What Is Challenging Behaviour?
Challenging behaviour is a behaviour of such intensity or frequency that affects the quality of life or the physical safety of an individual and those around them. It is a form of communication that expresses a person’s emotions, desires, or unmet needs.
Behaviour that challenges appear in a range of different forms and stems from various factors, including:
- Personal and emotional
- Physical
- Biological
- Social and environmental
- Life experiences
People who exhibit challenging behaviour experience difficulties expressing their needs, desire for attention or communication, and physical or emotional pain. Also, they may struggle to understand and interpret interactions in their social settings.
Understanding challenging behaviour is essential for everyone. Frequently, these behaviours pose difficulties in the individual’s personal, social or educational and can impact those around them. Therefore, it can unfortunately result in reactions that can be restrictive and lead to exclusion from the community.
Challenging Behaviour in Health and Social Care
In health and social care, behaviours that challenge often go hand in hand with neurodevelopmental differences and mental health challenges. Recognising and understanding challenging behaviours as a form of communication rather than a behaviour of concern is essential. Therefore, managing challenging behaviour requires a holistic, person-centred and humanised approach and focusing on identifying triggers and providing proactive solutions.
Challenging behaviour may be common for people who experience the following neurological or neurodevelopmental differences, including:
- Autism
- Attention deficit hyperactivity disorder (ADHD)
- Learning disability
- Dementia
Very often, behaviour that challenges affects a person’s daily life functioning as well as their relationships with family, friends, or at school. For that purpose, Nurseline Community Services is here to meet your urgent and complex care needs in moments of crisis. Providing consistency and an outcome-based approach is crucial in supporting challenging behaviour, and that is what our team is wholeheartedly committed to. With our highly trained professionals in Positive Behaviour Support (PBS), we can support your loved one in the journey towards independence and a fulfilled life.
Challenging Behaviour Types and Examples
Every one of us is different, with diverse reactions and behaviour. Behaviour that challenges can take many forms, including verbal, non-verbal, and physical forms of behaviour. The frequency and duration of outbursts or withdrawal from social interactions may indicate the level of support required.
Verbal Challenging Behaviour
Verbal challenging behaviour is a way for people to communicate their needs, desires, or pain. People may shout, scream or use threatening language. Verbal challenging behaviour can take many forms, including:
- Shouting
- Screaming
- Arguing
- Name-calling
- Threatening
- Using inappropriate or offensive language
It’s important to understand that these actions are not meant to hurt you, it’s a form of expressing distress.
Non-Verbal Challenging Behaviour
Non-verbal behaviour that challenges can manifest in a range of different ways and is often a coping mechanism for emotional or physical pain and distress. Some examples of non-verbal challenging behaviours include:
- Destructiveness
- Social withdrawal
- Eating inedible objects
- Swinging arms
- Pacing
This behaviour may affect a person’s daily life functioning, social communication and school focus.
Physical Challenging Behaviour
Physical aggression is a common example of challenging behaviour, which occurs when the person feels overwhelmed or over-stimulated. Although it may be difficult to recognise and understand the triggers, physical behaviour challenges can be prevented by using proactive PBS solutions.
Examples of physically challenging behaviours include:
- Hitting themselves or other people
- Hair pulling
- Kicking
- Biting
- Throwing things
With Positive Behaviour Support, people can learn healthy communication skills.
What Causes Challenging Behaviour?
Challenging behaviour can arise from various factors, and it’s important to remember that it’s a complex and individualised experience.
Here are some common causes of behaviour that challenges:
- Communication Difficulties: If a person is unable to communicate their needs, desires, or frustrations effectively, they might engage in challenging behaviours as a way of expressing themselves
- Unmet Needs: This can include basic needs like hunger, thirst, or the need for sleep, as well as more complex emotional or social needs such as a need for attention, sensory input, or autonomy
- Sensory Sensitivities: Some individuals may have heightened sensitivities to sensory stimuli (like light, sound, touch, or smell), which can lead to discomfort or distress, potentially resulting in challenging behaviour
- Physical Discomfort or Pain: If a person is in pain or experiencing discomfort, they may exhibit challenging behaviours to express their distress
- Emotional Distress: Feelings of frustration, anxiety, fear, or anger can lead to challenging behaviours, especially if the person lacks the skills to express these emotions healthily
- Cognitive Challenges: Individuals with certain cognitive or developmental differences might not be able to understand or process situations and emotions the same way as others. This can lead to frustration and challenging behaviours
- Environmental Factors: An environment that is overstimulating, chaotic, or not structured to meet the individual’s needs can contribute to challenging behaviour
- Lack of Social Skills: Some individuals may not have developed adequate social skills to navigate interactions with others, which can lead to misunderstandings, frustration, and challenging behaviours
- Reinforcement of Challenging Behaviour: If challenging behaviour leads to the individual getting what they want (e.g., attention, a preferred item), they may be more likely to repeat that behaviour in the future
- Learning and Modelling: Some challenging behaviours can be learned or modelled after observing others, especially when these behaviours seem to yield positive outcomes
- Mental Health Issues: Difficulties like anxiety, depression, or other mental health challenges can contribute to challenging behaviour
- Trauma or Past Experiences: Previous traumatic experiences can lead to challenging behaviours to cope with or express the impact of those experiences
It’s important to approach challenging behaviour with empathy, patience, and a true desire to understand the underlying causes. This often involves working with professionals, such as therapists, counsellors, or behaviour analysts, who can provide targeted support and interventions.
