Concluding Comments On Challenging Behaviour

When dealing with challenging behaviour, it is important to recognise the range of behaviours which challenge services, and the effect that these behaviours have on both adults with learning disabilities and those who support them.

Bear in mind that behaviours have causes, many of which are identifiable and many of which are related to either the needs of adults with learning disabilities or their inability to communicate these needs effectively. Careful and comprehensive assessment of the causes and functions of behaviour is essential, as are interactions which are designed to respond to the behaviour, which should be non-aversive (i.e. punishment of challenging behaviour is not the intervention of choice).

There are many ways of responding to challenging behaviour and they include:

• Careful analysis of the environment to ensure that it supports appropriate, rather than challenging, behaviour.

• Helping adults with learning disabilities to learn new skills and more appropriate ways of expressing their needs.

• Trying 'treatment' of the behaviour, with advice from other professionals, e.g. strategies for strengthening appropriate behaviour and weakening inappropriate behaviour.

• Ensuring that carers know how to react in accordance with clear and agreed guidelines when the challenging behaviour does occur.

Challenging behaviour will probably not 'go away', although, with a reasoned response, it may reduce. Therefore, ways of working with adults with learning disabilities with challenging behaviour need to remain in place permanently.

Long-term, effective support for carers working with adults with learning disabilities with challenging behaviour is essential, as working with these situations is often stressful and difficult. Overall:

• We need people with the skills to conduct this process. As the number of people with such skills is currently rather limited, significant investment in training is required; this must be consistent and pragmatic.

• We need to develop (or identify) model services which can support training and allow more extensive evaluation and development of the approach.

• We need services which are receptive to the approach. This involves both shared understanding about the nature of challenging behaviour and a willingness to make the sorts of changes to service practices which are required.

• We need appropriate research programmes and data gathering for reflective and evaluative analysis.

Finally, it is hoped that in combining the above and outlining some understanding of challenging behaviours, we will create a potential to improve progressively the lifestyles of adults with learning disabilities at risk of challenging behaviour and support their full inclusion, creating valued lives in the community with appropriate social standards.

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