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Dealing With Unwanted Behavior Patterns in an Adult With Intellectual Disability

by | Feb 20, 2023 | IDD, Neurodiversity

Forward, Together with western tidewater community services board

Intellectual Disability (ID) can cause behavior patterns that are challenging for parents, caretakers, and the individual with ID. This is especially challenging when these behaviors persist into adulthood. These types of behaviors can be very upsetting for an adult with ID who may feel like they can’t control them. Challenging behaviors can interfere with making friends, keeping a job, and daily life. To ensure quality of life for your loved one with ID, it’s crucial to manage these unwanted behavior patterns.

Examples of Unwanted or Challenging Behavior Patterns in Adults With ID

Challenging behavior is common with ID for several reasons. One is that individuals with ID are sometimes not able to communicate their needs in other ways, often because of limited communication skills. Individuals with ID may also experience “decreased comprehension, attention, and memory,” and have a low frustration tolerance. Mood dysregulation is also common in individuals with ID who have co-occurring behavioral or psychiatric conditions.

Some Challenging Behaviors That Can Occur With ID

  • Dangerous behaviors – aggression, self-injury, and property damage
  • Stimming behaviors – rocking of the body, hand flapping, or other unusual or repetitive movements or sounds. Stimming is more common in individuals who have developmental disorders, like autism or Down syndrome.
  • Purposeful behaviors to achieve a desired outcome – behaviors to get attention from caregivers or others or to avoid doing something they don’t want to do.

The Impact of Unwanted or Challenging Behavior in Adults With ID

Challenging behavior patterns can have major effects on people with ID, including:

  • Lower quality of life
  • Poor integration into society
  • Limited ability to build and maintain friendships
  • Interference with learning and development
  • Not being able to achieve what they want to or are capable of
  • A higher risk of physical harm and abuse, especially in a long-term care setting

It’s not just the individual with ID who’s at risk from challenging behavior. One case study documented the experiences of four people who grew up with mothers with an intellectual or developmental disability. The unmanaged challenging behaviors of the mothers impacted each individual in childhood and into adulthood. The participants reported having childhood experiences of “abuse, neglect, deprivation, anxiety, overburdening responsibilities, and a general lack of stability and support.

How To Handle Unwanted Behavior Patterns in Adulthood With ID

According to David L. Westling, Western Carolina University’s Adelaide Worth Daniels Distinguished Professor of Special Education, interventions for challenging behaviors in individuals with ID are usually comprised of at least three components:

  1. Altering the conditions that precede the behavior (e.g, environment, triggers, co-occurring conditions, etc.)
  2. Teaching alternative behaviors
  3. Altering the consequences of the behavior so that the alternative behavior, not the challenging behavior, results in reinforcement

Altering Conditions That Precede the Behavior

Meeting the Individual’s Needs

A lot of challenging behavior is simply due to unmet needs. Adults with ID have the same basic needs as other adults: “food, water, safety, love, a sense of belonging within their family and community, social interaction, and to develop a sense of independence and self-determination.” They may also require additional care.

Someone with ID who’s feeling sick, tired, depressed or unsafe may not know how to let caretakers or other people in their life know what’s going on and they may not even understand what they’re feeling. That’s why it’s important to keep up with their needs and pay attention to signs of unmet needs.

If the individual is stimming or self-injuring, they may have a sensory need that isn’t being met or may be experiencing anxiety, boredom, stress, or another mental, emotional or physical condition that needs to be managed.

On meeting needs, Professor Westling says:

“…[If] setting events can be identified and modified, then modification may be a useful intervention. For example, if a student is avoiding difficult work when he or she has not slept well the night before, a possible modification would be allowing him or her to sleep before working.” 

Changing the Environment

Sometimes, something in the environment is triggering challenging behavior in individuals with ID. An environmental element that’s causing distraction, overwhelm, or other upsetting feelings can lead to challenging behaviors. 

Managing Co-occurring Conditions

There are several common co-occurring conditions with ID, including mental health conditions like depression, anxiety, PTSD and trauma. Because people with ID often have certain vulnerabilities that open them up to mistreatment like abuse and bullying, they’re especially susceptible to trauma.

Trauma can result in challenging behaviors like:

  • Aggression
  • Irritability
  • Withdrawal from others

When it comes to managing these comorbidities, awareness is the first step. By learning about these conditions and their symptoms, you can better understand how to address them.

Teaching Alternative Behaviors and Altering the Consequences of Behavior

Behavioral Interventions

Dr. Brett Stone, a licensed psychologist specializing in developmental disabilities, analyzed behavioral interventions for reducing challenging behaviors with ID. While Dr. Stone notes that challenging behaviors don’t typically go away on their own, there are “evidence-based behavioral interventions for individuals with developmental disabilities to reduce challenging behaviors and increase more functional behaviors.”

Behavioral interventions that may help with challenging behaviors include:

  • Functional Behavioral Analysis (FBA)

FBA is a process in which a trained professional observes the individual to discover what might be triggering the behavior. 

Dr. Rory Panter, Licensed Psychologist, says: 

“The goal [of an FBA] is to determine … why the behavior occurs. After an FBA is completed, a detailed report is provided, which includes a description of the procedures used, information and data gathered, and comprehensive recommendations.”

  • Applied Behavioral Analysis (ABA)

ABA is associated with autism remediation in children, but can also be effective in reducing challenging behaviors in adults with ID. When used with adults, ABA involves teaching behaviors that are “essential to functioning effectively in the home, school, and community” and decreasing behaviors that can endanger health and safety and reduce quality of life.

A Community of Hope for Adults with Intellectual Disability

Our comprehensive Intellectual and Developmental Disability Services offers more than just treatment-based services – our complete wrap-around care system is designed to help individuals achieve independence, well-being, and integration into the community. We advocate for our community members living with ID/DD, as well as their support systems. 

We offer 24/7 crisis intervention, case management, respite care, and residential and day support services. 

Ready to get started? Make an appointment for same-day access online or by calling us at 757-758-5106.

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