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Journal article

Challenging behaviours: prevalence and topographies

Authors:
LOWE K., et al
Journal article citation:
Journal of Intellectual Disability Research, 51(8), August 2007, pp.625-636.
Publisher:
Wiley

Variations in reported prevalence of challenging behaviour indicate the need for further epidemiological research to support accurate planning of future service provision. All services providing for people with learning disabilities across seven unitary authorities, with a total population of 1.2 million, were screened to identify people with challenging behaviour. Interviews were conducted with primary carers to gain data on identified individuals' characteristics and support. Measures designed for a similar study conducted in Manchester University were incorporated to allow direct comparison with earlier findings, together with standardized tools to assess adaptive behaviour and social impairment. In total, 4.5 (2.5–7.5) people per 10,000 population were rated as seriously challenging, representing 10% (5.5–16.8%) of the learning disability population; the most prevalent general form was other difficult/disruptive behaviour, with non-compliance being the most prevalent topography. The majority showed multiple behaviours and multiple topographies within each general behaviour category. Also identified were substantial numbers of additional people reported as presenting challenging behaviours at lower degrees of severity. Prevalence rates for seriously challenging behaviours were comparable to those reported in the earlier studies, thus confirming previous findings. The prevalence of less serious challenging behaviour also has major clinical significance and emphasizes the need for enhanced understanding and skills among personnel within primary- and secondary-tier health, education and social care services, and for strengthening the capacity of community teams to provide behavioural expertise.

Journal article

Challenging behaviour: the prospect for change

Author:
MANSELL Jim
Journal article citation:
British Journal of Learning Disabilities, 22(1), 1994, pp.2-5.
Publisher:
Wiley-Blackwell

Considers the current situation for people with learning disabilities who also have challenging behaviour, and how that situation can be improved.

Journal article Full text available online for free

Research note: identifying individuals with learning disabilities whose behaviour challenges our services

Authors:
SPEAKE Brian, et al
Journal article citation:
Research Policy and Planning, 9(2), 1991, pp.27-30.
Publisher:
Social Services Research Group

Describes the collection of data on individuals relating to their functional abilities and challenging behaviour.

Journal article

The basic tenet

Author:
McGEE J.
Journal article citation:
Nursing Times, 8.8.90, 1990, pp.68-72.
Publisher:
Nursing Times

Argues that the essence of "gentle teaching" lies in inter-actions with people who exhibit challenging behaviours based on unconditional value giving.

Journal article

The emperor's new clothes?

Author:
TURNBULL J.
Journal article citation:
Nursing Times, 8.8.90, 1990, pp.64-65, 68.
Publisher:
Nursing Times

The author claims that "gentle teaching" for people with challenging behaviour is based on existing behaviour modification procedures.

BookDigital Media Full text available online for free

An introduction to residential child care: managing challenging behaviour

Authors:
SOCIAL CARE INSTITUTE FOR EXCELLENCE, STANLEY Jonathan, SAINSBURY Mary
Publisher:
Social Care Institute for Excellence
Publication year:
2008
Place of publication:
London

This e-learning resource explores how children communicate through their behaviour and covers techniques for managing challenging behaviour. It aims to improve understanding of: the notion of behaviour as communication; how to manage challenging behaviour in a planned way; key issues with regards conflict resolution, diverting and de-escalating challenging situations and restraint; tools and techniques for conflict resolution, diverting and de-escalating challenging situations and restraint; and the key stage of debriefing.

Journal article

Individualized formulation-led interventions for analyzing and managing challenging behavior of people with dementia: an integrative review

Authors:
HOLLE Daniela, et al
Journal article citation:
Aging and Mental Health, 21(12), 2017, pp.1229-1247.
Publisher:
Taylor and Francis

