1. Challenging Behaviour
Types
causes

2. 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.

3. 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

4. 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

5. “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)

6. 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

7. 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.

8. 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)

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

10. 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

11. 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.

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

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

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

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

16. 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