Challenging Behaviour Types causes

Learning Objectives To define Challenging Behaviour. To identify types of challenging behaviour . To recognise the causes of challenging behaviour in people with learning disabilities. To consider specific case studies relating to people with behaviour which challenges.

What is Challenging Behaviour – A definition? “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.” Emerson,(1 995, 2001,): Revision

Challenging Behaviour “Challenging behaviour” widely used concept Almost diagnostic, used to label people People who display CB are amongst the highest numbers of people requiring specialist “care” (admission and treatment) Re-cap from last week – definition of challenging behaviour. Explain this as a slide

“Behaviour which is likely to impair a child’s personal growth, development and family life and which represents a challenge to services, to families and to children themselves, however caused” (1997)

Historical Perspective A term that had been used in the US circa 1985 The Kings Fund credited with introducing it as a term to the UK The Kings Fund publication 'Facing the Challenge; An Ordinary Life for People with Learning Difficulties and Challenging Behaviour' (Blunden 1987) was an influential document in developing a framework for service development for people with challenging behaviour. Talk about this slide, the Kings Fund follow the link

Flawed definitions? What is “culturally abnormal”? Which came first – the impaired development leading to challenging behaviour or challenging behaviour leading to impaired development. The impact of CB can depend on the individual who is on the “receiving end”. There is often an interrelationship between challenging behaviour and mental health issues.

Prevalence Extremely difficult to estimate and current statistical information is limited. 2-20% of people with a LD displayed CB (Allen 2000) 2.4 people per 10,000 (7.3%) of people have a LD and exhibit serious challenging behaviour. (Emmerson 2001) 19% of people with a LD display some CB (Joyce et al 2001)

Task This person exhibits behaviour that challenges, what might those behaviours be?

What types of challenging behaviour are there? Violence Aggression Hyperactivity Antisocial behaviour Withdrawn behaviour Self stimulation Speech problems Sexually inappropriate behaviour Psychological disturbances Eccentric habits Inappropriate personal habits Bullying Small groups – think about what types of challenging behaviour there are – put onto a poster. Encourage to give examples. Give out this on a handout and discuss each point giving examples – whole group discussion Talk about cultural variations

Causes of Challenging Behaviour Biological Psychological Mental Health Environmental Social Take each word and see if they can work out from each one what kind of thing we are talking about. Small group work.

Biological Causes Brain injury, Epilepsy, ASD, Specific conditions (Cornelia De Lang, Prader-Willi, Fragile x), Medical conditions (diabetes, UTI, Pain), Hormonal imbalances

Psychological Causes and mental health problems Frustration Reinforced behaviours are repeated – either own behaviour or seen behaviour of others Specific mental health issues

Environmental Factors Restricted living areas Overcrowded living areas Institutionalised environments Dehumanised care Lack of choices

Social Issues Abuse Poor or difficult parenting Labelling and stereotyping – people are treated “differently” Communication difficulties or differences

Some Case Studies Task Consider the case studies And think about: The impact of this behaviour on The person Their family or carers The service provision