The term ‘challenging behaviour’ is a common one used among a wide spectrum of sectors, including education, healthcare and social care. It also includes behaviours which may be communicated by individuals with learning disabilities or learning difficulties. This blog aims to explore the intricacies of challenging behaviour, delving into its definition, contributing factors, and potential strategies for intervention.

Defining Challenging Behaviour

According to The Challenging Behaviour Foundation, ‘Challenging Behaviour is a term that refers to any behaviour which presents a serious risk to the person themselves and/or a challenge to those supporting them.’ This definition puts the emphasis on the services and skills required to meet the ‘challenge’ of this behaviour, rather than focusing on the negative association of the behaviour to the individual. The CBF suggests that the most reported challenging behaviours include aggression towards others, self-injury and environmentally destructive behaviours. This multifaceted concept encompasses a spectrum of behaviours that can be disruptive, harmful, or socially unacceptable. It is crucial to recognise that challenging behaviour is subjective and context-dependent, as what is considered challenging in one situation may not be in another.

Because the term ‘challenging behaviour’ is a very broad term and also widely used in society, it can be applied to generally challenging behaviour from any individual. In the realms of healthcare, education and social care, it has a very specific meaning  to refer to individuals who have a learning disability and therefore challenges in communicating effectively.

Specific Challenging Behaviours:

With a broad term such as ‘challenging behaviour’, it’s essential to look at the specific behaviours that may be communicated by an individual:

1. Self-Injurious Behaviour

This can be a wide range of behaviours which cause injury or potential injury to the self. For individuals with severe learning disabilities, this might include self-biting, head banging, picking at the skin or poking at the eyes.

2. Hurting Others

This behaviour includes any physical behaviour which may cause injury to another person. It can include hitting, slapping or grabbing, biting, kicking, hair-pulling and head-butting as a few examples.

3. Pica & Polydipsia

Pica - this is when an individual eats objects which are non-edible.

Polydipsia - this is when an individual has a constant desire to drink any form of liquid (including unsafe items such as cleaning fluids).

These two conditions are extremely challenging due to the risk of the individuals consuming an object or liquid which could have potentially fatal or lasting consequences.

4. Spitting

Spitting is a very challenging behaviour due to it being very unacceptable social behaviour. As this is a behaviour that many find to be disrespectful, it’s an essential challenging behaviour to manage.

5. Fleeing

Fleeing is a significant worry for both families and individuals working with someone with a learning disability. First and foremost, if the individual has a limited sense of danger, they are at significant risk when away from family or caregivers.

6. Sexual Behaviour

According to the CBF, boys and men are more likely to exhibit sexual behaviours than women. The main challenging sexual behaviours are:

• Masturbation - a perfectly normal behaviour for most, including those with learning disabilities but can become problematic.

• Sexual Contact with Others - this refers to unacceptable behaviours such as exposing genitals or sexual contact without consent.

• Pornography - while this is not a challenge in itself, the content of pornographic material should be legal (ie. consenting and participants of adult age).

Why Does Challenging Behaviour Occur?

While it may be distressing to witness any of the challenging behaviour mentioned, these behaviours are a form of communication for the individual or they may benefit from the behaviour in some way. Ie. The challenging behaviour displayed may be the most effective method of communication for the person to see to an unmet need. Understanding the root causes of challenging behaviour is paramount to effective intervention.

Strategies for Intervention

Addressing challenging behaviour requires a comprehensive and individualised approach. Here are some strategies that professionals, educators, and caregivers can employ:

Functional Assessment:

Conducting a Functional Assessment (usually carried out by a behaviour specialist) helps identify the reasons behind behaviours and consequences associated with challenging behaviour. This analysis provides valuable insights into the function or purpose the behaviour serves for the individual.

Positive Behaviour Support:

Positive Behaviour Support focuses on reinforcing positive behaviours and teaching alternative, more adaptive skills. By creating a positive environment and rewarding desirable behaviours, individuals can be encouraged to replace challenging behaviours with more socially acceptable alternatives.

Communication and Social Skills Training:

For individuals with communication difficulties, interventions should focus on improving expressive and receptive communication skills. Social skills training can also enhance interpersonal interactions and reduce the likelihood of challenging behaviour.

Environmental Modifications:

Modifying the physical and social environment to meet the individual's needs and reduce stressors can be instrumental in preventing challenging behaviour. This may involve creating a structured routine, providing sensory accommodations, or adjusting the physical space.

Collaboration and Support:

Collaborating with families, educators, and other professionals is crucial in developing a holistic approach to address challenging behaviour. Consistent communication and shared strategies can enhance the effectiveness of interventions.

SecuriCare Training & Resources:

At SecuriCare, we specialise in providing training and support for care providers, staff and families to manage challenging behaviour. This includes training to Prevent and Manage Challenging and Hazardous Behaviour, Clinical Holding Training and support to write Person Centred Behaviour Management Plans.

We have also developed an alternative mechanical restraint system which ensures the safety and comfort of the individual while also protecting those at risk of injury due to challenging behaviour. Our VIP-R Soft Mitts can be used to assist in transporting a person, to administer medication or ensure clinical procedures are able to be safely carried out. They are also a safe alternative to prolonged physical restraint.

Conclusion

The root causes of challenging behaviour often lie in unmet needs or communication difficulties, emphasising the importance of personalised and comprehensive approaches. Strategies for intervention include functional assessments, positive behaviour support, communication training, environmental modifications, and collaborative efforts among professionals, educators, caregivers, and families.

At SecuriCare, we specialise in providing training and resources to manage challenging behaviour effectively, emphasising preventive measures and alternative mechanical restraint systems. By fostering a collective and empathetic approach, society can create environments that support individuals in expressing their needs and emotions in healthier ways. In essence, addressing challenging behaviour is a shared responsibility aimed at enhancing the overall well-being of individuals facing these complex challenges.