Challenging Behaviour in Young People with a Learning Disability
Challenging behaviour is any behaviour that someone displays that is a challenge for others to manage and puts the young person or others at risk. Lots of young people with learning disabilities have behaviours that challenge.
There are lots of different types of challenging behaviour and behaviours that one person finds challenging another person may not.
Examples of common challenging behaviour:
Sexualised behaviour in public
Throwing items/destroying property
There may be multiple reasons as to why a young person displays challenging behaviour.
Challenging behaviour used to be attributed to the person or it would be thought that something was wrong with the person. However, it is now widely recognised that environmental factors, as well as individual factors, may contribute to and maintain challenging behaviour.
Possible triggers for challenging behaviour
LACK OF STIMULATION
When bored or under-stimulated, young people may display inappropriate behaviours as a way of stimulating themselves and meeting their sensory needs.
CHANGES TO ROUTINE
Some young people find it difficult to tolerate change and can become confused by changes, particularly if these are not communicated.
Every young person can tolerate a different amount of sensory stimulation in their environment. Too much sensory stimulation (e.g. too noisy, bright lights) can trigger challenging behaviour.
This can be confusing and scary for a young person, particularly if they are unable to communicate their pain, and so may result in challenging behaviour (e.g. they may hit their head if they have a headache or toothache).
This can also apply to a lack of communication from caregivers, resulting in confusion or frustration for the young person. The young persons' ability to communicate can also be a factor; if they do not have a way of communicating their needs/desires, they may do this through challenging behaviour.
This is likely to be unsettling and upsetting for young people, especially if no explanation is given.
Feeling anxious/sad/scared about something that has happened.
When an individual is asked to do a task that is beyond their competence or when given a task they do not know how to do or dislike.
Understanding challenging behaviour
The behavioural approach is one way of explaining how challenging behaviour is maintained. Behaviour is learned through being rewarded (by gaining something that was desired, or by the removal of something that was unwanted). This diagram shows two examples.
In the first example, Sally has learned to associate biting and shouting with the removal of something she does not like. In the second example, Bob has learned that he gains something which he desires by banging his head. In both these examples it is likely that the challenging behaviours will be repeated in order to gain the same response (reward).
Behaviour can sometimes be shaped by teaching new skills, distracting, ignoring or giving praise for appropriate behaviour. This should be done whilst always making sure the young person is safe.
In the example of Bob, his behaviour could be shaped by teaching him ways of gaining the attention of others more appropriately (e.g. distracting Bob with an activity he likes, giving him praise and reward at times he has communicated that he would like to spend time with someone in a non-challenging way).
It is useful to keep records of where and when challenging behaviours occur, as well as a note of what happened before and after, paying particular attention to the environment. This will help identify both the triggers and possible functions to the behaviour.
What to do if a young person starts to show/increase challenging behaviour
ASK YOURSELF THE FOLLOWING QUESTIONS
Could they be ill/feeling poorly or in pain?
Might they want more social contact, to be near people or want some attention?
Might they be bored at times or need some new activities to be introduced?
Have there been significant changes in their life recently (e.g. new school, a birth or death in the family)? They may not fully understand and may need an explanation for this change.
Could they have difficulty expressing their frustration? Do they need help in labelling their emotions?
Might they be unclear about what is happening and need to be given some clear, visual timelines of what is happening?
Think about their sensory needs. Is the environment too noisy? Is it too high pitched? Is it too bright? What touch are they experiencing? (some children prefer deep pressure as opposed to light touch).
It can be worth thinking through all of these questions to consider where any problems may be. Usually several of these issues need to be addressed in order to reduce challenging behaviour.
When to consider asking for more specialist help
CONSIDER SEEKING HELP:
If challenging behaviour is repeatedly putting the young person or others at risk.
If challenging behaviour is of a frequency and intensity that a young person may be excluded from school or activities in the community.
Please talk to your Paediatrician, Social Worker, or School about a referral to the LD-CAMHS team.
Further support, advice and self-help
The National Autistic Society provides information and support for people with Autism and their families and for professionals. They are a very active organisation and offer some really useful information about strategies and approaches for supporting people with Autism.
The British Institute of Learning Disabilities also have some useful information and further advice about a variety of common issues.
Local Offer is a Derbyshire-specific site which allows you to search for lots of different services, including parenting support groups, in the local area.