This resource demonstrates the techniques carers can use to build positive relationships with people with severe learning disabilities and challenging behaviour. The author uses a combined approach of using a person’s own ‘language’ to communicate with them (Intensive Interaction) while also trying to reduce the stress they experience by an exploration of their sensory reality and hyper-sensitivities. This video shows: the author establishing contact for the first time with a man with severe autistic spectrum disorder. It supports workers demonstrating how they put the techniques into action in their daily routines and shoes how new ways of communicating can make a difference to the lives of all concerned. The guidance notes provide an overview of autistic spectrum disorder and Intensive Interaction.
This resource demonstrates the techniques carers can use to build positive relationships with people with severe learning disabilities and challenging behaviour. The author uses a combined approach of using a person’s own ‘language’ to communicate with them (Intensive Interaction) while also trying to reduce the stress they experience by an exploration of their sensory reality and hyper-sensitivities. This video shows: the author establishing contact for the first time with a man with severe autistic spectrum disorder. It supports workers demonstrating how they put the techniques into action in their daily routines and shoes how new ways of communicating can make a difference to the lives of all concerned. The guidance notes provide an overview of autistic spectrum disorder and Intensive Interaction.
This guide is designed to help with establishing a framework to support individuals with learning disabilities or autistic spectrum disorders whose behaviour challenges services and presents a risk to themselves or others. It sets out in clear and simple terms a structured and systematic approach to the identification, assessment and management of risks associated with challenging behaviours.
This guide is designed to help with establishing a framework to support individuals with learning disabilities or autistic spectrum disorders whose behaviour challenges services and presents a risk to themselves or others. It sets out in clear and simple terms a structured and systematic approach to the identification, assessment and management of risks associated with challenging behaviours.
Extended abstract:
Author
POWELL Sharon.
Title
Risk in challenging behaviour: a good practice guide for professionals.
Publisher
British Institute of Learning Disabilities, 2005
Summary
This guide is designed to help with establishing a framework to support individuals with learning disabilities or autistic spectrum disorders whose behaviour challenges services and presents a risk to themselves or others. It sets out in clear and simple terms a structured and systematic approach to the identification, assessment and management of risks associated with challenging behaviours.
Context
Risk is an evolving concept; it is changing and rarely stays the same from one day to the next. Individuals are prepared to take calculated risks in their daily lives for a variety of reasons. Professionals are expected to identify and manage risk objectively. Reactive strategies for risk management when behaviour challenges should form part of an overall framework. This should include approaches that support positive behaviour. Physical interventions should be used only as a last resort.
Contents
A foreword explains recent developments and an introduction outlines the problem and the intentions of the guide. The first section, on philosophical and organisational issues, discusses organisational foundations, the nature of risk, taking risks, procedures for working with risk, why risk should be assessed, and the elements of risk. The second, on assessing risk, covers risk scoring, identifying hazards and risks, the risk assessment process, describing the challenging behaviour, articulating risk, managed and unmanaged risk, the assessment process, what might go wrong, and physical interventions in the context of risk assessment. Two sets of checklists are given, on procedures for working with risk, consisting of three lists, for developing risk policies, service user vulnerability, and breaking confidentiality; and on risk assessment process, with four lists, for information gathering, planning and consultation, implementation and monitoring, and evaluation and review. Three pro formas are also given, for behaviour description, articulating risk and assessment of service user vulnerability.
Journal of Intellectual and Developmental Disability, 44(4), 2019, pp.481-491.
Publisher:
Taylor and Francis
Background: Individuals with intellectual and developmental disabilities are more likely to engage in problem behaviours than peers with typical development. The purpose of this study was to provide descriptive and qualitative information about problem behaviours in children with fragile X syndrome (FXS) and how families respond to these behaviours. Method: The research examined interview responses from 53 mothers of 9-year-old children with FXS. Results: Defiance, tantrums, inattention, stereotypy, and aggression were the most frequently reported problem behaviours of children with FXS. Stereotypy, physical aggression, self-injury, and elopement were reported more often by mothers of children with dual diagnoses of FXS and autism than by mothers of children with a single diagnosis of FXS. Conclusions: Results indicated that for many families, by 9 years of age, problem behaviours led to frustration and altered family activities.
