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Multi-element behaviour support as a model for the delivery of a human rights based approach for working with people with intellectual disabilities and behaviours that challenge
- Author:
- DOODY Christina
- Journal article citation:
- British Journal of Learning Disabilities, 37(4), December 2009, pp.293-299.
- Publisher:
- Wiley
This paper, using the story of Mary, a 40 year old woman with moderate intellectual disabilities who is nonverbal and exhibits poor comprehension skills, demonstrates the effectiveness of the multi-element behaviour support (MEBS) model in meeting the rights of people with intellectual disabilities and behaviours that challenge. By explicitly linking the multi-element model to the guiding principles of a human rights based approach, these guiding principles are: rights; participation; empowerment; non-discrimination; and accountability. The background and functional assessment phase of the MEBS process enables the identification of rights infringements while the MEBS plan addresses those rights. The accountability tool in the MEBS model, the periodic service review, is then used as a measure of implementation of the MEBS plan and, as a result, the enabling of those rights. Implications in relation to the rights of those supporting persons in receipt of MEBS and those living with the person receiving MEBS are highlighted.
Defining 'sexualized challenging behavior' in adults with intellectual disabilities
- Authors:
- LOCKHART Karen, et al
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 6(4), December 2009, pp.293-301.
- Publisher:
- Wiley
Given their connotations of criminal intent or insight, the terms "sexual offending" and "abuse" are problematic in their applicability to people with learning disabilities. The authors propose adopting the term "sexualised challenging behaviour" and define it by using empirical methods. Using a qualitative methodology, they examined a six-month sample of service-based documentation reporting problem sexual behaviours. They also conducted semi-structured interviews with a staff-based sample and explored their views in relation to sexual behaviour. Common themes emerged across both documentation and staff interviews regarding the nature and characteristics of such behaviours. Their proposed definition encompasses a continuum of self- and other-directed behaviours related to touch, exposure, and communication, which they view as distinct from sexual offending. The findings further suggest that sexualised challenging behaviours have distinct characteristics that differentiate them from nonsexualised challenging behaviours. The authors conclude that sexualised challenging behaviours can be defined as a distinct class of behaviours that require further study among a broader cohort of adults with learning disabilities.
Understanding challenging behaviour: perspectives of children and adolescents with a moderate intellectual disability
- Authors:
- BYRNE Alison, HENNESSY Eilis
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 22(4), July 2009, pp.317-325.
- Publisher:
- Wiley
The present study examines understanding of challenging behaviour among a sample of children and adolescents with a moderate intellectual disability, and investigates their behavioural intentions towards peers with challenging behaviour. The study involved the collection of quantitative and qualitative data. In the quantitative part of the study participants (n = 39) completed a modified Friendship Activity Scale (FAS) following the presentation of vignettes depicting individuals with challenging and non-challenging behaviour. In the qualitative part of the study, participants (n = 31) took part in a semi-structured interview that sought their views on the causes of the challenging behaviour described in one of the vignettes. Analysis of the data from the FAS indicates that participants have significantly more positive intentions towards a vignette character that does not engage in challenging behaviour. Content analysis of the qualitative data indicates that participants hold a variety of beliefs about the causes of challenging behaviour. Suggestions include the possibility that it is a response to transient emotional states and to external events. The authors conclude that the findings are consistent with the findings of other studies on young people's understanding of and attitudes towards peers with atypical behaviour. The theoretical and clinical implications for young people with intellectual disabilities are discussed.
Impact of a 3-day training course on challenging behaviour on staff cognitive and emotional responses
- Authors:
- TIERNEY Edel, QUINLAND Dave, HASTINGS Richard P.
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 20(1), January 2007, pp.58-63.
- Publisher:
- Wiley
A range of factors have been suggested as determinants of staff behaviour in the context of working with people with challenging behaviour. The purpose of this study was to evaluate whether a typical challenging behaviour staff training course had an effect on staff feelings of efficacy, their negative emotional reactions to challenging behaviour, and their causal beliefs. Forty-eight staff from intellectual disability organisations in the Health Service Executive Southern Region in Ireland attending a 3-day training course on understanding challenging behaviour and managing stress were assessed pre-training and at a 3-month follow-up. Questionnaires assessing self-efficacy, emotional reactions and causal beliefs were used. Perceived self-efficacy in dealing with challenging behaviours increased significantly from pre- to post-training. There were no significant changes in either emotional reactions to challenging behaviours or causal beliefs. In common with previous research, there was a sizeable impact on staff confidence and efficacy after a 3-day training course. Given the potential significance of emotional reactions both in terms of staff behaviour and their psychological well-being at work, more research is needed to explore how these reactions might best be dealt with in staff training interventions.
Coping and positive perceptions in Irish mothers of children with intellectual disabilities
- Authors:
- GREER Felicity A., GREY Ian M., MCCLEAN Brian
- Journal article citation:
- Journal of Intellectual Disabilities, 10(3), September 2006, pp.231-248.
