1.0 Introduction
About 1 percent of the entire population has intellectual disability, which is a
considerable disorder in adaptive as well as intellectual function in the early stages of
development (Aveyard 2014). Individuals with the intellectual disabilities rate of developing
mental illness are greater in comparison to the whole population, however, challenges in
communication, access to services, literacy means that mental issues in persons with intellectual
disability are inadequately recorded. Moreover, the majority of persons with intellectual
disability exhibit challenging behaviors, meaning characters of intensity, duration, and frequency
that endangers their physical safety or those around them or even restricts accessing community
services.
For a long period, there have been concerns that psychotropic medicine especially,
antipsychotics are overused as such prescribed for problem behavior instead of diagnosing
mental sickness, regardless of insufficient proof on their effectiveness. Nonetheless, getting an
accurate amount of psychotropic in persons with learning disabilities is intricate, while present
literature is limited due to varying descriptions. In spite of inadequate proof from policy context,
there is no detailed assessment of psychotropic in adults with learning disability in United
Kingdom primary care conducted, while results from other nations cannot be generalised due to
variations in health care provisions as well as practices (Guerzoni & Zuleeg 2011).
Proof demonstrates that psychotropic use in entire population has been increasing
tremendously for the past years, however, few studies have investigated that the patterns used to
prescribe psychotropic among persons with intellectual disability. Regarding
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deinstitutionalization, creating warrens of psychotropic use, adverse effects and efforts to
minimise its use to individuals with learning disability through the implementation of
prescription standards are not clear. Furthermore, with the large as well as representative sample
size, it is apparent that there are increased rates of mental illness, challenging behavior and
psychotropic medicine among people with intellectual disability.
1.1 Research Question
- Do challenging behaviors among persons with learning disabilities result from mental
impairments? - Are social workers faced with challenges caring for persons with learning disabilities?
1.2 Research Objectives
- To establish whether or not challenging behaviors among persons with learning
disabilities result from mental impairments - To understand some of the challenges that come with caring for persons with learning
disabilities
1.3 Hypothesis
- H 0 : Challenging behaviors among persons with learning disabilities do not result from
mental impairments
- H 1 : Challenging behaviors among persons with learning disabilities do not result from
mental impairments
- H 0 : Social workers caring for persons with learning disabilities do not undergo
challenges that wear them down
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- H 1 : Social workers caring for persons with learning disabilities undergo
challenges that wear them down
2.0 What is challenging behavior?
An individual’s conduct may be regarded as challenging if it threatens their safety or
those around, particularly care or even contributes poor life quality. In addition, such behaviors
can influence their capacity to participate in routine activities. Challenging behaviors consist of
self-harm, destructiveness and aggression among others. Communication determines the way in
which people express their needs. In the event that communication is problematic, it may
extremely discourage individuals leading to challenging behavior. If such behavior contributes to
desire results, it may be repeated over and over. Challenging behaviors are common in persons
with problems that impact communication and the brain including learning disability, and
dementia (Economist Intelligence Unit 2011).
Challenging behavior or behaviors that challenge are culturally anomalous behaviors of
frequency or duration that endangers their safety or others. In most cases, an individual must
display trends that are a threat to services for a significant timeframe. Seriously challenging
behaviors are not transient occurrences. According to the National Institute for Health and Care
Excellence (NICE), challenging behavior is a concept that is associated with aggression,
stereotype, and agitation or self-harm, withdrawal, and sexual misconduct (NICE 2016).
Additionally, challenging behavior involves persons whose conduct present considerable
challenges to services. This comprises of behaviors that are associated with mental health issues.
Challenging behaviors are widely used among persons with learning or intellectual disability, in
addition to those with autism. Nonetheless, there are other groups that can be regarded to have
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challenging behaviors such as those with dementia and serious mental issues.
.
2.1 Impact of challenging behavior
Challenging behavior is described as ‘socially unacceptable behavior’, ‘bad behavior’
(Craver 2015). The term also reflects a challenge to those concerned. It indicates that something
is not working well, and it needs to be rectified and stopped. Behavior is challenging if it causes
harm to another individual, or prevents them from fulfilling certain things in their lives.
Challenging behaviors are detrimental to the lives of the affected persons and those around them.
Hence, dealing with challenging behaviors requires careful handling in a way that supports the
safety and well-being of people and others
2.1.1 Aggression and assault
In a study conducted by 76 social care workers in institutions that provide intellectual
disability services, three-quarter of respondents had faced aggression, self-harm, and disruptive
behavior. Recent studies of employees working with persons with dementia discovered that
roughly three-quarter of workers faced fearful events during their work (Springer et al. 2013).
The most common reported cause was physical assault. Among the respondents sampled, a fifth
said they had been injured, a quarter experienced fears during interaction, and half of the
interviewees stated that they adopted a more personal centered style while others learned to be
more vigilant.
This study gives indications of nature and level challenging behavior experienced by staff
in care homes for people with dementia. Recent studies of perception of severe behavior and
fear of assault showed that the degree of fear was greater when staff was exposed to challenging
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behavior. Researchers, however, found unclear evidence for the relationship between the
quantity of challenging behavior and the level of fear of assault.
In a survey of staff in regular care units with a high prevalence of hostility and a study of
officials in two community settings with a minimum occurrence of cruelty for people with
intellectual disabilities, staff reported significant lower fear for aggression and a high self-
efficacy compared to a city team (Emerson, 2011). Self-efficacy was defined as the ability of an
individual to handle aggressive conduct (Craver, 2015). Persons susceptible to fear prefer
working with the less difficult group.
In another study done to determine the extent of risky behavior, 48% of the respondents
and 93% of the care group had cared for clients who had a history of contact with criminal
justice service (Neale, 2008). They also found remarkable differences between private care
providers and charitable care providers. Private sector homes had a high prevalence of clients
who had been arrested by the police and of customers who had been sanctioned under mental
health, yet they had less security provision than voluntary sector homes (Springer et al. 2013).
The authors further found out that care providers lacked background knowledge of the offenders
under their care. This indicated the importance of information exchange while safeguarding
against risks and susceptibility for criminals and prospective victims. It also highlighted the need
and the importance of doing a background check on an individual before admitting them for care.
2.1.2 Stress
Pressure is defined as the result of interactions between environment and individual
(Riekert et al. 2013). It is the body’s way of reacting to any demand or threat. When one feels at
risk, the nervous system releases stress hormones which prepare the body for emergency action.
This is further explained regarding demands placed on the person and their ability to cope. Staff
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stress and burnouts are major areas that affect staff well-being and their interactions with clients.
In a study done to determine the relationship between challenging behavior and stress with
employees working with persons with intellectual disabilities, it was found that there was an
association between challenging behavior and staff stress (Emerson, McGill & Mansell, 2013).
Attributes such as emotions, coping, self-efficacy