(Edited publisher abstract)
Background: Individuals with intellectual and developmental disabilities are more likely to engage in problem behaviours than peers with typical development. The purpose of this study was to provide descriptive and qualitative information about problem behaviours in children with fragile X syndrome (FXS) and how families respond to these behaviours. Method: The research examined interview responses from 53 mothers of 9-year-old children with FXS. Results: Defiance, tantrums, inattention, stereotypy, and aggression were the most frequently reported problem behaviours of children with FXS. Stereotypy, physical aggression, self-injury, and elopement were reported more often by mothers of children with dual diagnoses of FXS and autism than by mothers of children with a single diagnosis of FXS. Conclusions: Results indicated that for many families, by 9 years of age, problem behaviours led to frustration and altered family activities.
(Edited publisher abstract)
Shares the learning from the ‘So what, what next?’ project, which was designed by the Transforming Care empowerment steering group to look at ways of supporting people with a learning disability or autism who have recently been discharged from hospital. The focus was on supporting people to use their strengths, become active citizens, to grow their independence and to find ways to contribute to their local communities. Community Catalysts, a social enterprise, led the project and worked with the Black Country Transforming Care Partnership to support people with move out of hospital. The project aimed to help people in the Black Country to see themselves differently and to help professionals to see people differently and change how they work. As well as key learning points, the report includes 13 tips for professionals and supporters. It also includes the stories of 10 people with experience of life in hospital who were involved in the project.
(Edited publisher abstract)
Shares the learning from the ‘So what, what next?’ project, which was designed by the Transforming Care empowerment steering group to look at ways of supporting people with a learning disability or autism who have recently been discharged from hospital. The focus was on supporting people to use their strengths, become active citizens, to grow their independence and to find ways to contribute to their local communities. Community Catalysts, a social enterprise, led the project and worked with the Black Country Transforming Care Partnership to support people with move out of hospital. The project aimed to help people in the Black Country to see themselves differently and to help professionals to see people differently and change how they work. As well as key learning points, the report includes 13 tips for professionals and supporters. It also includes the stories of 10 people with experience of life in hospital who were involved in the project.
(Edited publisher abstract)
Subject terms:
learning disabilities, autism, autistic spectrum conditions, hospital discharge, long stay care, challenging behaviour, communities;
A workbook for panel members to record their findings during a Care and Treatment Review (CTR) for adults in a secure hospital setting. The workbook is based on the key lines of enquiry (KLOE), shows what sort of questions to ask and where to find evidence. It also provides space to record findings and to record what you think if the person’s quality of care overall for each KLOE. The KLOEs, are: Does the person need to be in hospital?; Is the person receiving the right care and treatment?; Is the person involved in their care and treatment?; Are the person’s health needs known and met?; Is the use of any medicine appropriate and safe?; Is there a clear, safe and proportionate approach to the way risk is assessed or managed?; Is there active planning for the future and for discharge?; and Are family and carers being listened to and involved?. The workbook will also help with deciding what goes into the CTR report. It is one of a series of 6 workbooks, which each cover different types of CTR and Care, Education and Treatment Review panels.
(Edited publisher abstract)
A workbook for panel members to record their findings during a Care and Treatment Review (CTR) for adults in a secure hospital setting. The workbook is based on the key lines of enquiry (KLOE), shows what sort of questions to ask and where to find evidence. It also provides space to record findings and to record what you think if the person’s quality of care overall for each KLOE. The KLOEs, are: Does the person need to be in hospital?; Is the person receiving the right care and treatment?; Is the person involved in their care and treatment?; Are the person’s health needs known and met?; Is the use of any medicine appropriate and safe?; Is there a clear, safe and proportionate approach to the way risk is assessed or managed?; Is there active planning for the future and for discharge?; and Are family and carers being listened to and involved?. The workbook will also help with deciding what goes into the CTR report. It is one of a series of 6 workbooks, which each cover different types of CTR and Care, Education and Treatment Review panels.
(Edited publisher abstract)
Updated policy and guidance setting out the expectations for implementation of Care (Education) and Treatment Reviews (CTRs) across England. Care and Treatment Reviews (CTRs) were developed to improve the care of people with learning disabilities, autism or both in England with the aim of reducing admissions and unnecessarily lengthy stays in hospitals and reducing health inequalities. This revised policy and guidance builds on learning following the introduction of the first Care and Treatment Reviews (CTR) policy in October 2015 and in working partnership with people with learning disabilities and their families. The document includes information on the review process, the Key Lines of Enquiry responsibilities, and pathways to CTRs. It also includes additional guidance in relation to the successful implementation of CTRs for children and young people. Although CTRS are being driven by the NHS, the involvement of local authorities and education services in the CTR process and its outcomes are necessary for improving care and treatment for people with learning disabilities and their families.
