This is Challenging Behaviour assignment, it is an essay and part of our essay assignment help.
The challenging behaviour is a tedious task to handle as it can interfere significantly with the quality of their life and the quality of the life of the other users of service and also those people who care for their life and live with them. At times individuals who have challenging behaviours are prescribed medication of high level so that their behaviour can be controlled. Even their families can find it difficult to deal with them so they make reach their breaking point and cane even demand for or file a request to have an alternative provision for residence. Those individuals who are falling in the criteria of challenging behaviours may also face additional needs for mental health that requires specialist intervention from the psychiatrists. These behaviours which are challenging cause an increase in the demand of the specialist types of services. The real challenge is to establish a service pattern so that it responds effectively to the demands of the individuals with the challenging behaviours (Emerson, 1995).
Challenging behaviour is a terms which is coined global and it is used to decipher the identify the severe problems of behaviour which may include the various types of behaviours, i.e. the physical type of aggression, destruction of property, and self-injurious type of behaviour. The term defined globally has caused many problems to the definition. The behaviour can be defined as the ones which is challenging in the particular kind of contexts. For instance, even we consider the case of physical ring then physical aggression is promoted but in the ring of the setting of the hospital it is not taken into consideration. There are different ideas quoted by different sets of people regarding the word challenging. Even cases of such identical behaviour are considered challenging by the staff of one type of setting but not in the other one. The interpretations of challenging differ and that causes a difference in the impact in the prevalence estimates majorly. It is found out that the rate of prevalence which is reported in the studies usually fall between the 8% & 38% of the population which is surveyed with the disabilities in learning (Chung 1996). The US and the UK studies of the rate of prevalence of the challenging behaviours (Quershi, 1994, Emerson, 2001 and Borthwick-Duffy, 1994), are the best ones available till date based on the estimated at the base level to the other populations. If we go through these studies then it becomes quite clear that tout of a total population of 100,000, there exists 24 and 63 individuals on an average who are disabled intellectually and who possess serious type of challenging behaviours.
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If we consider a lot of cases, then the multiplicity of the factors are considered important to understand the causes which are underlying in case of the challenging behaviours. If maximum times we see an individual who exhibit behaviour which is quite challenging then with the help of the external environment of the person it can be easily found out the reasons which are causing the difficulties for the person. Most often, if the environment is altered so that the needs of the person are met then it can alleviate the amount of distress caused and also the related types of behaviour which is maladaptive. The factors of the environment which are included are, (under- simulation) too less activities which are structured are in place or, (over-simulation) too much activity and noise; or even carers which employ the inconsistent approach to the users of the service. Read more : Psychoactive Drugs in clinical psychology: A perspective
Often it is found difficult for people with challenging behaviours to have the disabilities in the communication and they also find it difficult to articulate the needs and the wants. The individuals who face difficulty in expressing about them should be offered any type of tool so that the communication might get enabled. The illness which is mental and physical should be diagnosed in an accurate manner so that it can be treated and then ruled out. The physical types of factors can be defined as, stomach aches, constipation, problems of addiction; headaches etc. and they can lead to distress and discomfort on a physical basis. So it is quite evident that individuals can present with the challenging behaviour which may result in the distress and discomfort on a physical basis. For instance, if a person has a hearing impaired and has limited command on the verbal skills of communication may give the response by hitting the ear, so that he is able to communicate the pain he is bearing. If a person has the problem of disability intellectually and also illness of mental health then he may get confused, anxious and depressed and may also give the response by being aggressive verbally towards the carers. It is difficult for many people to report to their experiences on a subjective basis according to the communication limitations and moreover, the symptoms of the mental and physical illness in health are often misconstrued.
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Challenging Behaviours has been defined as abnormal cultural behaviours with such frequency, intensity or duration which puts the physical/tangible safety of other people in serious danger. In other words it is the behaviour which will most probably result in limiting or denying people from using ordinary facilitates available for use to the entire community. It is often seen that challenging behaviours is exhibited by individuals with psychosis, dementia, developmental disabilities or children, but such behaviour can be seen in any individual (Emerson, 1995).
Case Study Analysis
The case is about my younger brother whose behaviour changed tremendously over the increasing years of his age. He is 13 years old. Till he was 10 years old, my father used to teach him and look after his studies on a regular basis. My father used to help me a lot in his studies and due to his experience he was able to handle him easily and he was good at studies and behaved normally when my father used to look after him. Then my father gave me the responsibility to look after his studies. But then the difficulty started as he behaved differently and this change in his behaviour was difficult to handle. He used to at times shout at me and behaved aggressively which caused me a lot of difficulty in handling him. He was no better at study and this change I feel is because of influence from his friends. He became aggressive when I tried to tell him that he should not meet his friends and study he never used to listen to me. This gave me the idea to study about this challenging behaviour and try to help my younger brother in his changed behaviour.
Types and forms of Challenging Behaviours
Some of the usual types of challenging behaviours are:
- Self Injuring Behaviour: It includes various behaviours displayed by people such as biting, head-butting, hitting, etc.
- Behaving Aggressively: It includes various behaviours displayed by individuals such as screaming, kicking, spitting, hitting others, etc.
- Sexualised behaviour: It includes various inappropriate behaviours of individuals such as grouping or masturbating in public.
- Stereotyped behaviours: It includes various behaviours displayed by individuals such as echolalia, elective self gratification, insistent rocking, etc.
- Violent behaviours directed towards properties including throwing and stealing objects, etc.
Causes for Challenging Behaviours
Challenging behaviours may be caused by one or more of the below mentioned factors:
- Biological Factors: Challenging behaviour may be displayed by a person because of because of various biological factors including factors like medication, pain, desire for sensorial stimulation, etc.
- Social Factors: It includes various behaviours displayed by individuals such as the desire for control, the desire to grab people’s attention or in other words trying to be the centre of attraction, psychoanalysis deficiency of knowledge of community or social; norms.
- Environmental Factors: it includes various physical or tangible aspects like lighting and noise or the desire to gain access to preferred activities or objects, etc.
Many times challenging behaviours have been seen to help bring about the desired results or rewards and there is also a possibility of using it to teach individuals new behaviour to attain the same results. The most common principle among the principles of behavioural management is to look for messages people try to communicate through the challenging behaviours.
Behaviour Response Cycle
It has been observed that challenging behaviours occur in a cycle. First there is a Trigger, which leads to Escalation, this results in a Crisis which is followed by a Recovery.
Analyzing this cycle helps provide a foundation which uses various strategies in trying to minimize the trigger of such challenging behaviours, teaching individual’s appropriate behaviour as a response to such triggers or trying to encourage appropriate reaction by providing a consequence for the challenging Behaviours. The strategies on behaviour like the applied analysis on behaviour, positive support on behaviour and operant conditioning take use of the approaches in a similar manner to analyse and respond to the behaviours which are challenging.
Below is stated the analysis of the steps which lead to each of the behaviours:
Challenging Behaviours by Individuals in Learning Disability Services
Some people with difficulty in learning also find deficiency in their language skills accompanying their existing condition and as a result they have difficulty in using verbal schemes in resolving conflicts, expressing themselves, etc. This leads to them resorting to a behaviour which can be judged to be Challenging.
Managing Challenging Behaviours
When we respond to challenging behaviour we should ensure that our response is corresponding to the actions, the response should be enforced as soon as it is practicable or possible and it should be properly explained to the individual child and his/her parents. The following alternatives can be considered by the volunteers and staff while dealing with kids who show challenging or negative behaviour:
- Reparations: It is the process or act of making rectification or amends.
- Timeout: It involves taking a break to ensure a change in environment while performing the activity, individually or in a group.
- Reinforcement of Behaviour: Rewards and recognition must be given for appropriate or good behaviour and consequences or punishment should be given for negative or undesirable behaviour. For example giving a chocolate for good behaviour and cancelling an outing/ picnic for a negative behaviour.
- Supervision: increased superintendence by volunteers or staff.
- De-escalating the Situation: It involves talking the child through.
- Contractual Agreements: it involves the usage of personalized agreements or contracts to ensure their continued or future participation.
- Exclusions: The use of permanent or temporary exclusion.
- Specialists: Seeking specialist/additional support by working in collaboration with other institutions/agencies to ensure that the child’s requirements are met sufficiently.
- Restitution: it involves reciprocation by ensuring that the individual gets back something for his behaviour or act.
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The following behaviours should not be permitted ever, for managing children’s behaviour:
- Refusal to interact and speak with the individual child
- Verbal or physical intimidation, humiliation or ridicule.
- Physically punishing the child or the threat of doing so.
- Depriving the child of water, food, access to toilets or changing room or similar essentially required facilities.
Volunteers and staff should inspect the needs of the child who frequently requires sanctions. Such inspection should also involve the individual child, his/her family and in certain cases other people involved in providing support or services to the child or his family. This helps ensure that a correct decision is made for the child’s continued or future participation. If the child exhibits continued behaviour of high risk or dangerous to himself or other people then it may be considered to terminate or suspend him from club or group activities.
A variety of theoretical types of frameworks are prevalent on the conceptualization of the challenging behaviours, including the sociological and psychoanalytic theories. It is widely observed that learning theory is serving as a basis for the detailed of challenging behaviours and it is becoming a separate area for research in itself. Learning theory, fundamentally, puts emphasis on the purpose that the behaviour serves for an individual. The form of behaviour is considered as secondary. In the functional assessment, functions of the behaviour, for which study is being done, are treated as hypothesis and then the same are evaluated in the functional analysis part. Challenging behaviour is also considered as a way of communication part from adjusting to the events in any form. The modern functional analysis lays greater weight on emotions and events as multi-functionality is one of the characteristics of challenging behaviour at times (Sturmey, 1996). read about : types of Psychology
Literature written through studies with experiments has focused on the persons facing disability associated with learning, trying to cure and under some kind of treatment. The findings of many such research on SIB clearly indicate that challenging behaviour is a product of learned behaviour rather than the learning disability and the same is gained through the actions and environment surrounding the person in case. There are also enough studies which have used functional analysis as a method and concluded that it is very useful and effective in knowing the environmental determinants of SIB for an individual (Iawata, 1994). The functions of the target behaviour have to match with environmental determinants for treatment to be effective.
In the recent past, the functional analysis as a methodology is used and applied in experiments targeting persons without disability related to learning with conditions spanning many problems and personality disorders.
Depression refers to an illness which can arise out of an affective or disorder related to mood and the same creates the feeling of hopelessness and self-blame. The effect of the illness spans across mind and the body. Schwartz & Schwartz (1993) argue that the illness is a measure of facing life’s pressure.
Depression may be an illness for the person, suffering only to the person in case, but in reality, it is a suffering for the individuals who are in any way relatives to the patient. The time period for the illness varies in the range of two weeks to two years. The illness can be cured effectively same as other psychological disorders but, many times, with the help of others.
Depression arises due to a lack of positive reinforcement. This is because the person either avoids social situations which could provide rewards, or because their behaviour in such situations makes rewards less likely. Depression may also be positively reinforced by extra attention and sympathy.
Depression becomes a problem from the point where the patient starts avoiding daily routine. The person suffering from the depression does not have the energy to be present at work, school, etc. and motivation to refrain from the illness. The patients mainly perceive the illness as having a heavy thing on his or her back or head which is most of the times an accumulation of stress and unexplainable as well.
The speech of depressive is slow and physically, he or she is sluggish most of the times (Comer, 1992). They most of the times complain that they are suffering from headache and other disease which have no explanation. Due to impaired memory, they show confusion and difficult in things which are pretty simple to a normal person.
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If we see through the perspective of the learning theories then there are two theories in contrast with each other for the treatment and assessment of the challenging behaviours (Goldiamond, 1974). The approach which is pathological gives the view on the challenging behaviour as the problem which has been removed or suppressed. As it can be seen that many studies have reported effectiveness in the suppression of the targeted behaviour of challenged people (like by extinction), the interventions which are based on the pathological type of approach can be defined as the ‘prosthetic’, and these are the problems which are well-established and generalised across the settings, substitution in place of symptoms, and the maintenance for long-term. If we see the constructional approach then it meant as a successful way of serving the function. This can be visible in individuals wherein the resources are exposed as a logical and legitimate path to the desired consequence in a natural way, albeit it is distressing to the individual and the others around. The interventions based on the constructional type of approach focuses on the establishment of the new and the less distressing type of behaviours which will be serving the same functions and will lead to similar consequences.
On seeing the case study it became evident that my younger brother had the challenging behaviour of behaving aggressively. So to handle it patience is required and I have to be more proactive in my handling. To manage this challenging behaviour I need to do a de-escalation of his situation and do a continuous supervision of his behaviour. I need to use the method of reinforcement wherein I can praise him for his work and support him whenever needed. I can also use the method of restitution wherein I can also ask his ideas and use them. So to manage his behaviour I have to be more proactive so that he does not get aggressive in his behaviour and listens to me. I should not act like an elder but like a friend so that he feels free to share his thoughts with me and become comfortable and also then listens to whatever I say and then this will also help him to improve in his studies.
A system which is flexible enough which has the continuum of the provision of services is used to render support to the various needs of the individuals with challenging behaviours and this will have the inclusion of the allocation of the resources which are additional to the surviving services and also to the establishment of the specialist long-term support in the housing and the day-to-day services and also the specialist in the community-based health mentally and the challenging behaviours supporting teams.
People with the challenging types of behaviours do a comprehensive type of need assessment, person-centred planning and intensive case management. There should be a consultative and collaborative planning which exists between the mental health and disability services. A large number of beds are needed for an appropriate type of setting to exist so that assessment in terms of in-patient and acute kind of treatment can be done for the individuals with intellectual disability who have a mental kind of disorder and who presents major risk to others and themselves (Linehan 1993).
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A large group of the individuals exist who have a meek disability intellectually and challenging behaviours so they cannot or fail in accessing the mainstream service. People who fall in the category of meek intellectual disability need a large range of support. There exists a need of case manager system so that coordination of the integration of the social services, mental health services, and disability services for the individuals with meek intellectual disability requires. Specialist types of assessment of sexual and therapeutic services are needed for the individuals with the problematic sexualized type of behaviour (Lindsay et al, 1993).
The staff should be trained enough in the treatment based on evidence approach and the supervision which is ongoing to practise the effective and safe ways for the management of the challenging behaviours. Safer outcomes can be associated with the services, which have employed ‘active support’ in areas of the planning of activity, support of the staff, and person-centred type of planning. If we see the most efficient strategies for the challenging behaviours then in the present times it is derived as the Applied Behaviour Analysis. Information sharing, communication and the support networks development are crucial in managing the challenging behaviours.
A large range of the family services for support are also required to accompany the person with the challenging behaviour who is living in the family house. Individuals who have challenging behaviours need regular access to the services which are respite as they meet the demands of them. The respite services for emergency and the after hour support services for crisis should be encouraged further and then evaluated.
- Borthwick-Duffy, S. (1994) Epidemiology and prevalence of psychopathology in people with mental retardation. Journal of Consulting and Clinical Psychology, 62, 17-27.
- Chung, M.C., Cummella, S., Bickerton, W.L. & Winchester, C. (1996). A preliminary study on the prevalence of challenging behaviours. Psychological reports, 79, 1427-1430.
- Emerson, E. (1995): Challenging behaviour: analysis and intervention with people with learning difficulties. Cambridge: Cambridge University Press
- Emerson, E. (2001): Challenging Behaviour assignment: Analysis and intervention in people with learning disabilities (2ndEdition). Cambridge: Cambridge University Press.
- Goldiamond, I. (1974). Toward a constructional approach to social problems. Behaviourism, 1, 1–84.
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