Objective: This review aims to describe and examine existing Individualised formulation-led interventions managing challenging behaviours in people with dementia and to review their evidence. Methods: PUBMED, PsycINFO [EBSCO] and CINAHL [EBSCO] databases were searched between February and April 2014 using key terms related to dementia, challenging behaviour and individualised formulation- led interventions. The literature search was limited to German and English publications published from 1995. No limitations were placed on the type of paper, type of study design and stage of disease or setting. 37 relevant papers that met the inclusion criteria were included in this review. Results: The literature review provided 14 different individualised formulation-led interventions. The effects on people with dementia were diverse, as only half of the studies showed a significant reduction in behaviours compared with the control group. Family caregivers felt less upset about the challenging behaviour and more confident in their ability to manage the behaviour. Conclusion: There is a clear need for further research on individualised formulation-led interventions. The results of this review have the potential for developing interventions and for designing methodological robust evaluation studies that take into account the effectiveness of individualised formulation-led interventions on patient and caregiver outcomes. (Edited publisher abstract)

Journal article

‘It’s a matter of your personality more than anything else’: the experiences of seasonal workers regarding challenging behaviour in children

Author:
ETHERIDGE Leanne
Journal article citation:
Journal of Intellectual Disabilities, 21(1), 2017, pp.40-52.
Publisher:
Sage
Place of publication:
London

The impact on full-time carers of children with intellectual disabilities who exhibit challenging behaviour has been well researched (e.g. Lach et al., 2009; Shah et al., 2010; Wodehouse and McGill, 2009), however, there is to date no published research into the impact of behaviour that challenges on seasonal carers. Five participants who had been employed in summer playschemes for children and young people (up to the age of 18) were interviewed about their experiences of behaviour that challenges. The transcripts were analysed using interpretative phenomenological analysis, which revealed six superordinate themes: the belief in and sanctuary of temporary work, emotional impact, personality and gender, strength through knowledge, communication difficulties and the belief in integration. Seasonal workers discussed suppressing their emotions in order to stay in control of a challenging situation, using coping styles developed through experience or based on personal skills; it is suggested that formalized training, particularly regarding non-verbal communication, would support playscheme workers in the management of and adaption to challenging behaviour. (Publisher abstract)

Journal article

Systematic review of restraint interventions for challenging behaviour among persons with intellectual disabilities: focus on experiences

Authors:
HEYVAERT Mieke, et al
Journal article citation:
Journal of Applied Research in Intellectual Disabilities, 28(2), 2015, pp.61-80.
Publisher:
Wiley-Blackwell

Background: The second in a two-part series, this article focuses on experiences with restraint intervention for challenging behaviour among people with intellectual disabilities. Methods: A mixed methods research synthesis involving statistical meta-analysis and qualitative meta-synthesis techniques was applied to synthesize 76 retrieved articles. This second article reports on the qualitative meta-synthesis of 17 articles on experiences with restraint intervention for challenging behaviour among people with intellectual disabilities. Results: The 17 included articles report on important variables relating to the persons receiving restraint intervention, to the persons giving restraint intervention and to their interactions and relationship, as well as variables situated at the meso- and macro-level. Conclusions: The developed model can assist in reflecting on and improving of current restraint intervention practices among people with intellectual disabilities. (Edited publisher abstract)

Journal article

Criterion-related validity of challenging behaviour scales: a review of evidence in the literature

Authors:
TURTON Raistrick W., et al
Journal article citation:
Journal of Applied Research in Intellectual Disabilities, 28(2), 2015, pp.81-98.
Publisher:
Wiley-Blackwell

Background: Behaviour that challenges has negative impacts on physical and emotional well-being and quality of life. Challenging behaviour scales are used to identify needs and evaluate interventions and must be valid measures. Criterion-related validity is important, and the best quality assessment uses direct measures of behaviour as criteria. Previous reviews of scales affirm their validity but present little supporting evidence. The current review examines the evidence presented in studies of validity. Methods: Searches of MEDLINE and PsycINFO to identify scales that focus on challenging behaviour and find publications that assess their criterion-related validity. Results: Searches identified twelve scales and 21 publications that assess validity. One assessment used direct measures of behaviour, and the remainder used indirect measures that themselves have limited evidence of validity, including membership of diagnostic or service groups and other scales. Conclusions: Little firm evidence of validity was found, but what was found is encouraging. (Publisher abstract)

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