FOUR RESPONSE CLASSES FOR CHALLENGING BEHAVIOR
Attention
People can engage in problem behavior to get another person to attend to or spend time with them. Attention can be verbal, physical, social or related to proximity. The length of attention can vary.
Tangible
A person wants to access an item, service, food/drink or activity. Gaining materials and activities that positive behavior may not be so effective in accessing may positively reinforce challenging behavior.
Sensory
This provides input into one or more sensory-perceived pathways. Looks, sounds, smells, tastes or feels good or otherwise produces pleasure for the person. Challenging behavior may be positively reinforced by the automatic sensory or perceptual consequence of the behavior.
Escape
The escape or avoidance of a request, task or activity can negatively reinforce problem behavior. If problem behavior occurs more often under these conditions, it is inferred that the behavior occurs to escape the demand.
In Table 1, the factors that contribute to challenging behaviors are detailed.
Table 1 Factors which contribute to challenging behavior
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Adults with learning disabilities
• Mental health problems
• Personal stress
• Recent crisis
• Expecting interaction to be difficult because of previous experience
• Young people possibly less control because of immaturity
• Presence of a particular individual
• Positive feedback from peers
• Tiredness
Carer factors
• Health, overwork, stress and reduced tolerance
• Age
• Experience
• Sex
• Personality
• Temperament
• Attitudes
• Workload
• Shift work
• Appearance
Interaction factors
• Giving bad news
• Correcting behavior
• Providing personal care
• Withdrawal of service
• Inflexible routines
Situational factors
• Temperature of environment
• Working alone
• Transporting someone in your car alone
• Time of day
• Noise level
• Increased number of people
• Moving between settings
• Task/activity too difficult for individual
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Case study
Concepts of challenging behavior
John is sitting quite happily in the sitting room. He likes spending time alone. Someone comes along and asks him to go into the dining room and guides him there. As soon as the request to move is made, John begins to slap himself and starts screaming. He bites his right fist and hits the wall.
What is the cause/trigger? Perhaps he:
• does not like the person
• does not like the dining room
• was interested in what was on TV
• does not like the food he knows he is going to get
• has a pain in his stomach and does not want to eat
• does not like the person he will have to sit beside at the table
• feels anxious about a training program designed to help him feed himself.
ACTION: Identify and discuss possible triggers and behaviors resulting from these triggers.