(Edited publisher abstract)
Updated policy and guidance setting out the expectations for implementation of Care (Education) and Treatment Reviews (CTRs) across England. Care and Treatment Reviews (CTRs) were developed to improve the care of people with learning disabilities, autism or both in England with the aim of reducing admissions and unnecessarily lengthy stays in hospitals and reducing health inequalities. This revised policy and guidance builds on learning following the introduction of the first Care and Treatment Reviews (CTR) policy in October 2015 and in working partnership with people with learning disabilities and their families. The document includes information on the review process, the Key Lines of Enquiry responsibilities, and pathways to CTRs. It also includes additional guidance in relation to the successful implementation of CTRs for children and young people. Although CTRS are being driven by the NHS, the involvement of local authorities and education services in the CTR process and its outcomes are necessary for improving care and treatment for people with learning disabilities and their families.
(Edited publisher abstract)
BUSKERMOLEN Willem Meindert, HOEKMAN Joop, ALDENKAMP Albert Pierre
Journal article citation:
British Journal of Learning Disabilities, 45(1), 2017, pp.32-38.
Publisher:
Wiley
Background: In this article, the authors describe a study of the prevalence of behaviour that challenges and which internal factors are related to behaviour that challenges in 21 people (fourteen are male, seven are female, varying in age from 12.4 to 42 years; mean 26.6, SD 7.27) with intellectual disabilities who have hearing impairments.
Materials and Methods: Data were obtained by recording behaviour on a daily basis during one year using the ‘Individual Behaviour Observation and Rating Scale’ that was developed especially for this study.
Results: It was found that 100% of the participants in this study showed behaviour that challenges, although this was not observed every day in each participant. Prevalence rates during a year varied from 1.8% to 77.3%. On average, the prevalence rate was 28.9%. The auhtors found a significantly negative correlation between behaviour that challenges and delay of communication as well as the level of social independence. They also found that in people with autism spectrum disorder, the prevalence of behaviour that challenges was significantly higher than in people without autism spectrum disorder. The level of intellectual disability as well as the level of hearing impairments was not related to the prevalence of behaviour that challenges.
Conclusion: Because there are several patterns of increasing and decreasing behaviour that challenges throughout the day, it is not possible to draw one conclusion on this issue for the whole group. However, where certain individual patterns can be recognised, it is possible to make individual plans for the clients. This could mean an improvement in daily care and as a result an improvement in the quality of life for people with intellectual disability who have hearing impairments. Implications for clinical practice are discussed.
(Edited publisher abstract)
Background: In this article, the authors describe a study of the prevalence of behaviour that challenges and which internal factors are related to behaviour that challenges in 21 people (fourteen are male, seven are female, varying in age from 12.4 to 42 years; mean 26.6, SD 7.27) with intellectual disabilities who have hearing impairments.
Materials and Methods: Data were obtained by recording behaviour on a daily basis during one year using the ‘Individual Behaviour Observation and Rating Scale’ that was developed especially for this study.
Results: It was found that 100% of the participants in this study showed behaviour that challenges, although this was not observed every day in each participant. Prevalence rates during a year varied from 1.8% to 77.3%. On average, the prevalence rate was 28.9%. The auhtors found a significantly negative correlation between behaviour that challenges and delay of communication as well as the level of social independence. They also found that in people with autism spectrum disorder, the prevalence of behaviour that challenges was significantly higher than in people without autism spectrum disorder. The level of intellectual disability as well as the level of hearing impairments was not related to the prevalence of behaviour that challenges.
Conclusion: Because there are several patterns of increasing and decreasing behaviour that challenges throughout the day, it is not possible to draw one conclusion on this issue for the whole group. However, where certain individual patterns can be recognised, it is possible to make individual plans for the clients. This could mean an improvement in daily care and as a result an improvement in the quality of life for people with intellectual disability who have hearing impairments. Implications for clinical practice are discussed.
(Edited publisher abstract)
NATIONAL DEVELOPMENT TEAM FOR INCLUSION, CHALLENGING BEHAVIOUR FOUNDATION
Publishers:
National Development Team for Inclusion, Challenging Behaviour Foundation
Publication year:
2017
Pagination:
5
Place of publication:
Bath
Building the Right Support (NHS England et al., 2015) sets out a national plan to develop community services and close inpatient facilities for people with a learning disability and/or autism who display behaviour that challenges. This plan covers children and young people, and includes a new service model of local support arrangements to prevent admission. This explanatory note explains why local pathways are needed to improve outcomes for children and families, target public funding more effectively, and fulfil the duties under the Children and Families Act 2014. It also lists the range of organisations who are responsible for the development and delivery of local pathways. It is one of a set of three resources commissioned by the NHS England Transforming Care Programme help Transforming Care partnerships, local authorities and CCGs to work together with local families.
