Assessment of Challenging Behavior Exhibited by People with Intellectual and Developmental Disabilities: A Systematic Review.

The assessment of challenging behavior exhibited by people with intellectual and developmental disabilities is essential for the planning of prevention and intervention programs. This review aimed to identify and analyze the standardized instruments that exclusively focus on the assessment of challenging behavior. We identified and organized 141 articles into four categories: original instrument studies, validation studies, relational studies, and intervention studies. The results identified 24 instruments that generally show high-quality psychometric properties and other utilities beyond the observation of the presence of challenging behavior and diagnostic categorization. Age, level of adaptive behavior, disability, presence of autism spectrum disorder, and medication are some of the variables that were found to be possibly related to the occurrence of challenging behavior. Additionally, the results suggest that interventions focused on supporting positive behavior or providing training on behavior to professionals and caregivers significantly reduced the occurrence of these behaviors. Instruments that help us to understand and measure the challenging behavior exhibited by people with intellectual and developmental disabilities are essential for the design of effective evaluation and intervention protocols.

Functional variables of challenging behavior in individuals with intellectual disabilities.

Research suggests that different types of challenging behavior (CB) may be maintained by different contingencies of reinforcement. In this study, we examined functional variables for nine types of CB (physical aggression, verbal aggression, self-injury, tantrums, non-compliance, property destruction, disruptive behavior, stereotypes and inappropriate verbal behavior) in 300 people with intellectual disabilities. The Questions About Behavioral Function (QABF) instrument was administered to 183 direct care staff members to assess a total of 328 challenging behaviors. Results of non-parametric analyses distinguished significant differences across behavioral functions. CBs associated with each subscale of the QABF were identified. Results were consistent with previous research, stereotypic behavior was scored significantly higher across the non-social functions measured by the QABF, whereas other types of CB (such as aggressive behavior) were scored significantly higher across social functions. The results of this study extend the literature on this issue, and implications for future research and direct care professionals are discussed.

Antecedent events as predictive variables for behavioral function.

Challenging behavior is one of the largest barriers to ensuring that people with intellectual disabilities (ID) are able to participate in the community. These difficulties have become one of the main causes of social exclusion. The research into and treatment of challenging behavior has usually involved the identification of its function and the manipulation of the events or environmental conditions that influence its occurrence (antecedent variables). The present research explores the relationship between antecedents and behavioral function and the extent to which antecedent variables may act as predictors of behavioral function. This relationship is explored using two standardized instruments: Questions About Behavioral Function and Contextual Assessment Inventory. Data from the validation of these instruments for the Spanish population involved 300 participants with ID and 328 challenging behaviors. The results suggest that social/cultural variables are most related to challenging behavior, whereas biological variables seem to only be related to physically maintained behavior.

Questions About Behavioral Function (QABF): adaptation and validation of the Spanish version.

People with intellectual disabilities (ID) often engage in problem behaviors, such as verbal or physical aggression, property destruction, or self-injury. These behaviors become a challenge for the families and for professionals. Functional behavioral assessment (FBA) is a method used to identify variables that influence or maintain challenging behaviors (CB) and aid in the development of intervention plans. Two major concerns of FBA are that it is time-consuming and requires specialized professionals to interpret data from the natural or experimental environment. Therefore, indirect FBA methods can be used as an alternative. An instrument with excellent psychometric properties that aims to identify the function of behavior is the Questions About Behavioral Function (QABF). This study presents the adaptation of the QABF in Spain. Data from 300 participants with ID and 328 behavioral problems were obtained. An exploratory factor analysis was conducted to identify the components of the QABF, and the test-retest reliability was assessed to evaluate the stability of the QABF over time.

Types of motivating operations in interventions with problem behavior: a systematic review.

A motivating operation (MO) alters both the effectiveness of a stimulus as a reinforcer and the current frequency of all behavior that has been reinforced by that particular stimulus. This article reviews studies that have manipulated a MO during interventions with school-age participants with intellectual disabilities and problem behavior. A systematic review was conducted using the following major electronic databases: PsychInfo, Education Resources Information Center, Science Direct, Blackwell, SAGE, and Medline. A total of 31 published articles representing 55 participants was examined. Findings from this study suggest that the modification of a MO usually has an effect on the problem behavior by either establishing or abolishing its motivation. Furthermore, a relationship was found between the type of MO and the behavioral function identified. The theoretical and practical implications of these findings, limitations of this study and potential issues for future research are discussed.