Meaning of Challenging Behaviour
Behaviour that challenges covers various behaviours considered challenging or could put the individual, or others, at risk.
People with Autism and other learning disabilities are often deemed to behave in a challenging way. While these behavioural differences pose a challenge to family members and carers, they may be functional to people with disabilities themselves.
In most cases, exhibiting behaviours that challenge is directly linked to the environment or a need. For example, children and adults with learning disabilities may show behaviours of distress in crowded, excessively noisy, or unpredictable spaces with a lack of choice in terms of social interaction.
Every behaviour that challenges serves a certain purpose for the person, such as seeking assistance or creating sensory stimulation.
Children, young people, and adults with learning disabilities engage in challenging behaviour due to various factors affecting their mental health and overall well-being. Challenging behaviour is not a personal failure but a consequence of stress, fear, frustration, and social barriers imposed on people with learning disabilities.
What causes challenging behaviour
There are a variety of reasons why some people exhibit challenging behaviour. Often these individuals demonstrate a lack of ability to communicate in neurotypical ways. This makes them prone to frustration, and their inability to express themselves effectively, can leave them with feelings of inadequacy as well as feeling estranged from society. It can also promote a deterioration in well-being when such symptoms escalate.
Challenging Behaviour in Health and Social Care
Behaviour that challenges may include outbursts of aggression towards educators or carers, attempts at self-harm and intense fear or paranoia. Therefore, challenging behaviour can disrupt the education or treatment process, endangering the person’s access to care and social integration.
Trained carers can observe certain attitudes and identify signs of behaviour that challenges. Care professionals should be able to provide a safe and comfortable environment for individuals with learning disabilities where they can work on the way they interact with others. This way, people prone to behaviours of distress can perform routine activities without any disturbances and reach full integration into the particular environment.
Identifying the early warning signs is a crucial part of helping people with a learning disability in cases of behaviour that challenges. Without a suitable intervention after its initial signs, challenging behaviour may escalate into intense behavioural outbursts, leading to physical injuries. Once carers identify the initial signs of challenging behaviour, they should outline adequate strategies for dealing with the situation.
Our Impact - The Story of P.
With the right support and care, every individual can rise above their challenges and thrive. That is why we know how essential it is to share P.’s journey, which is one of the individuals we support at Leaf Complex Care.
Besides living with autism and a learning disability, additionally, P. developed a behaviour that challenges due to deterioration in P.’s overall well-being resulting from years of inconsistent and inadequate care. When our support workers started working with P., they brought a humanised approach, consistent and understanding support that made a positive impact.
Read the entire story of P. that created a world where every individual living with behaviour that challenges have the opportunity to become more independent and live a life filled with joy and fulfilment.
Challenging Behaviour Types and Examples
Challenging behaviour represents a wide range of actions that may put the individual exhibiting them and the people around them at risk. This includes the risk of physical injuries or possible exclusion from several spheres of life, such as school, the workplace, or relationships.
Behaviour that challenges can be understood better by dividing it into three main types: verbal, non-verbal, and physical.
Verbal Challenging Behaviour
Verbal challenging behaviours refer to language considered unacceptable and offensive within most areas of society. This may include:
Furthermore, people with a learning disability might repeat certain words, shout, or scream while in distress.
Non-Verbal Challenging Behaviour
Non-verbal challenging behaviour involves various non-verbal actions that are frowned upon within society and deemed inappropriate or offensive. For example, the individual may engage in the following forms of behaviour:
Physical Challenging Behaviour
Physical challenging behaviour covers outbursts of physical aggression in individuals with Autism and other learning disabilities. It can be self-harm, directly aggressive, or non-person directed.
Physical challenging behaviour may involve:
What Causes Challenging Behaviour?
Care providers should be aware that individuals with learning disabilities and other health problems exhibit challenging behaviour due to distress and the inability to communicate certain thoughts.
Behaviour that challenges are a sign that the person struggles to express their needs, desires, fears, and boundaries in a conventional way.
Challenging behaviour can occur in situations when the person:
Compassionate, person-centred support can help each individual with a learning disability or health problem through situations of distress and reduce the need for challenging behaviour.
Acknowledging that these behaviours are not the person’s fault and identifying the cause of distress is vital to delivering humanised care for people with learning disabilities.
