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The efficacy of positive behavioural support with the most challenging behaviour: the evidence and its implications
- Authors:
- LAVIGNA Gary W., WILLIS Thomas J.
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 37(3), September 2012, pp.185-195.
- Publisher:
- Taylor and Francis
Positive behaviour support (PBS) is behaviour analysis applied in support of people with challenging behaviour. However, questions have been raised as to PBS effectiveness, costs, and accessibility. This review examined the efficacy of 12 outcome studies encompassing 423 cases. Findings indicated that PBS was effective with both severe and high-rate behaviour problems, was cost-effective, used a methodology that was easily trained and widely disseminated, and worked in institutional settings in which the most difficult problems are thought to be, as well as in the community. The major implication of this review is that practitioners may be obligated to use PBS when faced with the need to develop a plan of support given the ethical principle of using the least restrictive method consistent with the right to effective treatment. Implications for practice are discussed.
Challenging behaviour and associated risk factors: an overview (part I)
- Authors:
- KORITSAS Stella, IACONO Teresa
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 6(4), 2012, pp.199-214.
- Publisher:
- Emerald
This review, the first in a two-part series, explores challenging behaviour in adults, its prevalence, risk factors and causes. It aims to provide an overview of prevalence studies and explore the various risk factors that have been associated with challenging behaviour. The authors also seek to explore methodological differences across studies that may contribute to the prevalence variations reported in the literature. The article summarises the findings from frequently cited prevalence studies as well as more recent studies. The prevalence of challenging behaviour reported in the literature has varied due to methodological differences across studies. Despite this, the best estimate is believed to be from 15 to 17.5 per cent. A range of factors have been associated with challenging behaviour and include gender, age, severity of disability and residential setting.
A systematic review of quality of life measures for people with intellectual disabilities and challenging behaviours
- Authors:
- TOWNSEND-WHITE C., PHAM A.N.T., VASSOS M.V.
- Journal article citation:
- Journal of Intellectual Disability Research, 56(3), March 2012, pp.270-284.
- Publisher:
- Wiley
Six of the twenty-four quality of life instruments identified, were considered to be psychometrically sound and were assessed against 24 criteria developed from the consumer outcome measurement literature. None of the instruments were specifically developed for use with people with intellectual disability. One scale, the Multifaceted Lifestyle Satisfaction Scale, performed well in most respects but suffered from a lack of replication; a criticism applied to all of the instruments studied in detail. The need for further development and validation of quality of life measures for use with people who display challenging behaviour, or have intellectual disabilities, is emphasised.
Social inclusion and people with intellectual disability and challenging behaviour: a systematic review
- Author:
- BIGBY Christine
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 37(4), December 2012, pp.360-374.
- Publisher:
- Taylor and Francis
Noting that the high risk of social exclusion for people with intellectual disability is compounded for those with challenging behaviour, this systematic literature review examined how social inclusion of people with intellectual disability and challenging behaviour has been researched and operationalised in the literature. It also aimed to explore the evidence about the extent of social inclusion of this group. 14 papers reporting community inclusion outcomes for people with challenging behaviour were identified through database searches, and thematic analysis was used to synthesise and interpret the findings. The article includes a table summarising the key features of the studies included in the review. It reports that the analysis found that social inclusion had been poorly defined and measured, and that the little research that had occurred in respect of people with challenging behaviour had demonstrated their potential to be socially included. The author discusses the implications of the findings, with particular reference to practice in Australia.
Promoting positive behaviour when supporting people with a learning disability and people with autism
- Author:
- PALLEY Sharon
- Publisher:
- British Institute of Learning Disabilities
- Publication year:
- 2012
- Pagination:
- 144p.
- Place of publication:
- Kidderminster
This book is primarily aimed at those working with people whose behaviour challenges services and who are studying for the level 2 or 3 diplomas in health and social care; in particular level 3- promoting positive behaviour. It puts the person at the centre of the support offered and uses real life stories, activities and thinking points to address the required learning outcomes. Practical examples offer guidance in applying the ideas in practice. The book explores how to promote positive behaviour and the use of proactive and reactive strategies. The author explains how to respond to incidents of challenging behaviour and support people following an incident. She also explains how to review and revise support plans and the legislative framework for providing support to people whose behaviour challenges services.
Who’s challenging who?
- Authors:
- DAVIES Rhodri, HUTCHINSON Lisa
- Journal article citation:
- Llais, 103, Summer 2012, pp.9-11.
