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Predictors of challenging behaviour in people with intellectual disability

posted on 09.02.2017, 05:39 authored by Koritsas, Stella
A range of factors have been associated with challenging behaviour in people with intellectual disability (ID). In general, the literature has been dominated by three approaches that have been proposed to explain the causes of challenging behaviour: applied behaviour analysis, biological factors, and psychiatric disorders. Although challenging behaviour has received substantial research attention, the research has been limited because of a focus on single causes. Focussing on only single causes of challenging behaviour provides only incomplete explanations because it fails to explore possible interactions between causes. The motivation of the current study was to address this limitation and use an approach that enabled investigation of potential interactions of various factors that had previously been identified in the literature as contributing to challenging behaviour. The aim of the research was, therefore, to determine the extent to which mental health, physical health, communication, learnt function of behaviour, severity of disability, living arrangement, age, and gender predicted challenging behaviour. Seventy-four adults with ID and their paid carers were recruited into the study. Data about each factor were collected using a combination of carer completed questionnaires and interviews, and direct observation and assessments of each participant with ID. For 12 participants, a second carer was recruited to provide inter-rater reliability data. Multiple measures were used for challenging behaviour, mental health, and learnt function of behaviour because of the paucity of sound measures appropriate for this population. The selection of one measure for mental health and learnt function of behaviour, for use in a multiple regression to address the research question, was based on inter-rater reliability and concurrent validity. Because many of the measures selected comprised subscale scores and in light of sample size requirements, the number of independent variables retained were reduced using further analyses. Based on these analyses, the variables retained as independent variables for multiple regression were severity of disability, Anxiety and Depressive scores, and Sensory, Escape and Attention scores. For challenging behaviour, a single measure could not be selected due to the shared variance across the measures. Factor analysis was, therefore, used to explore the underlying construct(s) being tapped. The results of the factor analysis revealed the presence of two components that were labelled contact and non-contact behaviours. The scores on these components were subsequently used as the dependent variables; hence two multiple regression equations were conducted. The results of the standard multiple regression revealed that contact behaviours were predicted by Anxiety scores and severity of disability: higher scores on contact behaviours were associated with more severe disability and higher Anxiety scores. In addition to severity of disability and Anxiety scores, non-contact behaviours were also predicted by Sensory scores: higher non-contact behaviours scores were associated with higher Anxiety scores, greater disability, and higher Sensory scores. These results indicate that challenging behaviour is influenced by a combination of factors. A recommendation based on these results is that a variety of factors be considered in formulations of possible reasons for challenging behaviour.


Principal supervisor

Teresa Iacono

Year of Award


Department, School or Centre

General Practice

Campus location



Doctor of Philosophy

Degree Type



Faculty of Medicine Nursing and Health Sciences