Challenging Behavior: Types, Risk-Factors and Interventions

Challenging Behavior

 Behavior refer to how a person conducts themselves to their reaction, actions, and functioning in response to everyday situations and different environments. Challenging behavior is a termed used to describe behavior that interferes with a person’s daily life. Challenging behavior also describe behavior that is challenging to everyone who support the person to understand why it is happening and find solution. Challenging behavior is more common to person with learning disabilities; people with emotional, physical, social and communication difficulties; underlying medical and psychiatric condition. 

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 Some types of behavior that can be describe as challenging; Self-injurious behavior exhibited by people with developmental disabilities, common form of these behavior include: hand-biting, head-banging, and excessive self-rubbing, and scratching; Physical aggression is behavior threatening or causing physical harm towards others. It includes biting, hitting, kicking, using weapons and breaking toys or other possession; Behavioral Communication refer to express their feelings, thoughts and needs using direct and indirect communication; Stereotypy or self-stimulatory behavior common in individual with developmental disabilities and more common in autism. It’s refers to repetitive movement of body, repetitive movement of object and repetitive speech.

Risk Factors

 Risk factor of people with challenging behavior is important to identify; First, identifying the risk factor that can lead to representing of constructive interventions to relieve behavioral problems. Second, identification of risk factor can also help as a guide for future planning of support and care for the client. Base on many studies indicates that behavioral disorder, people with learning disabilities are relating to a range of social factors, psychological, demographic and neurobiological. Some people with learning disabilities have a lack of emotional skills and communication to convey what they need. A person may show a certain behavior to communicate what they are experiencing, emotional or physical discomfort. Hearing lost are also a big impact on individual’s quality of life, both emotional and physical. Hearing loss are also linked to depression, stress, loneliness and reduced mental and physical health.

Triggers and Precursor Behavior

 Triggers is event or situation that happen before the challenging behavior to cause it, also known as “antecedent”. The first step to reduce challenging behavior is being aware of potential triggers. Environment or external cause are triggers for challenging behavior, can also contribute the occurrence of particular behavior. Some example of environmental that trigger to the behavioral of people: Overwhelmed by stimulating surrounding – a situation that too noisy, too many choices and too many people speaking at the same time that can trigger anxiety, withdrawal or frustration; Change in routine and unfamiliar environment can also triggers person behavior, resulting to change their behavior such as agitation, aggression and restlessness; Caregiver approach, communication and confrontation with other can also be trigger to a catastrophic reaction of frustration or anger if there are confuse or won’t answer his question correctly.

 Precursor behavior are sign of harmless behavior that reliably to prevent the occurrence of problem behavior. By preventing the occurrence of severe problem, intervention effort might apply to precursor. A person that do mumbling and clenching their teeth, jaw or fist are some example of precursor behavior. Awareness of the problem can help a person to identify their thoughts and feelings. Recognizing the persons vulnerability and anticipating their needs can also help to avoid serve problem. Reporting and documentation are also help as a basis to prevent the occurrence of challenging behavior in every individual.

Professional Boundaries

 Relationship between workers and client requires in often care work in intimate personal setting. Rapport and trust are also required in care work to create supportive and calm environment. Personal relationship to care works must highly recommend to maintain clear professional boundaries at all times. Some example of professional boundaries: professional behavior – always address the client professionally, avoid calling in their nicknames and endearing terms like honey or sweetie; relationship boundary – must not overly attached and emotionally entangled in life of client and their families; privacy and confidentiality – any private information of clients should never seek out that is not relevant to your duty as a caregiver; Gifts – do not accept money or expensive gift from the client and their family to maintain professional relationship.

Reporting and documenting challenging behavior

 Every changes and development in challenging behavior of the client is essential to document. Any unacceptable behavior of the client must be recorded and also include any formal observation. Documentation also help to analyze any particular patters for future references or action. Reporting any behavioral problem of the client is important to inform all person involved in the community. Reporting of any challenging behavior is also help to give corresponding action.

Scenario

 Oscar M. is seven years old and diagnose with Autism (A). When we were in the swimming pool, Oscar and his sister play together. But Oscar suddenly grab the toy of his sister without any permission, and his sister cried. I get the toy from him and return it back to his sister. But Oscar not willing to return it back, he is mad in her sister and also to me. I explain to him that it is not a good attitude instead if you want to barrow, you need to get permission. When I go to him nearly, he punches me and kick me.

Strategy I – Making other things that can destruct to his attention that trigger to his challenging behavior. I know that Oscar is angry to me, instead of explaining to him about what happened I make other way to destruct him. I talked to him about his favorite games and make funny action to destruct his attention. I’ll dance of his favorite dance move and ask to him if it is right.

Strategy II – Leave the person to calm down or remove other persons that trigger of his challenging behavior. Oscar say’s to me that “leave me alone” so I decided to go further to him and pretend that I’m busy in doing anything. A few minutes he came back to me and asking for forgiveness and he say ‘sorry’ to me. 

Strategy III – Diverting the attention to other things to forgot what happen. Give his other possession that he wants like other toys to divert his attention. Give other topics to discuss, talk to him about his favorite move or his favorite games for them to divert his attention.

Consequences of not addressing challenging behavior

 People with challenging behavior is important to monitor and give corresponding action to replace and reduce challenging behavior with positive outcome. If challenging behavior is not addressing, it results to negative consequences. This negative consequence increases the probability of the behavior happening in the same circumstances.

References

• SCOPE.FUNDRAISING REGULATOR: https://www.scope.org.uk/support/parents/challenging-behaviour/managing
• Government of Western Australia: https://www.commerce.wa.gov.au/publications/guide-working-safely-challenging-behaviours-health-care
• Verywell Health. Dash: https://www.verywellhealth.com/environmental-causes-97609
• Mencap: https://www.mencap.org.uk/learning-disability-explained/conditions/challenging-behaviour
• Contact A Family. 2012: https://contact.org.uk/medical-information/conditions/c/challenging-behaviour/