- Publisher:
- Sage
- Place of publication:
- London
Thirty-six mothers of children aged between 5 and 8 years with intellectual disabilities completed five self-report questionnaires measuring variables related to behavioural and emotional difficulties, levels of care demand, family supports, coping and positive perceptions. The relationships among these variables were investigated using a working model proposed by Hastings and Taunt (2002). Child behavioural and emotional problems in the non-clinical range predicted low levels of care demand. Formal social support was an effective form of support for mothers; helpfulness of formal social support predicted mobilizing the family to acquire and accept help in the community; and mobilizing the family predicted levels of strength and family closeness. The majority of respondents rated agreement with statements that their child was: a source of happiness or fulfilment; a source of strength and family closeness; and a source of personal growth and maturity. The theoretical and clinical implications of these results are discussed.
Impact of challenging behaviour on siblings of people with autism
- Authors:
- YACOUB Evan, et al
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 12(5-6), 2018, pp.145-152.
- Publisher:
- Emerald
Purpose: Despite being largely supportive of their sibling with an autism spectrum disorder (ASD), some siblings without ASD also feel the effects of the disorder particularly in relation to challenging behaviour and lack of empathy. The purpose of this paper is to explore the experiences adults who have a sibling with ASD and intellectual disability (ID) with challenging behaviour. Design/methodology/approach: Interviews were conducted with 11 capacitous adult siblings of service users who have ASD and ID as well as a history of challenging behaviour. A modified version of the autism Parenting Stress Index was used to assess the impact on those siblings. thematic analysis was utilised to analyse their responses. Findings: Four main themes emerged from the interviews, which highlighted that challenging behaviour can cause emotional losses and can impact upbringing and the sibling relationship. Despite the siblings making adjustments, they continue to have concerns for the future. Originality/value: Chronic challenging behaviour can impact on siblings, and it is important to support entire families, and not exclusively parents. (Edited publisher abstract)
Positive behaviour support: what model of disability does it represent?
- Authors:
- GREY Ian, LYDON Helena, HEALY Olive
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 41(3), 2016, pp.255-266.
- Publisher:
- Taylor and Francis
Positive behaviour support (PBS) has become well established as an intervention approach for individuals with intellectual disability and challenging behaviour. However, what remains unexplored is the relationship between PBS and the medical and social models of disability, which historically are the dominant conceptual frameworks put forward in understanding disability. This paper identifies the difficulties in exploring this relationship due to the often simplistic portrayals of such models. Though PBS has a change agenda, typically a characteristic of the medical model, it is change at an ecological level that is central to PBS. An analysis of the practices of PBS demonstrates a concern with pragmatically identifying the interaction between person and environment to reduce the occurrence of challenging behaviour. PBS practices are considered to be more aligned with a supports model because they build an individual ecology of support tied to meaningful quality of life outcomes for individuals with challenging behaviour. (Publisher abstract)
Identifying the prevalence of aggressive behaviour reported by Registered Intellectual Disability Nurses in residential intellectual disability services: an Irish perspective
- Authors:
- CROTTY Gerard, DOODY Owen, LYONS R.
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 8(3), 2014, pp.174-187.
- Publisher:
- Emerald
Purpose: Despite the high incidence of aggressive behaviours among some individuals with intellectual disability, Ireland has paid little attention to the prevalence of aggressive behaviours experienced by Registered Intellectual Disability Nurses (RNID). Within services the focus is mainly on intervention and management of such behaviours. Therefore a disparity occurs in that these interventions and management strategies have become the exclusive concern. Resulting in aggressive behaviour being seen as a sole entity, where similar interventions and management strategies are used for ambiguously contrasting aggressive behaviours. Consequently the ability to document and assess-specific behaviour typologies and their prevalence is fundamental not only to understand these behaviour types but also to orient and educate RNIDs in specific behaviour programme development. The paper aims to discuss these issues. Design/methodology/approach: This study reports on a survey of the prevalence of verbal aggression, aggression against property and aggression against others experienced by RNIDs’ within four residential settings across two health service executive regions in Ireland. A purposeful non-random convenience sampling method was employed. Totally, 119 RNIDs responded to the survey which was an adaptation of Crocker et al. (2006) survey instrument Modified Overt Aggression Scale. Findings: The findings of this study showed the experienced prevalence rate of verbal aggression, aggression against property and aggression against others were 64, 48.9 and 50.7 per cent, respectively. Cross-tabulation of specific correlates identifies those with a mild and intellectual disability as displaying a greater prevalence of verbal aggression and aggression against property. While those with a moderate intellectual disability displayed a higher prevalence of aggression against others. Males were reported as more aggressive across all three typologies studied and those aged between 20 and 39 recorded the highest prevalence of aggression across all three typologies. The practice classification areas of challenging behaviour and low support reported the highest prevalence of aggression within all typologies. Originality/value: The health care of the person with intellectual disability and aggressive behaviour presents an enormous challenge for services. In-order to improve considerably the quality of life for clients, services need to take a careful considered pragmatic view of the issues for the person with intellectual disability and aggressive behaviour and develop realistic, proactive and responsive strategies. To do this, precise knowledge of the prevalence of aggressive behaviours needs to be obtained. This study is the first of its kind in the Republic of Ireland. (Publisher abstract)
A model for training staff in positive behaviour support
- Author:
- DENCH Caroline
- Journal article citation:
- Tizard Learning Disability Review, 10(2), April 2005, pp.24-30.
- Publisher:
- Emerald
Although front-line staff are the key agents in delivering positive behavioural competencies, their skills are not very well developed. This article describes a training model that demonstrates effective outcomes for service users, participating staff and the host organisations. Outlines critical elements of the training and describes the principle outcomes.