Predictors of challenging behaviour in adults with intellectual disability
| DOI | https://doi.org/10.1108/AMHID-06-2015-0029 |
| Pages | 312-326 |
| Date | 02 November 2015 |
| Published date | 02 November 2015 |
| Author | Stella Koritsas,Teresa Iacono |
| Subject Matter | Health & social care,Learning & intellectual disabilities |
Predictors of challenging behaviour in
adults with intellectual disability
Stella Koritsas and Teresa Iacono
Dr Stella Koritsas hold an
adjunct appointment with
The Centre for Developmental
Disability Health Victoria,
Monash University,
Melbourne, Australia.
Professor Teresa Iacono is
based at Rural Health School,
La Trobe University,
Bendigo, Australia.
Abstract
Purpose –The purpose of this paper is to determine the extent to which mental health, physical health,
communication, learned function of the behaviour(s), severity of disability, living arrangement, age, and
gender, alone or in combination, predicted challenging behaviours in adults with intellectual disability.
Design/methodology/approach –In total, 74 adults with intellectual disability and their paid carers were
recruited into the study from adult disability services in Victoria, Australia. Paid carers provided information
about participants with intellectual disability on a range of measures targeting each variable of interest.
Findings –Based on principle components analyses of three challenging behaviour measures, two
topographies of challenging behaviour emerged: contact and non-contact behaviours. Multiple regression
analysisrevealed that contact behaviourswere predicted by anxiety scoresand severity of disability. In addition
to severity of disability and anxiety scores, non-contact behaviours were also predicted by sensory scores.
Practical implications –The results of the current study indicate that contact and non-contact behaviours
were determined by multiple factors. Clinicians and others who work with people who display challenging
behaviour may, therefore, find it helpful to utilise the biopsychosocial model in their formulations of possible
reasons that motivate a person to engage in challenging behaviour.
Originality/value –These results contribute to the evidence base available to clinicians and researchers to
guide future assessment for challenging behaviour. Expansion of functional assessment methods to explore
factors not traditionally included, such as mental health and severity of intellectual disability, as causes of
challenging behaviour, may prove helpful.
Keywords Intellectual disability, Health, Adults, Mental health, Predictors, Challenging behaviour
Paper type Research paper
Challenging behaviour has received substantial research attention because of its effect on the
quality of life of people with intellectual disability (Murphy, 2009; Schalock, 2004), including
their access to the community (Emerson et al., 1988) and opportunities for social inclusion
(Murphy, 2009). Challenging behaviour also has an impact on carers, and has been linked to
burnout (Ko et al., 2012) and negative emotions and reactions (Jahoda and Wanless, 2005;
Weigel et al., 2006; Zijlmans et al., 2012). Results of these combined outcomes include
placement breakdown (Broadhurst and Mansell, 2007) and increased costs of providing care
and support (Knapp et al., 2005).
Several challenging behaviour risk factors have been identified, particularly in relation to specific
topographies. These risk factors include gender (McClintock et al., 2003; Smith et al., 1996; Tyrer
et al., 2006), age (Crocker et al., 2006; Emerson et al., 2002; Tyrer et al., 2006), severity of
intellectualdisability (Emersonet al., 2002; Smith et al., 1996), residential setting(Lowe et al.,2007;
Smith et al., 1996), and autism (McClintock et al., 2003). It is clear that challenging behaviour is
related tomany factors, and that thereare a range of models or theoriesthat have been developed
to explain why some people with intellectual disability display challenging behaviour. The three
dominant inter-related approaches that are evident in the literatureand were recently reviewed by
Received 4 June 2015
Revised 6 August 2015
Accepted 2 September 2015
The work reported here formed
part of the first author’s doctoral
thesis. The authors would like to
acknowledge the carers and
people with disabilities who
participated in the research, and
the Victorian Centre of Excellence
(bbVCoE) in Depression and
Anxiety for funding the research.
PAGE312
j
ADVANCESIN MENTAL HEALTH AND INTELLECTUAL DISABILITIES
j
VOL. 9 NO. 6 2015, pp.312-326, © Emerald Group Publishing Limited, ISSN 2044-1282 DOI 10.1108/AMHID-06-2015-0029
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