Challenging behaviour in a person with developmental disability: overview

The general practitioner has an important role in initial assessment and support for people with developmental disability who are exhibiting challenging behaviour, including:

• recording and interpreting the behaviour history and the topography of the behaviour (eg where, when and under what circumstances does it occur and not occur)
• investigation for potential causes (eg biological, psychological, social)
• ongoing support for the person and their family or carers
• referral as required
• monitoring and review.

The approach to a person with developmental disability exhibiting challenging behaviour should be driven by principles of good practice, and will usually require multidisciplinary referral including for specialist behaviour support.

Challenging behaviour is not a medical condition to treat per se, but rather a symptom of underlying pathology that requires careful diagnosis, intervention and treatment. The issues could be biological, psychological, social or environmental in nature; more likely, the behaviour is due a combination of these factors. Investigations, intervention and treatment for people with developmental disability who are exhibiting challenging behaviour need to reflect such multifaceted circumstances.

For advice on assessing and managing an acute behavioural disturbance, see here.