Functions of Challenging Behaviour
Every instance of challenging behaviour has a specific function for the individual with a learning disability. Behaviour that challenges are a sign that some of the person’s needs are left unmet, and they struggle to express this in a typical way.
Understanding these functions is the first step towards providing Positive Behaviour Support for the person. Below are listed the most common functions of challenging behaviour.
People with neurodevelopmental differences may exhibit behaviour that challenges due to boredom or lack of control over the situation.
An individual with Autism or another disability can behave in a challenging way to get noticed, gain attention from those around them, and achieve social interaction.
A child or an adult with a learning disability can find it hard to label their emotions and articulate them in ways that are commonly expected and acceptable within society.
Challenging behaviour is a way to communicate frustration, fear, anger, sadness, surprise, or enjoyment.
If a person with a learning disability is stuck in a task or situation that brings them distress, they may engage in challenging behaviour to escape it.
This often involves sensory overload from high-pitched noises, bright lighting, or specific textures that trigger the individual.
Feeling Unwell/In pain
Challenging behaviour can also serve as the individual’s way of alarming those around them that they need medical attention for a certain type of pain.
Children and adults on the autism spectrum may express discomfort through irritability, low mood, appetite changes, reduced activity, and aggression.
What Is the Cycle of Challenging Behaviour?
Getting familiar with the main stages of challenging behaviour will prepare you to intervene, de-escalate the behaviour, and decrease the possibility of it happening again.
Each stage requires specific action from family members, carers, or teachers. Below are listed and explained the phases of challenging behaviour in order.
The challenging behaviour cycle is initiated by a particular experience or event that arouses discomfort or anger in the individual, i.e. a trigger.
Some triggers may be sudden and come as a single word, action, or a specific noise. Others are slow-burning and can disturb the individual’s peace over a more extended period of time, such as lack of sleep, lack of attention, or over-instruction.
Without suitable intervention right after the trigger, the individual’s behaviour will enter the second stage and reach a point of escalation.
In this stage, a person with Autism or another learning disability may show obvious signs of irritation and hostility, such as clenching their fists, muttering, and grumbling.
As the individual’s level of agitation rises, they may leave their seat, start arguing, or refuse to respond to those around them. This is the point where carers should employ their intervention strategies.
When the person reaches the crisis stage of challenging behaviour, they enter a fight-or-flight state. In this phase, individuals with learning disabilities lose the ability to reason and may pose a risk to themselves and those around them.
For instance, the person may exhibit verbally disruptive and aggressive behaviour, including insults, swear words, and threats. In some cases, the crisis stage could even include physical aggression towards other people or damage to property.
In the final stage of the challenging behaviour cycle, the situation has de-escalated, and the individual slowly begins to calm down. As they return from the crisis state to normal functioning, they may show remorse for their actions, start crying or fall asleep.
To support a client with a learning disability through a recovery period, caregivers should provide a comfortable space, play soothing music, or engage them in special interests.
ABC Charts for Challenging Behaviour
ABC charts for behaviours that challenge can help caregivers understand factors that cause challenging behaviour and what effectively work to de-escalate that behaviour. This model educates family members, teachers, and carers to identify the causes of challenging behaviour, create strategies to prevent or reduce it, and encourage positive behaviour instead.
The ABC approach breaks down challenging behaviour into three main elements: antecedents, behaviour, and consequences.
Perceiving behaviours of distress in this framework helps parents and teachers understand why a child may behave in a challenging way. Therefore, ABC charts allow caregivers to prevent challenging behaviour and develop meaningful methods of accommodating people with neurodevelopmental differences.
Antecedents are any actions that occur immediately before the behaviour that challenges.
Common examples of antecedents include:
Identifying the antecedent that results in challenging behaviour is the first step towards creating a comfortable environment for your loved one with a learning disability.
Challenging behaviour is any action that could harm the individual, or family members, friends, and care providers.
Children, young people, and adults with learning disabilities may behave in a challenging way because they struggle to communicate their needs or emotions in a conventional manner. These behaviours may involve verbal outbursts, physical aggression, or non-person-directed behaviour.
