Intellectual Disability and Behaviour Disorders
Intellectual Disability and Behaviour Disorders
Purpose of Review: To critically review the most recently published studies on the treatment of challenging behaviours/behaviour disorders for individuals with intellectual disability.
Recent Findings: Literature published in the review period was from three traditions: applied behaviour analysis, psychopharmacology, and service evaluation. Applied behaviour analysis treatments have a large evidence base, and recent research has focused on refining issues such as dealing with low rate behaviours, improving generalization, the effects of choice-making, and setting event variables that may affect treatment outcomes. Recent interest in risperidone as a treatment for behaviour disorder has dominated the literature on pharmacological interventions. Several empirical studies support the use of risperidone in children, although a recent review is more sceptical of the quality of the evidence to date. A small number of service evaluation studies suggest in particular that applied behaviour analysis technologies can be scaled up to benefit large numbers of patients.
Summary: Applied behaviour analysis methods for the assessment and treatment of behaviour disorders continue to be the focus of research, and continue to result in positive outcomes. Recent data show the value of using applied behaviour analysis technologies as a service model for people with behaviour disorders. Pharmacological treatments, especially risperidone, also have a developing evidence base despite a lack of understanding of their mechanisms of action. A number of questions about behaviour disorders remain unanswered, especially whether early intervention may be effective and their putative relationship with psychiatric conditions.
The purpose of the present review is to consider recent evidence on interventions for behaviour disorders in children and adults with intellectual disabilities. We have included studies published during 2004 and the first few months of 2005, and used a broad definition of behaviour disorder. Thus, we have included studies of classic 'challenging behaviour' (such as self-injury, aggression towards others or the environment, stereotyped/repetitive behaviours), studies of general problem behaviours in individuals with intellectual disabilities, and behaviour problems labelled with common psychiatric terminology (especially conduct disorder, attention deficit hyperactivity disorder (ADHD)/hyperactivity). The main sections of the review focus on evidence for interventions using methods derived from applied behaviour analysis (ABA), pharmacological interventions, and also a number of service delivery models. However, the literature review also identified a number of general issues that have implications for our understanding and treatment of behaviour disorders in intellectual disability and it is to these that we turn first.
Purpose of Review: To critically review the most recently published studies on the treatment of challenging behaviours/behaviour disorders for individuals with intellectual disability.
Recent Findings: Literature published in the review period was from three traditions: applied behaviour analysis, psychopharmacology, and service evaluation. Applied behaviour analysis treatments have a large evidence base, and recent research has focused on refining issues such as dealing with low rate behaviours, improving generalization, the effects of choice-making, and setting event variables that may affect treatment outcomes. Recent interest in risperidone as a treatment for behaviour disorder has dominated the literature on pharmacological interventions. Several empirical studies support the use of risperidone in children, although a recent review is more sceptical of the quality of the evidence to date. A small number of service evaluation studies suggest in particular that applied behaviour analysis technologies can be scaled up to benefit large numbers of patients.
Summary: Applied behaviour analysis methods for the assessment and treatment of behaviour disorders continue to be the focus of research, and continue to result in positive outcomes. Recent data show the value of using applied behaviour analysis technologies as a service model for people with behaviour disorders. Pharmacological treatments, especially risperidone, also have a developing evidence base despite a lack of understanding of their mechanisms of action. A number of questions about behaviour disorders remain unanswered, especially whether early intervention may be effective and their putative relationship with psychiatric conditions.
The purpose of the present review is to consider recent evidence on interventions for behaviour disorders in children and adults with intellectual disabilities. We have included studies published during 2004 and the first few months of 2005, and used a broad definition of behaviour disorder. Thus, we have included studies of classic 'challenging behaviour' (such as self-injury, aggression towards others or the environment, stereotyped/repetitive behaviours), studies of general problem behaviours in individuals with intellectual disabilities, and behaviour problems labelled with common psychiatric terminology (especially conduct disorder, attention deficit hyperactivity disorder (ADHD)/hyperactivity). The main sections of the review focus on evidence for interventions using methods derived from applied behaviour analysis (ABA), pharmacological interventions, and also a number of service delivery models. However, the literature review also identified a number of general issues that have implications for our understanding and treatment of behaviour disorders in intellectual disability and it is to these that we turn first.
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