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Supporting older people with learning disabilities and their families
Supporting older people with learning disabilities and their families

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1 What are ‘behaviours that challenge others’?

A photograph of a man sitting on a sofa with his head in his hands.

You will start by hearing members of the panel discussing the term ‘behaviours that challenge others’.

Activity 1 Defining behaviours that challenge others

Timing: Allow about 10 minutes

Watch this video of our panel members taking about the term ‘behaviours that challenge others’.

As you watch the video, make notes in the text box below on:

  • why people might display these behaviours
  • the implications of using terms such as ‘challenging behaviours’ or ‘behaviours that challenge others’.
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Everyone on the panel agreed that behaviour is a form of communication. They emphasised that it is important for practitioners and families to learn and understand what the person is trying to express and why they may be exhibiting a particular behaviour, at a particular time. Behaviours may emerge because the person is unwell, distressed, or due to specific issues within their environment. All panel members preferred the term ‘behaviours that challenge others’ to ‘challenging behaviours’ because it shifts the onus away from the person, and places responsibility on services to understand and respond to these behaviours in more sensitive and appropriate ways. However, as panel members pointed out, regardless of the precise wording used, the term can become a label that unhelpfully ‘sticks’ to people, prejudicing how they are treated by services and limiting the opportunities available to them. As Ben highlighted in the example he gave from his own practice, practitioners need to engage with the person and their needs and take a reflective and critical perspective with regards to labels that have been previously assigned to a person.

It is important to remember that ‘behaviour that challenges others’ (sometimes referred to as ‘challenging behaviour’ or ‘behaviours of concern’) is not a diagnosis. Rather, it is a label that is given to people’s behaviour for a variety of reasons and purposes. This label may be used to refer to things like aggression, self-injury, stereotypic behaviour, withdrawal, and disruptive or destructive behaviour (NICE, 2015). But it is critical to understand why people behave in these ways, and in what contexts. People may be trying to communicate or be engaging in sensory stimulation (The Challenging Behaviour Foundation, 2021). People may also be trying to gain help or avoid demands. We also know that some environments or situations may increase the likelihood of these behaviours occurring, for example, due to boredom, anxiety, distress, or pain. People may behave in these ways because of excessive noise, lack of choice, and sensory issues, or because they are in an inappropriate, neglectful or abusive care environment (NICE, 2015). And sometimes the behaviours are linked to events that have happened in a person’s life history (Mansell, 2007). The behaviours may be consistent over long periods of time, but they may come and go, depending on the context.

Activity 2 To label or not to label?

Timing: Allow 5 minutes

Do you think it can ever be helpful to label people as having ‘behaviours that challenge others’?

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In this course, the term ‘behaviours that challenge others’ is used to show how relational and subjective this area of practice is. As a practitioner, it is essential that you continually reflect your own framing of ‘behaviours that challenge others’, with a continued focus on how to best support people’s health and wellbeing.