is a thorough assessment, used to find out the function of the behaviour (usually called a functional assessment or analysis).
- Once the reason for the behaviour is identified, the intervention can be designed. The most commonly-used approach is positive behavioural support, which has a focus on building new skills alongside reducing less desirable behaviours.
- Adults presenting with challenging behaviours should be supported by the local ‘Community Team for People with Learning Disabilities’ (CTLD), who will undertake the functional assessment and design an appropriate intervention.
- Children should be referred to the local Child and Adolescent Mental Health Service (CAMHS) who may have a specialist learning disability practitioner within the team.