Responding to challenges
Behaviour that challenges can be very distressing for people with learning disabilities and their carers. Finding ways to keep you and your relative safe and prevent problems from increasing at these times may be your immediate priority. There are lots of things that can be done to make these behaviours less likely. It is also important to have strategies to support your relative and yourself when these behaviours do happen.
What are behaviours that challenge?
Behaviours that challenge are things someone does that cause physical harm to themselves, others or property or are disruptive in other ways and impact on quality of life. This might include (but is not limited to):
aggressive acts (i.e., hitting, kicking, scratching others);
self-injury (i.e., biting, scratching self);
breaking or throwing objects;
sexually inappropriate behaviours (like undressing or masturbating in public places);
pica behaviours (eating inedible objects).
Video: "Behaviours that challenge and helping your relative get what they need"
Behaviours that challenge can be difficult to understand and very upsetting for all involved. It’s important to remember however that:
all behaviours and emotions happen for a reason;
they signify that something is not right for the person experiencing or displaying them;
they indicate the person needs some help and support;
people might have few (or no) other ways to communicate these things.
What to do when behaviours that challenge happen: Keeping you, your relative and others safe
People who display behaviours that challenge need an individualised assessment and a variety of long term supports. Contacting your local Learning Disability services (NHS, Social Services and/or Education Services) to request this is always recommended. The way to access this support can be different depending on where you live. If you are unsure how to go about this, the best person to speak to is your relative’s GP. If your relative is under 25, you can also visit your Local Authority’s ‘Local Offer’ which you can find by typing the name of your local authority and “local offer” into an internet search engine. If looking for support for a child, their class teacher, or Special Educational Needs Coordinator (SENCO) can usually assist you with accessing support (such as an Education, Health and Social Care Plan).
It is also very important to have a plan for how to support your relative right at the point they are displaying behaviours that challenge. This is likely to be your priority initially. At the point of displaying behaviour that challenges, your relative will likely be very upset and may be at risk of hurting themselves or others. You and others may also be at risk of harm and likely very upset also.
The key priorities at this time are to:
keep everyone safe;
stop things getting worse;
find ways of helping your relative calm.
Different people may need different things but the following points can help:
1) Try to appear calm even if you do not feel so
Think about your body language, speed of movements, eye-contact, expression, tone and volume of voice, use of language. Be aware of personal space.
2) Make the environment as safe as possible
Remove hazardous objects, make a safe space around your relative, look out for and attend to other hazards.
3) Reduce risks for other people
Consider whether you, siblings, others can withdraw or be physically protected
4) Reduce risks for your relative
Placing a cushion under their head, removing any other hazardous objects.
It is also helpful to:
Look for ways to support your relative to be calm
Can you distract them with something else (a favourite item or activity)? Give access or encourage your relative to do things you know they find relaxing (i.e., a cold drink, some fresh air, favourite music, use of sensory items).
Remember, this is not a time for learning
Do whatever you need to do to keep everyone safe but do not worry about teaching consequences, or trying to discuss why this is happening, right now. This can come later (see below).
Ask yourself if there is anything that is particularly upsetting your relative?
Listen to your relative and look at the situation and environment. Is there something they want, don’t want, something that is making them uncomfortable, causing pain, confusion or fear?
See if you can support your relative based on this
Provide what they need and/or reduce anything that is causing them distress.
The calm after the storm
After an episode of behaviour that challenges, there is still the potential for your relative’s emotions and behaviour to escalate again. It is likely that you and others will be feeling drained at this time but trying to find ways of continuing to support your relative will be really helpful in the long run and avoid further episodes of difficulty.
You might consider:
Keeping your relative feeling calm. Providing access to things they like, limiting requests and demands placed on them and attending to their sensory needs could all help.
Staying with your relative and /or gently speaking with them about everyday things.
Giving them space alone if this is helpful for them.
Being as patient as possible - this may take quite sometime.
Checking that everyone is OK.
My son can take many, many hours to ‘come down’ after a period of very challenging behaviour. There are little signs I look for to see if he is still in that uncertain period (and likely to escalate easily) such as short answers to questions and his voice being slightly higher pitched than normal. He may seem calm after just 20 minutes but it used to surprise me when 6 hours later the tiniest thing set him off again
Looking After You
Supporting someone who is displaying behaviour that challenges can be very upsetting for carers. Having some strategies to support your own wellbeing and some ways to look after yourself right at these times is important. Exploring the ‘Looking After You’ section of this resource might be helpful for this.
The Challenging Behaviour Foundation has a family support service that includes a helpline for individual support and information, a listening ear service, and an anonymised family carer email network where you can share ideas, thoughts, feelings, solutions and challenges with other families in similar situations.
Challenging Behaviour Foundation Family Support Team:
0300 666 0126 between 9am – 4pm or email firstname.lastname@example.org