The document discusses challenging behavior, providing definitions and describing common types. It notes that challenging behavior is influenced by risk factors, ecological factors, setting events, and specific triggers. The consequences of behavior, whether reinforcement or punishment, influence whether the behavior will occur again. Positive behavioral support is presented as a proactive approach for understanding behavior and making environmental changes to reduce challenging behavior over time.
2. Activity 1
1. Pair up & pick 5 behaviours each so you
have 10 in total.
2. Hand your list to the pair to your left.
3. Work out the percentage of behaviours are
considered positive by society.
4. Pair with highest % wins chocolate bar.
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3. Shout out 10 examples of behaviour
Pinching
Pulling
Shouting
Headbutting Self/harm & aggression?
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4. Behaviour
Such is the power of our culture; it is difficult to think about
behaviour objectively, in a passive, neutral way. We
judge before observing.
We must train ourselves to do the opposite; to observe
and gather evidence before judging.
Mugger?
Hypoglycemic?
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5. Challenging Behaviour
- What it looks like
‘culturally abnormal behaviour of such an intensity,
frequency or duration that the physical safety of the
person or others is likely to be placed in serious
jeopardy, or behaviour which is likely to seriouslylimit
use of, or result in the person being denied access to,
ordinary community facilities’.
Emerson, 1995
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6. Challenging Behaviour
- What it looks like
'Behaviour can be described as challenging when it is of
such an intensity, frequency or duration as to threaten
the quality of life and/or the physical safety of the
individual or others and is likely to lead to responses
that are restrictive, aversive or result in exclusion.'
Challenging Behaviour - a unified approach: British Psychological Society,
Royal College of Psychiatrists and Royal College of Speech and
Language Therapists. 2007
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8. Impact
Physical Health Mental Health
Isolation Exclusion
Neglect Quality of Life
Stress Relationship Strain
Guilt/Shame Expense
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9. Behaviour in context
Risk Ecological Setting Specific
Behaviour Consequence
Factors Factors Events Triggers
Antecedent Behaviour Consequence
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10. Risk
Factors
Risk Factors
10-15% of people with learning disability will display challenging behaviour.
54% of individuals exhibit more than one CB.
Risk factors include:
Level of LD, Gender, Age, Specific Disorders.
Emerson et al 2001
Lesch Nyhan Syndrome
Prader Willi Syndrome
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11. Ecological
Factors
Ecological Factors
‘Ecology’ is the relationship between us and our
environment. The influence of the environment on our
behaviour.
Challenging behaviour is more likely under the following
conditions:
No stimulation
Inadequate Training & Support
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Disorganised
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12. Other unhelpful conditions
Too controlling
Lack of choice
Reactive to challenging behaviour. Ignore appropriate behaviour.
Abusive
Crowded
Temperature
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13. Setting Events
Setting
Events
Setting events increase the
Sometimes called ‘slow triggers’.
likelihood of challenging
The start and end of setting behaviour by increasing the
events is often unclear. potency of consequences
(reinforcement/punishment)
Setting events precede
challenging behaviour but can
e.g. Being tired increases the
continue during and after value of going to bed.
challenging behaviour.
e.g. Food tastes better when your
hungry.
e.g absence makes the heart
grow fonder...
Setting events are more functionally connected
to challenging behaviour than ecological or risk factors.
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14. Setting Events
Feeling Physically Unwell Psychologically Unwell
Sitting around doing nothing Lack of carer attention
Waiting for long time without food or drink
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15. Specific Triggers
Specific
Triggers
Whether or not challenging behaviour occurs will be
determined by more obvious events, with clear
starting and stopping points.
These are known as antecedents or fast triggers or
technically speaking 'discriminative stimuli'.
These occur immediately before behaviour and end prior
to the behaviour occurring.
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16. Examples of Triggers
Specific
Triggers
Asked to do something you don't want to do
Or don't know how to do
Being ignored when you want something
Being told you can't have something you want
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17. Activity 2
In a group draw a comic strip showing how setting events and triggers can
culminate in particular behaviour.
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18. Consequence
Consequences
Our behaviour is influenced by our environment and the
impact our behaviour has on our environment.
The nature of that impact determines whether we will go
on to repeat the behaviour when faced with similar
conditions in future.
This is how we learn and our behaviour evolves.
