Unit 27 Dealing with Challenging Behaviour

1. Unit 27 Dealing with Challenging Behaviour Managing Challenging Behaviour # 1

2. Lesson Objectives • To recall a definition of challenging behaviour and behaviours that challenge. • To describe interventions to manage challenging behaviour. • To recognise the principles of clear assessment, planning and evaluation of interventions used with people whose behaviour challenges.

3. What is Challenging Behaviour – A definition? • “Culturally abnormal behaviour(s) of such an intensity, frequency or duration that the physical safety of the person or others is likely to be placed in serious jeopardy, or behaviour which is likely to seriously limit use of, or result in the person being denied access to, ordinary community facilities.” Emerson,(1 995, 2001,):

4. Behaviours which challenge: • Violence • Aggression • Hyperactivity • Antisocial behaviour • Withdrawn behaviour • Self stimulation • Speech problems • Sexually inappropriate behaviour • Psychological disturbances • Eccentric habits • Inappropriate personal habits • Bullying • Verbal abuse

5. Working with people who Challenge

6. Assessment/Identify the problem Question?: With the examples you have thought about : • How is this challenging behaviour assessed? • By who? • How is the assessment recorded?

7. Assessment – the Legal Framework Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 says that: • The registered person must take proper steps to ensure that each service user is protected against the risks of receiving care or treatment that is inappropriate or unsafe, by means of— • (a) the carrying out of an assessment of the needs of the service user; and • (b) the planning and delivery of care and, where appropriate, treatment in such a way as to—(i) meet the service user’s individual needs, • (ii) ensure the welfare and safety of the service user, • (iii) reflect, where appropriate, published research evidence and guidance issued by the appropriate professional and expert bodies as to good practice in relation to such care and treatment, and (iv) avoid unlawful discrimination including, where applicable, by providing for the making of reasonable adjustments in service provision to meet the service user needs

8. Working with people who Challenge

9. Devise a plan of action Some do’s and don’ts: • Empowering • Service user and their family should be involved • Nature of the intervention plan should be clear and explicit. • Person focussed not organisationally focussed

10. Interventions can be: • Remedial • Preventative • Rehabilitative • Habilitative

11. Working with people who Challenge

12. Intervene and Evaluate • Interventions should be morally and ethically robust • Should be risk assessed • Goals must be realistic • Must consider whose life they are aimed at improving • Do staff and others supporting the service user have the skills, abilities and do they agree with the intervention.

13. Recording/Evaluation • There should be a clear, transparent audit trail from assessment to intervention and back again! • Clear understanding of the legal framework • A clear evaluation method and timeframe with designated accountability for the evaluation.

14. Autism and challenging behaviour Autism and Challenging Behaviour • People with autism may behaviour “differently” • Can be a way of communicating • Can be a way of self managing a situation/coping strategy

15. Some Approaches to alleviate challenging behaviours • Picture exchange system • Cognitive behavioural therapy • Relaxation therapy • Social stories • Relaxation therapy • DRO DRI approaches (positive reinforcement • Linking obsessional thoughts to more functional behaviours • Diet ( controversial) • Pharmacology e.g. for anxiety • Sequential diaries • Not exhaustive

16. And Finally ……………. Tony Osgood, the Tizard Centre.