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Challenging behaviours in adults with an intellectual disability: a total population study and exploration of risk indices
- Authors:
- BOWRING Darren L., TOTSIKA Vasiliki, HASTINGS Richard P.
- Journal article citation:
- British Journal of Clinical Psychology, 56(1), 2017, pp.16-32.
- Publisher:
- Wiley
Objectives: Considerable variation has been reported in the prevalence and correlates of challenging behaviour (CB) in adults with intellectual disabilities (ID). To provide a robust estimate of prevalence, we identified the entire administrative population of adults with ID in a defined geographical area and used a behaviour assessment tool with good psychometric properties. Methods: Data from 265 adults who were known to services were collected using a demographic survey tool and the Behavior Problems Inventory – Short Form. The prevalence of self-injurious, aggressive/destructive, stereotyped, and overall CB was evaluated. We explored the potential of developing cumulative risk indices (CRI) to inform longitudinal research and clinical practice. Results: The prevalence of overall CB was 18.1%. The prevalence of self-injurious behaviour was 7.5%, aggressive–destructive behaviour 8.3%, and stereotyped behaviour 10.9%. Communication problems and severity of ID were consistently associated with higher risk of CBs. CRIs were significantly associated with CBs, and the five methods of CRI development produced similar results. Conclusions: Findings suggest a multi-element response to CB is likely to be required that includes interventions for communication and daytime activity. Exploratory analyses of CRIs suggested these show promise as simple ways to capture cumulative risk in this population. Subject to longitudinal replication, such a tool may be especially useful in clinical practice to identify adults who are priority for interventions and predict future demand on services. (Edited publisher abstract)
Staff reactions to self-injurious behaviours in learning disability services: attributions, emotional responses and helping
- Authors:
- JONES Cheryl, HASTINGS Richard P.
- Journal article citation:
- British Journal of Clinical Psychology, 42(2), June 2003, pp.189-203.
- Publisher:
- Wiley
This study explores an amended version of Weiner's helping behaviour model potentially more specific to the context of care staff working with people with learning disabilities and challenging behaviours. Key elements of the helping model (causal attributions, affective responses and helping behaviour) were assessed using self-report questionnaires. Helping behaviour was conceptualised as behaviour likely to reinforce challenging behaviour rather than as willingness to expend extra effort helping. 123 care staff in adult services viewed one of two videos depicting a person with learning disabilities engaging in self-injurious behaviour. Staff completed self-report scales after viewing the video material. Results found little evidence for the predicted associations between causal attributions and both positive and negative afffect. The study found no evidence that Weiner's model could be amended to account for staff working with challenging behaviour. Discusses the potential utility of alternative models in addition to methodological and conceptual issues.