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19. Consequence Consequence Types
Reinforcement Punishment
Strengthens behaviour
Weakens behaviour
Increases the future
Decreases the future
frequency, duration and frequency, duration and
or intensity of behaviour or intensity of behaviour
There are two kinds of both
punishment & reinforcement
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20. Consequence Common Outcomes
- More or Less
Sate –verb (used with object), sat·ed, sat·ing.
1.to satisfy (any appetite or desire) fully.
Get sensory feedback or
stimulation
Sensory
Get attention
Get objects, item or
Attention
activities
Tangible
Escape or avoid
something or someone Escape
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21. Consequence
Reinforcement
Positive Negative
Strengthen behaviour
Behaviour is strengthened
because the outcome of because the outcome of
behaviour is something behaviour is that
pleasant or rewarding is something unpleasant or
added. unrewarding is taken
away.
e.g. When I hit my head staff
come and sit with me.
e.g. When I take the stone
from my shoe my foot
stops hurting.
Reinforcement STRENGTHENS behaviour – whether positive or negative
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22. Consequence
Activity 3
I am tired
I need sleep!
I get 'noticed' I sign 'bed'
(sent to bed) (no one notices)
I throw a cup
(it breaks)
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23. Consequence
Punishment
Positive Negative
Behaviour is weakened Behaviour is weakened
because the outcome of because the outcome of
behaviour is that behaviour is that
something unpleasant or something pleasant or
aversive is added. rewarding is taken away.
e.g. As I walk through a low e.g. My dinner is in the dog
door way my head is for being late home.
bashed.
Punishment WEAKENS behaviour – whether positive or negative
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24. What Type of Punishment is this?
Click here to go to video http://goo.gl/q0wyB
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25. Whether an outcome is punishment or reinforcement is decided by its
effect on behaviour.
A hug could positively punish
behaviour where this is an
aversive sensation, as
Restraint can positively occurs in ASD.
reinforce behaviour it is
designed to manage.
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26. Positive Behavioural Support
PBS is a way of working with people who present challenging behaviour. Starting by
looking at the context in which it occurs (see slide 9) and the meaning it has for
the individual concerned, drawing understanding from this and developing
appropriate methods of working with the person.
PBS is proactive, ethically sound and values led. It offers a solution-focussed
framework of support that rejects the use of aversives or punishment.
Improvements in lifestyle can, under the PBS model, be seen both as intervention
and as the result of intervention.
Because people with challenging behaviours often have long standing and difficult to
understand behaviours we do not expect overnight change. PBS is a long term
realistic developmental approach.
There is significant research supporting its efficacy.
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27. PBS recognises:
The environmental influence on behaviour.
The importance of quality information to support approaches.
The need to create the right conditions in the first place.
The need to understand 'triggers' for prevention.
The need to improve & develop skills.
Improving skills Quality information
The right conditions
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28. The PBS Model
Broadly thought of as having three stages:
1) Primary Prevention
Approaches that reduce challenging behaviour likelihood - 'baseline'
approaches.
2) Secondary Prevention
Approaches used when a person’s challenging behaviour begins to emerge,
when early signs are noticed.
3) Reactive Strategies
Approaches that allow challenging behaviour to be safely responded to
when prevention is no longer possible. These are crises and risk
minimising approaches.
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30. Final Thoughts...
Challenging behaviour is functional, serving legitimate
•
needs.
99% of the time it serves as a way of communicating these
•
needs.
The challenge is working out what is being said, why and
•
creatively changing conditions so that challenging
behaviour is no longer necessary or is replaced by more
socially acceptable skills.
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31. Challenging Behaviour
What's
The
Function?
Thank you for listening!
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Discuss the common conception that behaviour is only ever thought of in the negative sense. Ask participants how many of the behaviours shouted out they had displayed themselves.
Traditionally ABC model used, which is still useful and easy to remember.
Gender: approximately two-thirds of the people identified were boys/men Age: close to two-thirds of the people identified were adolescents or young adults Level of LD: people who showed more demanding challenging behavior were more likely to need greater levels of assistance in eating, dressing and washing, be incontinent and have more restricted expressive and receptive communication
These are setting events or ‘slow triggers’ for challenging behaviour; they have an impact on behaviour by temporarily altering the value of reinforcement relationships.
