Angelman
New Perspectives on Understanding Challenging Behaviour
Some individuals with intellectual disabilities can show behaviours such as self-injurious behaviour and aggression which may seem difficult to understand. It is not surprising then that before the 1980s, many individuals who observed these behaviours felt they were purposeless or meaningless. However in 1985, the two researchers Carr and Durand changed how these behaviours were understood forever. What Carr and Durand were able to show was that behaviours, such as self-injurious behaviour, served a ‘function’ or ‘purpose’ for an individual and that overtime, the behaviours had been shaped by the consequences that followed after the behaviours were shown. You can read more about how behaviours are shaped by visiting our challenging behaviour pages in each syndrome group on this website.
The knowledge that behaviours served a function led to a useful communication analogy. Clinicians, families and support workers started to ask the question ‘what is the behaviour communicating?’ and many strategies for intervening with behaviour involve working this out. The environment can then be changed to meet a person’s needs or the person can be taught more appropriate forms of communication that do not pose a risk to the person or those around them. This approach has dominated clinical practice over the last thirty years in learning disability services and has been shown to be effective in reducing behaviours such as self-injury, aggression and destruction of property.
Despite the success of interventions based on changing the environment or teaching communication strategies, many individuals continue to show behavioural difficulties across their life span. Sometimes, it is the case that an individual has shown behaviour for a very long time before they get support and this can make it harder, although not impossible, to reduce the behaviour. This may be because behaviours become well established and families may find it harder to change the way they respond to behaviour when the person is an adult. In addition, many families describe how the behaviours seem to have a compulsive like quality, or that they are juggling so many of their children’s needs that responding to behaviour differently is very hard.
This has led to a focus on early intervention. Can we identify risk markers that help us predict who is most at risk of developing challenging behaviour and can we intervene earlier to stop behaviours becoming established? Research has pointed towards several risk markers that may be important for understanding challenging behaviour, the most recent including impulsivity, overactivity and repetitive behaviours. Some of these risk markers occur more often in particular genetic syndromes and you can read about them by visiting the syndrome pages on this website. When coupled with the knowledge we already have about the function of behaviours, this research may have the potential to lead to more effective and earlier interventions for behaviour difficulties.
To hear Caroline Richards discuss these risk markers watch the short film below: