Functional Analysis of Challenging Behavior in People with Severe Intellectual Disabilities

2014 ◽  
Vol 115 (3) ◽  
pp. 655-669 ◽  
Author(s):  
C. Delgado-Casas ◽  
J. I. Navarro ◽  
R. Garcia-Gonzalez-Gordon ◽  
E. Marchena

Challenging behaviors exhibited by individuals with developmental disabilities often hinder the acquisition of academic, social, and life skills. Functional analysis has been useful for assessing challenging behavior in various settings. The purpose of this study was to implement an operant methodology for recognizing the functional properties of challenging behavior in people with intellectual disabilities. Four adults diagnosed with profound intellectual disability received assessment under several experimental conditions using a functional analysis methodology: social attention as positive reinforcement, negative reinforcement such as the termination of demands, positive tangible reinforcements, absence of social contingencies, and escape from noisy stimuli. Results showed that different types of reinforcement or avoiding contingencies affected the rate of aggression, self-injury, disruption, stereotypy, or socially offensive behaviors, and functional analysis may potentially be a viable alternative for identifying challenging behaviors.

2000 ◽  
Vol 33 (2) ◽  
pp. 181-194 ◽  
Author(s):  
Brian A. Iwata ◽  
Michele D. Wallace ◽  
SungWoo Kahng ◽  
Jana S. Lindberg ◽  
Eileen M. Roscoe ◽  
...  

2017 ◽  
Vol 41 (S1) ◽  
pp. S159-S159
Author(s):  
N. O’Kane ◽  
I. Hall

BackgroundIn May 2015, NICE published guidelines for people with intellectual disabilities whose behavior challenges (NG11). Eight quality standards were subsequently developed by NICE to help service providers, health and social care practitioners and commissioners implement the necessary recommendations within the new NG11 guidelines.MethodsWe used a Quality Improvement (QI) methodology including process mapping, driver diagrams, and fortnightly QI team meetings. We conducted a baseline audit of the quality standards and used Plan-Do-Study-Act (PDSA) cycles to pilot interventions generated by the team to improve compliance with the standards.ResultsBaseline compliance with the quality standards was low. We identified four priority areas for intervention: annual physical health checks, recording the indication of medication, multidisciplinary case discussion and concurrent psychosocial interventions for those prescribed medications for challenging behavior. Using a PDSA cycle for each intervention, we have demonstrated improved compliance with the NG11 guidelines. Compliance for the recording of indication of medication for all case reviews was previously 0% and now 100%. At least one target case is discussed at each MDT team meeting. Full results for annual health checks are awaited, but intervention has already shown an improvement in the uptake from 40% to 70%. Staff and carers knowledge of psychosocial interventions for people with challenging behavior showed an improvement after training.ConclusionsQuality Improvement methodology was successful in improving adherence to NG11 guidelines. We are currently assessing whether this is leading to reductions in challenging behavior and improvements to people's well-being.


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