In this thoroughly revised and updated new edition, Eric Emerson provides a comprehensive overview of the current findings regarding the nature, epidemiology, causes, and treatment outcomes of challenging behavior caused by learning disability. The material discussing motivational factors and the relationship between challenging behavior and psychiatric disorder has been considerably expanded. The book combines evidence and research drawn from the fields of psychology, psychiatry, and medicine. This volume will become essential reading for clinicians and all health care professionals involved in the assessment and treatment of challenging behavior.
Author(s): Eric Emerson
Edition: 2
Year: 2001
Language: English
Pages: 232
Cover......Page 1
Half-title......Page 3
Title......Page 5
Copyright......Page 6
Contents......Page 7
1 Introduction......Page 11
Intellectual disability......Page 12
Challenging behaviour......Page 13
An overview......Page 14
2 The social context of challenging behaviour......Page 17
The impact of challenging behaviours......Page 20
Inappropriate treatment......Page 21
Exclusion, deprivation and systematic neglect......Page 22
Summary......Page 23
The social validity of intervention outcomes......Page 24
3 Epidemiology......Page 27
The prevalence of challenging behaviours......Page 28
Types of challenging behaviours......Page 31
The co-occurrence of challenging behaviours......Page 32
Gender......Page 33
Specific syndromes and disorders......Page 34
Setting......Page 35
Onset......Page 36
Persistence......Page 37
Applied behaviour analysis......Page 41
The importance of function......Page 44
The contextual control of behaviour......Page 46
A systems approach......Page 48
The positive and negative reinforcement hypotheses......Page 49
Descriptive studies......Page 51
Experimental demonstrations of the contextual control of challenging behaviour......Page 52
Experimental manipulations of the reinforcing contingencies hypothesized to be maintaining challenging behaviour......Page 55
Summary......Page 56
Automatic reinforcement......Page 58
Respondent behaviour......Page 60
Schedule-induced behaviour......Page 61
Dopamine......Page 62
Opioid peptides (Beta-endorphin)......Page 64
Psychiatric disorders and challenging behaviour......Page 65
Challenging behaviour as a secondary feature of psychiatric disorders......Page 66
Psychiatric disorders may establish a motivational basis for the expression of challenging behaviours maintained by operant processes......Page 67
Causal and maintaining factors may be dissimilar across individuals......Page 68
Maintaining factors may vary over time......Page 69
Causal and maintaining factors may vary across different forms of challenging behaviour shown by the same individual......Page 71
Maintaining factors may vary across contexts......Page 72
Summary......Page 74
The constructional approach......Page 76
The functional perspective......Page 78
Social validity......Page 79
The ‘aversives’ debate......Page 80
The ethics of intervention......Page 81
Feasibility assessment of potential solutions......Page 82
Assessing risks, costs and benefits......Page 83
Decision making......Page 84
Functional assessment......Page 85
Selecting socially valid targets for intervention......Page 86
The form and function of behaviour......Page 87
Including functionally equivalent behaviours in the assessment process......Page 89
The unit of assessment......Page 90
Descriptive analyses......Page 91
Informant-based approaches......Page 92
ABC charts......Page 94
Sequential analysis......Page 96
Generating hypotheses......Page 98
Hypothesis testing: experimental functional analysis......Page 100
Summary......Page 103
Assessing existing skills, competencies and potential reinforcers......Page 105
Discrepancy analysis......Page 106
Identifying preferences......Page 107
Evaluating the risks, costs and benefits of intervention......Page 108
Summary......Page 109
Preventing the occurrence of challenging behaviours through the modification of establishing operations......Page 112
Modification of bio-behavioural state......Page 114
Changing the nature of preceding activities......Page 115
Curricular design and supported routines......Page 118
Environmental enrichment and noncontingent reinforcement......Page 120
Summary......Page 122
Behavioural competition and response covariation......Page 123
Functional displacement......Page 125
Differential reinforcement......Page 129
Modification of maintaining contingencies: extinction......Page 131
Default technologies: punishment......Page 133
Response cost: time-out and visual screening......Page 134
Positive punishment......Page 135
Cognitive–behavioural approaches, self-management and self-control......Page 136
Multicomponent strategies......Page 137
Summary......Page 138
8 Psychopharmacology......Page 145
Dopamine antagonists......Page 146
Serotonin agonists......Page 148
Beta-endorphin antagonists......Page 149
Anti-manics......Page 151
Summary and conclusions......Page 152
9 Community-based supports......Page 154
Living in the community......Page 155
Community-based intervention services......Page 156
Implementing and sustaining positive behavioural support in community settings......Page 158
The importance of resources......Page 159
Rules, beliefs, emotions, attitudes and behaviour......Page 160
‘Contextual fit’ and sustainable change......Page 162
Exploring the interaction between behavioural and biological processes......Page 165
Developing more sophisticated models of the emergence and maintenance of challenging behaviour......Page 166
Refining assessment procedures......Page 168
Prevention......Page 170
Early intervention......Page 171
Facilitating the widespread implementation of behavioural supports......Page 172
References......Page 175
Index......Page 231
