Descriptive analysis of challenging behaviours shown by adults with acquired brain injury

• Published in: Neuropsychological rehabilitation 2010-04, Vol.20 (2), p.212-238
• Main Authors: Rahman, B., Oliver, C., Alderman, N.
• Format: Article
• Language: English
• Subjects: Adult; Adult and adolescent clinical studies; Aggression; Biological and medical sciences; Brain Injuries - complications; Brain injury; Challenging behaviour; Challenging behaviours; Descriptive analysis; Environment; Female; Functional assessment; Humans; Male; Medical sciences; Mental Disorders - etiology; Middle Aged; Models, Psychological; Observation; Organic mental disorders. Neuropsychology; Probability; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Reinforcement; Reinforcement (Psychology); Self-Injurious Behavior; Social Behavior; Social models; Social reinforcement; Survivors; Time Factors
• ISSN: 0960-2011; 1464-0694
• DOI: 10.1080/09602010903021097

The neurorehabilitation field has been slow to embrace the practice of functional analysis prior to behavioural intervention. In this study we employed a descriptive functional assessment using continuous recording techniques facilitated by observational software. The aim was to explore whether challenging behaviours shown by nine ABI survivors were socially mediated. Analyses appraised the likelihood of challenging behaviours and environment events occurring concurrently and in sequence to test if a mutual social reinforcement hypothesis was applicable. All nine participants exhibited at least one behaviour that was socially reinforced. Across all participants, 88% of challenging behaviours showed a significant concurrent association with an environmental event. A demand escape function was identified for 13 behaviours and an attention maintained function in 13 cases. The complete behavioural repertoire of three participants served the same function. Five participants presented challenging behaviours with multiple functions. Only 8% of the concurrent analysis results were not explicitly corroborated by the sequential analysis. The findings indicate that challenging behaviours shown by these nine ABI survivors adhered to a social model of reinforcement and were functional. It is suggested that formal functional assessments within the field of neurorehabilitation may lead to better treatment outcomes.