DEFINING CHALLENGING BEHAVIOR

Prior to discussing any issues pertaining to challenging behavior, it is essential to refer to definitions of challenging behavior, in order to establish a framework to help carers who assist adults with challenging behavior, and to identify those who are labelled as having ‘challenging’ behaviors.

Challenging behavior, by definition, presents carers with difficult emotional and professional challenges. The term ‘challenging behavior’ has been defined as:

‘. . . culturally abnormal behavior(s) of such an intensity or duration that the physical safety of the person or others is likely to be placed in serious jeopardy, or behavior which is likely to seriously limit use of or result in the person being denied access to ordinary community facilities.’

(Emerson et al. 1988)

The Department of Health (1993) pointed out that any successful interventions rely on staff/carers having a broad knowledge base in relation to safe reactive strategies, psychological and behavioral approaches and long-term skills-teaching strategies. Skills and knowledge linked with behavior are central in managing challenging behavior and have been shown to be effecive (Lindsay 2001). It is useful to have an overview of a range of definitions; these are presented in Table 1.

Many carers refer to challenging behavior as a specific behavior or a group of behaviors which involve significant risks to people’s physical well-being, or which act to reduce access to community settings, or result in being denied access to ordinary community facilities. These may include, for example, exhibiting physical and verbal aggression and perhaps minor self-injury and stereotyping behaviors which may lead to significant levels of avoidance by members of the public. It should be noted that challenging behavior is not synonymous with mental health or psychiatric disorder, but appears to be a functional adaptive response to particular environments, people and objects, for example, rather than the manifestation of any underlying psychiatric pathological impairment. As Blunden and Allen (1987) point out, the term ‘challenging behavior’:

‘. . . emphasizes that such behavior represents challenges to services rather than problems with individuals with intellectual disabilities in some way carry around with them.’

(Blunden & Allen 1987, p. 14)

Many people are unaware of the implications of definition and therefore the label challenging behavior is often misused or misinterpreted. As Gates (1997) stated, it may well be that the term is used as a euphemism for, or an attempt to sanitize, what some regard as unacceptable behavior, implying that the ownership of such behavior therefore must reside with the individual displaying it.

In many senses, it is preferable to think about people’s behaviors in terms of the thoughts and feelings which generate them. However, ‘challenging behavior’ is the popular, universal term currently in use.

To construe a situation as a challenge rather than a problem encourages more constructive responses, although it would, of course, be mistaken to believe that minor changes in terminology are capable of bringing about major changes in practice.

The spectrum of challenging behavior as adapted from Nihira et al. (1993) is a portrayal of negative behaviors which often are used as definitions, such as:

• violence

• rebelliousness

• destructiveness

• stereotypical behavior

• unacceptable eccentric habits

• hyperactivity

• non-socially accepted behavior

• peculiar mannerisms and mimicries

• SIB (self-injurious behavior)

• untrustworthiness

• emotional/psychological disturbances.

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مواضيع ذات صلة

NATIONAL PATIENT SAFETY AGENCY

HEALTH IMPROVEMENT CLINICS

HEALTH FACILITATION

HEALTH SCREENING FOR PEOPLE WHO HAVE LEARNING DISABILITIES

HEALTH PROMOTION APPROACHES

ATTITUDINAL BARRIERS

BARRIERS TO ACCESSING HEALTH CARE

Health Promotion Perspectives for Adults with Learning Disabilities

Epilepsy and Adults with Learning Disabilities CONCLUSION

CARE OF THE PERSON WITH EPILEPSY

MONITORING EPILEPSY IN ADULTS WITH LEARNING DISABILITIES

WOMEN AND AEDS