(Edited publisher abstract)
Building the Right Support (NHS England et al., 2015) sets out a national plan to develop community services and close inpatient facilities for people with a learning disability and/or autism who display behaviour that challenges. This plan covers children and young people, and includes a new service model of local support arrangements to prevent admission. This explanatory note explains why local pathways are needed to improve outcomes for children and families, target public funding more effectively, and fulfil the duties under the Children and Families Act 2014. It also lists the range of organisations who are responsible for the development and delivery of local pathways. It is one of a set of three resources commissioned by the NHS England Transforming Care Programme help Transforming Care partnerships, local authorities and CCGs to work together with local families.
(Edited publisher abstract)
British Journal of Learning Disabilities, 44 (4), 2016, pp.322-328.
Publisher:
Wiley
Background: This study investigated whether care staff's causal attributions and emotional reactions to the challenging behaviour displayed by service users were influenced by the service user's diagnostic label.
Materials and Method: One hundred and twenty care staff were randomly allocated to one of three conditions. Participants viewed a video of a senior staff member describing a service user, varying only in diagnostic label (autism, learning disability or Down syndrome). Participants then rated their endorsement of possible causes and emotional reactions to challenging behaviour.
Results: Participants in the autism and Down syndrome groups made more use of biomedical causes and less use of learned behaviour as an explanation for challenging behaviour than those in the learning disabilities group. Those in the former groups reported more positive and fewer negative emotions than those in the learning disabilities group.
Conclusions: The way staff viewed people with learning disabilities was affected by their diagnostic label. Implications for further research and training have been discussed.
(Edited publisher abstract)
Background: This study investigated whether care staff's causal attributions and emotional reactions to the challenging behaviour displayed by service users were influenced by the service user's diagnostic label.
Materials and Method: One hundred and twenty care staff were randomly allocated to one of three conditions. Participants viewed a video of a senior staff member describing a service user, varying only in diagnostic label (autism, learning disability or Down syndrome). Participants then rated their endorsement of possible causes and emotional reactions to challenging behaviour.
Results: Participants in the autism and Down syndrome groups made more use of biomedical causes and less use of learned behaviour as an explanation for challenging behaviour than those in the learning disabilities group. Those in the former groups reported more positive and fewer negative emotions than those in the learning disabilities group.
Conclusions: The way staff viewed people with learning disabilities was affected by their diagnostic label. Implications for further research and training have been discussed.
(Edited publisher abstract)
MENCAP, CHALLENGING BEHAVIOUR FOUNDATION, NATIONAL AUTISTIC SOCIETY
Publisher:
Mencap
Publication year:
2016
Pagination:
12
Place of publication:
London
Guide to help local groups and individuals campaign for change to enable people with a learning disability, autism and/or challenging behaviour to move from inpatient units into the community. The guide highlights NHS England's promise in 'Building the Right Support' to close 35-50 per cent of inpatient beds and develop the right support in the communities by March 2019. It sets out the scale of the challenge and outlines the role of the 48 Transforming Care Partnerships, set up to implement NHS England's plans. The guide then provides advice on how campaigning groups and individuals can contact local Transforming Care Partnerships to find out more about their plans and find out what is being done to develop the right support. It includes a template letter to help contact local Partnerships; a checklist of key principles that should be included in Transforming Care Partnership plans; and a list organisations that can provide further support.
(Edited publisher abstract)
Guide to help local groups and individuals campaign for change to enable people with a learning disability, autism and/or challenging behaviour to move from inpatient units into the community. The guide highlights NHS England's promise in 'Building the Right Support' to close 35-50 per cent of inpatient beds and develop the right support in the communities by March 2019. It sets out the scale of the challenge and outlines the role of the 48 Transforming Care Partnerships, set up to implement NHS England's plans. The guide then provides advice on how campaigning groups and individuals can contact local Transforming Care Partnerships to find out more about their plans and find out what is being done to develop the right support. It includes a template letter to help contact local Partnerships; a checklist of key principles that should be included in Transforming Care Partnership plans; and a list organisations that can provide further support.
(Edited publisher abstract)
Subject terms:
learning disabilities, hospital discharge, challenging behaviour, autistic spectrum conditions, community care, policy implementation, interest groups;