Behaviour that challenges
We have a section about behaviour that challenges in our Crisis Prevention Survival Guide.
That Survival guide however, is aimed at families with children/young people who are in or at risk of going in to an Assessment and Treatment Unit or secure hospital placement.
However, we know that challenging Behaviour is a struggle for many families.
Examples of challenging behaviour
Examples of challenging behaviour include: hitting, kicking, spitting, throwing things, self-harming, self-injury, biting, scratching, trichotillomania (pulling hair out), damaging the environment or clothing, screaming, pica (eating non-food items) and smearing.
You can find more information on challenging behaviour at:https://www.challengingbehaviour.org.uk/about-us/what-is-c-b/what-is-challenging-behaviour.html.
Please note: The term ‘challenging behaviour’ here is not intended as a diagnosis or label used to describe people who display it, but rather to describe the effect of the behaviour on those around the person, as it is them who are ‘challenged’ by the behaviour.
Causes of challenging behaviour
The root causes of challenging behaviour can be physical, emotional or social, and will likely be the result of an unmet need. All behaviour is a form of communication, and all behaviour has a reason and/or purpose. For those living with a learning disability, autism or both, difficulties in understanding and using language can make it difficult to communicate needs effectively (e.g. hunger, thirst, discomfort or pain). It is likely that they have learned over time that, as their behaviour often gets an instant reaction, it is a useful communication technique to use to get noticed and gain some control over their situation.
Challenging behaviour can be caused by any number of things for what may seem to us the smallest of reasons, but for the person may be very hard for some to cope with, for example:
- changes in routine or to the environment (even something that may seem very subtle to others);
- sensory issues, which can be particularly overloading for people with autism because of sensory processing differences (e.g. pain, distress caused by loud noise, the light touch of clothes labels in clothes);
- differences in understanding and getting on with others (i.e. the social communication difficulties diagnosed in autism) and differences in thinking flexibly (e.g. social imagination difficulties characteristic of autism);
- sensitivity to the moods of people around them, difficulties trying to communicate health needs (hunger, thirst, pain or discomfort; and
- significant life changes or transitions concerning family or home life (e.g. puberty, transition to adult services, death of a loved one or moving home).
The consequent increase in anxiety, confusion or discomfort can result in challenging behaviour that requires others to identify then reduce or remove the cause(s) of the distress.
While some behaviour may be seen regularly, a sudden change could indicate something serious, such as an undiagnosed health problem in need of some timely attention. Although it could just be a minor tummy upset or a developing cold, it could also indicate more significant or fluctuating pain and infection (e.g. earache, toothache, constipation) or even something more serious. If there is any doubt, call your GP. Other examples of health-related issues that can impact upon behaviour include: epilepsy, vision and hearing impairments, the side effects of medication, allergies, and mental health illness.
Please note: There is a wealth of evidence that people with learning disabilities often have unmet health needs, so it is always recommended to think health first when a person is showing behaviours or distress.
Pathological Demand Avoidance and Challenging Behaviour
A lot of families living with Pathological Demand Avoidance also experience Challenging Behaviour, or behaviour which challenges.
Steph from Steph’s Two Girls talks about this in her blog post https://www.stephstwogirls.co.uk/2017/11/challenging-behaviour-and-pathological.html
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