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Assessment of Challenging Behaviour

When trying to assess the causes of challenging behaviour in people who have Fragile X Syndrome, it is important to remember that challenging behaviour has not always occurred and does not occur all of the time for any child or adult (it just feels like that sometimes!). This means that the challenging behaviour is likely to be related to either internal or external factors that have changed over a long period of time or change on a more short-term basis.

Successful assessment of the causes of challenging behaviour rests on finding out more about the factors that appear to be present when challenging behaviour is occurring and absent when it is not.

There are a number of assessments that can be conducted to help understand the factors that may be causing challenging behaviour. Some of the assessments can be carried out by anybody who has a good knowledge of the person showing challenging behaviour.  However, some assessments require more expertise and families are encouraged to seek assistance from professionals.

When conducting an assessment, it is essential to keep good written records as these records will be the key to understanding behaviour.  A professional, such as a clinical psychologist or behavioural nurse, will be able to help you interpret these records.


Health Assessment

Revisit the pain and discomfort page to learn about the signs of pain in a person with intellectual disability.  Pain and discomfort should always be ruled out first.


ABC Charts

The ‘ABC’ stands for antecedent, behaviour, consequence.  The person who completes these charts writes down exactly what was going on before, during and after the challenging behaviour.  It’s really important that the record keeper gives a really good and detailed description when completing ABC charts.

Download instructions for completing an ABC chart

Download an example ABC chart

Download a completed ABC chart


Unstructured natural observations

In an unstructured natural observation, the person with Fragile X syndrome is observed in a number of naturally occurring situations and environments. For example, playing with an adult, playing by themselves when an adult is present in the room or completing a less preferred activity.  The person observing keeps a record of how many times the challenging behaviour occurred and for how long, in each situation.  If behaviour goes up and down in different situations this gives a clue to the ‘function’ of the behaviour.  It is very important to do several good quality observations before making any conclusions about the behaviour.  Getting support from a behavioural specialist such as a clinical psychologist or behavioural nurse is advised when interpreting the records collected from these assessments.


Specialist Assessments

There are several assessments that we would recommend are conducted with the help of a professional as there are risks associated with these assessments that need to be managed carefully.  The assessments are experimental analogues and structured descriptive assessments.  These assessments are the gold standard in behaviour assessment and involve changing the environment around the person to see how this impacts on behaviour.



NEXT:  Interventions for challenging behaviour

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