Functions of Challenging Behaviour
Challenging behaviour serves various functions or purposes for individuals who exhibit it. These functions can vary from person to person and situation to situation. Typical functions include communication (expressing needs and emotions), escape or avoidance of undesirable situations, gaining control, seeking attention, and obtaining tangible rewards. Understanding these functions is crucial for developing effective strategies to address the underlying needs and teach more adaptive behaviours.
Social Attention
Individuals who engage in challenging behaviours may seek social attention as a primary function. These behaviours can serve as a means to gain the attention of caregivers, peers, or others around them. In many cases, people with a learning disability may behave in a challenging way to say they’re here and willing to participate in a conversation or an activity.
Communication
Some individuals resort to challenging behaviours when they face difficulty expressing themselves verbally or non-verbally. These behaviours may serve as a way to convey their needs, feelings, or distress to others. Understanding this aspect is crucial for caregivers and professionals to find alternative, more effective means of communication and address the underlying issues prompting the challenging behaviour. This might involve teaching alternative communication methods or improving existing ones.
Escape/Avoidance
Escape and avoidance are common functions of challenging behaviour. When faced with uncomfortable, overwhelming, or undesirable situations, individuals may resort to challenging behaviours to escape or avoid those circumstances. This can include withdrawing from an over-stimulating environment or avoiding specific tasks or interactions. This function is common in people with learning disabilities, autism, or ADHD. Recognising this function is crucial in developing strategies to create more nurturing and supportive environments.
Feeling Unwell/In pain
When feeling unwell or in pain, people with a learning disability, autism or ADHD might behave in a challenging way. Sometimes, that’s the only way they know to communicate their feelings, inner struggles or current physical pain.
What Is the Cycle of Challenging Behaviour?
Challenging behaviour often follows a distinct cycle. It typically begins with an antecedent, which is a triggering event or situation. This is followed by the behaviour itself, where the individual responds to the antecedent. The behaviour leads to consequences, which can either reinforce or discourage the behaviour from occurring again. Understanding this cycle is crucial in identifying triggers and implementing proactive strategies to support individuals in managing their behaviours more positively and adaptively.
Trigger
The antecedent, or the initial trigger to the challenging behaviour, could be an event, situation, or circumstance that the individual finds distressing or challenging. Antecedents can vary widely, such as demands placed on the person, sensory overstimulation, or unmet needs.
Escalation
Escalation in challenging behaviour refers to the progression or intensification of disruptive or problematic actions exhibited by an individual. It often follows a pattern, starting with early signs of distress or agitation and culminating in more severe and potentially harmful behaviours.
Crisis
A crisis in challenging behaviour refers to a situation where an individual’s behaviour reaches a significantly heightened and potentially dangerous level. This can involve severe aggression, self-injury, or other behaviours that pose an immediate risk to the individual or others. During a crisis, caregivers and professionals must prioritise safety for everyone involved. This may include implementing de-escalation techniques, ensuring a calm and controlled environment, and, if necessary, seeking immediate professional help or intervention. After the crisis, it’s important to conduct a thorough assessment to understand the triggers and factors that led to the crisis to develop more effective preventive strategies for the future.
Recovery
Recovery from challenging behaviour refers to the process of returning to a state of calm and equilibrium after a crisis or escalation. It involves helping individuals regain control over their emotions and behaviours and re-establishing a sense of safety and well-being. Recovery strategies often include:
- Providing a supportive and structured environment
- Implementing calming techniques
- Offering opportunities for self-expression
Preventing and Management of Challenging Behaviour
Preventing and managing challenging behaviour is crucial for an individual’s well-being and quality of life. Prevention involves creating a supportive environment, addressing unmet needs, and teaching effective communication and coping skills. This includes structured routines, clear expectations, and providing appropriate sensory input.
In the event of challenging behaviour, a well-planned management strategy is essential. This may involve de-escalation techniques, ensuring the safety of everyone involved, and offering alternative, more adaptive ways to express needs or emotions. Consistent positive reinforcement for desirable behaviours also plays a vital role.
Ongoing assessment and adjustment of strategies are key to promoting long-term success. By focusing on prevention and effective management, individuals can lead more fulfilling lives while minimising the occurrence of challenging behaviours.
Implementing PBS Approach in Challenging Behaviour Management
Positive Behaviour Support is an evidence-based approach used to manage behaviours that challenge and improve the quality of life of people with complex care needs and mental health needs. PBS is based on the human rights model of care, implementing proactive and person-centred strategies to identify and prevent the triggers of challenging behaviour.
The goal of the PBS technique is to promote independence and self-awareness by creating a nurturing and safe environment where individuals can thrive and reach their full potential. At Nurseline Community Services, we are dedicated to creating an urgent, well-developed and tailored PBS plan with the help of our in-house speech and language therapists and PBS specialists. Our team is skilled in creating positive and adaptive care plans where every individual can express their skills, strengths and talents, fostering positive communication and reducing the potential for challenging behaviour.
How Nurseline Community Services Can Help
Families turn to Nurseline Community Services due to our fast response, high-quality services and consistent care teams that lead to positive outcomes for the people we serve.
Our experienced clinicians have a deep understanding of challenging behaviour and are trained to approach any situation with immense compassion, empathy, and a result-driven strategy.
If your or your loved one’s quality of life is affected by challenging behaviour, our team can create an environment where they can identify the unmet needs causing these types of behaviours.
We deliver CQC-regulated services across the UK, with offices in Bristol, Birmingham and Gloucester. Contact us today for a personalised and outcome-based approach that prioritises the well-being of your loved one.