Consequences are defined as actions or events that happen immediately after the behaviour that challenges. This category includes carers giving attention, removing certain demands or activities, or giving access to wanted objects in response to challenging behaviour.
While antecedents turn on challenging behaviours, consequences aim to turn them off.
Preventing and Management of Challenging Behaviour
There are several actions that care providers should consider in the prevention and management of challenging behaviour.
First, carers need to identify any material conditions that trigger the individual and remove these triggers from their surroundings. For instance, care professionals can offer a comfortable environment to a child or adult with Autism by eliminating potential causes of sensory overstimulation, such as bright lights, loud noises, intense smells or tastes, and particular textures.
If recognising and removing triggers isn’t possible in the specific context, the carer must develop strategies for defusing the situation. They should identify early symptoms and alleviate the person’s distress before they enter the crisis stage. Caring for a child or adult prone to challenging behaviour requires patience and readiness to explain stressful situations calmly and clearly, leaving them time to process information.
Quality long-term care for a person with a learning disability includes encouraging alternative communication skills. The positive behaviour support model helps care providers teach the people they serve new ways to express their needs and emotions.
This humanised approach seeks to reduce challenging behaviour by improving the individual’s quality of life rather than trying to “fix” them.
Implementing PBS Approach in Challenging Behaviour Management
Positive Behaviour Support (PBS) is a comprehensive, person-centred approach to providing care for individuals who exhibit behaviours of distress. PBS is beneficial for children, young people, and adults with Autism and other learning disabilities.
Unlike traditional care methods, Positive Behaviour Support aims to accommodate these individuals rather than trying to “fix” them. This approach reduces the probability of challenging behaviour by tackling its causes, removing triggers, and encouraging the person to learn new behaviours.
The main goal of Positive Behaviour Support is to improve the individual’s quality of life and remove any factors that put them in distress and result in challenging behaviour. A person with Autism or another learning disability is likely to receive PBS from more than one professional, service, or support group. Families, care professionals, and service providers play specific roles and must collaborate to support the individual.
An elaborate Positive Behaviour Support plan is the first step towards providing personalised, compassionate support for a loved one with neurodevelopmental differences. As a caregiver, you can initially focus on one area of PBS and then select additional ones to work on. Positive behaviour support plans usually include the following factors:
Steady routine and structure – a visual timeline can help the individual grasp the social circumstances around them, making them feel safe and in control of the situation
Quality of life – making sure that the person has access to interactions that improve their confidence and mental health, such as engagement in local community activities, hanging out with peers, playing games, and staying physically active
Accommodation of demands – ensuring that the child or adult receives tasks that suit their individual skills, avoiding stress due to under-stimulation or overstimulation by particular activities
Alternative means of communication – introducing pictures, signs, and symbols as tools for the individual to express their needs and feelings to those around them
Comfortable environment – paying attention to lights, noise levels, sounds, smells, textures, and other factors that may cause sensory overstimulation in children and adults with learning disabilities
Overall health state – checking in on the individual regularly to make sure all their medical needs are met and they don’t struggle with pain, discomfort, lack of sleep, or any other health problems
Will was diagnosed with Down Syndrome at birth, and his story outlines the importance of having consistent, dedicated support from a committed care provider.
After going through multiple care providers that didn’t satisfy Will’s needs and his mom Maurizia going through a health scare, Leaf Complex Care was asked to support Will. The support workers at Leaf Complex Care created a Positive Behaviour Support plan outlining expectations and ensuring that care is continuous and consistent.
“For me personally, their support has given me a new lease of life. Incidents have become less frequent and less intense.” – Maurizia, Will’s mom.
How Leaf Complex Care Can Help?
At Leaf Complex Care, our mission is to provide expert support for children, young people, and adults with neurodevelopmental differences in their most delicate moments.
Our trained support workers recognise the complexity of challenging behaviour and adopt humanised, person-centred strategies to support individuals. Our heart-driven teams focus on addressing the causes and functions of challenging behaviour rather than “fixing” the individual.
If you or a loved one needs support for challenging behaviour, Leaf Complex Care is the right choice for you.
We provide tailored support for people with complex needs across the UK, and you can find our offices in Bristol, Exeter, Slough, Somerset and the Midlands. Contact us, and we will outline a personalised care plan catering to your needs.