- Publisher:
- Learning Disability Wales
This article describes the work of “Who’s challenging who?”, an 18-month knowledge transfer partnership between Mencap Cymru and Bangor University. It aims to improve challenging behaviour services for people with a learning disability by improving staff attitudes and increasing empathy. The work was done with Claire Bowler and Martin Banks, two people who have previously displayed challenging behaviour. Martin and Claire helped to co-author and deliver a series of pilot training sessions to social and healthcare staff across Wales. The staff gained a notable change in attitudes and more empathy towards people with challenging behaviour. Encouragingly, over 75% of people on the sessions said that they thought training in this area was a good use of their time, and the same number said that they would apply what they learned in their jobs.
Screening for psychiatric disorders in a total population of adults with intellectual disability and challenging behaviour using the PAS-ADD checklist
- Authors:
- ALLEN David, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 25(4), July 2012, pp.342-349.
- Publisher:
- Wiley
The nature of the relationship between psychiatric disorders and challenging behaviour in people with intellectual disabilities is the subject of debate; a picture that is confused by challenging behaviour itself sometimes being classified as a form of psychiatric disorder. The authors explore this relationship in a population sample of adults with challenging behaviour. More than 800 service settings in a defined geographical area in Wales were screened to identify individuals with challenging behaviour. Detailed behavioural data, Psychiatric Assessment Schedule for Adults with a Developmental Disability (PAS-ADD) checklist and Adaptive Behaviour Scale (Part 1) scores were collected for 76% of the 930 adults identified. Just under 17% of participants reached threshold scores on one on more subscales of the PAS-ADD checklist. There was some evidence of increasing behavioural severity being associated with increasing psychiatric symptoms but there were no associations between specific forms of challenging behaviour and individual symptoms. The authors conclude that these data support previous suggestions that it is unlikely that the majority of challenging behaviours in adults with intellectual disability are underpinned by psychiatric disorders.
Changes in attributions as a consequence of training for challenging and complex behaviour for carers of people with learning disabilities: a systematic review
- Authors:
- WILLIAMS Sophie, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 25(3), May 2012, pp.203-216.
- Publisher:
- Wiley
The overall aim of this paper was to critically review studies of staff training in challenging behaviour, which included the measurement of staff beliefs about challenging behaviour. It had three specific objectives: to review the main constructs and measures that were used to identify the theoretical assumptions that underpinned them; to discover whether carers’ beliefs were changed as a result of training; and to make suggestions on further work focusing on staff cognitive change in challenging behaviour training. Papers were included if they reported outcomes for carer training on the behaviour of people with intellectual disabilities and used a measure of carer attribution of the behaviour of people with intellectual disabilities. Eleven papers were reviewed, most studies using behavioural curricula for their training, and none explicitly set out to change attributions. Eight of the 11 papers reviewed reported changes in attribution although core characteristics of training did not distinguish those papers that reported such changes and those that did not. The authors conclude that changes in beliefs and attributions occur even though these are not identified as a focus within the training provided. They suggest that the formulation processes involved in behavioural training may play a key part in changing attributions as a consequence of this training.
The availability of normative data for the Developmental Behaviour Checklist for Adults
- Authors:
- MOHR Caroline, et al
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 37(1), March 2012, pp.61-64.
- Publisher:
- Taylor and Francis
The Developmental Behaviour Checklist (DBC) is a teacher and carer-completed screening checklist of emotional and behavioural disturbance which is available in several forms which cater for all age levels of people with intellectual disability and developmental disorders. An important component of checklist development is the provision of standardised normative data that can be used by clinicians, researchers, and service providers. The purpose of this article is to alert readers to the availability of new normative data for the adult version of the DBC (DBC-A). This data was obtained from the use of the DBC-A in a large-scale Australian study of emotional and behavioural disturbance. The population sample for this study comprised 1,538 adults aged 18 to 85 years of which 35.0% had mild intellectual disability, 29.5% had moderate intellectual disability, and 35.6% had severe intellectual disability. Normative data for the DBC-A is available for 3 age groups and 3 levels of intellectual disability. A condensed version of DBC-A normative data is presented in the article, and more detailed information can be obtained from the authors.
Carers' responses to challenging behaviour: a comparison of responses to named and unnamed vignettes
- Author:
- DAGNAN Dave
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 25(1), January 2012, pp.88-94.
- Publisher:
- Wiley
In this study, 62 paid carers working in homes for people with intellectual disabilities reported their responses to vignettes illustrating challenging behaviour presented by an unknown person and the same behaviour presented by a named and known person. Questionnaires were used to gather information about the care workers' attributions, emotional responses, intended behavioural responses and behavioural knowledge. This article describes the background to the study, the methodology and measures used, and the results of data analysis. The results suggested that in general carers make more internal and global attributions and identify themselves as less optimistic in response to vignettes relating to named and known people with intellectual disabilities than those relating to unnamed people. The author discusses how the findings may contribute to understanding carer interaction with people with intellectual disabilities.