Imagine that no one speaks to you directly, but that they talk about you and your problems in your presence, that the people around you always interrupt your attempts to do something and do it for you, that they don’t let you make any decisions, that no one asks you what you prefer to do, eat or wear. Imagine that they are only attentive to your behavioral problems.

It has been 30 years since Dr. Judith LeBlanc wrote these words to develop empathy in relation to the quality of life of people with high support needs.

Can you imagine how you would feel? What would your behavior be?

Problem behavior

Problem behavior, challenging behavior, and/or complex behavior is considered “any culturally abnormal behavior of such intensity, frequency, or duration that the physical safety of the person or others is likely to be seriously endangered, or that is likely to limit the use of, or even deny access to, opportunities provided by the community.” (Emerson, 1995)

Types of behavioral problems

Self-injurious behavior: when the person causes pain to him/herself by hitting, biting or scratching.

Heteroaggressive behavior: when pain is caused to other people or animals.

Destruction of objects: the person breaks, destroys or damages objects or furniture.

Disruptive behavior: interruptions of the activity through unmotivated shouting, complaining, crying or laughing or looking for a fight.

Offensive social behavior: includes anything that is offensive to others, such as urinating in inappropriate places, using foul language, threatening, shouting or swearing.

Stereotypies: repetitive behaviors, such as rocking, wandering, jerking or grinding of teeth.

Uncooperative or negativistic behavior: non-compliance with rules or refusal to perform relevant activities.

Withdrawal or inattention: isolation, inactivity, lack of concentration or negative self-talk.

If you did the reflection exercise proposed at the beginning of the article, you may have already realized that any person in any certain circumstances could show defiant behavior.

Is it just a question of the person or the disability? Or, on the contrary, will it have something to do with the environments in which we move in or the opportunities we have to guide our own lives?

Person-centered services

The meaning that we people give to our own lives, the activities that we carry out in our daily lives, all those small or big decisions that we sometimes make almost without realizing it, the possibility of evaluating different options, of making mistakes and rectifying them, mean that even if we sometimes feel like shouting, breaking things or any other challenging behavior, we do not do it.

The work of Plena Inclusión

Therefore, from Plena Inclusion we have been working for many years to implement person-centered services and that people with intellectual disabilities also have these opportunities.

Some of these person-centered services are:

• Quality of Life Model
• Person-centered planning
• Life Project
• Promoting healthy environments
• Change of beliefs and support styles
• Preventive methodologies

Preventive methodologies for behavioral problems

Below we will discuss three different methodologies to address behavioral problems.

Active Support

Active Support is a systematic approach that helps people with intellectual or developmental disabilities to participate in meaningful, everyday activities, thereby improving their quality of life and personal development. It is a person-centered approach that promotes personalized support by responding to each person’s interests and needs (K. Lowe and E. Jones, 2015).

The goal of active support is the active participation of the person in activities that are meaningful to him or her, giving the support that is necessary for each of the small steps of the activity.

In addition, in active support, reinforcement is of great importance, not the result, but the participation, involvement and attachment of the person to that activity that is important for his or her life.

This participation leads people to have a higher quality of life, greater satisfaction, better relationships with their support persons and greater control over their lives.

As a result, challenging behaviors are significantly reduced.

Positive behavioral support

Positive behavioral support is a set of strategies to reduce or eliminate maladaptive behaviors through environmental improvements and the teaching of alternative skills.

The principles underlying positive behavioral support are:

• Challenging behavior has a function. The person is usually pursuing a legitimate goal; the problem is the behavior he or she uses to achieve it.
• People do not intend to cause harm, although this sometimes occurs.
• Behaviors are related to the contexts in which they occur.
• Support plans should take into account the person’s values, interests, preferences and aspirations.

Reduction of restrictions

Closely related to the philosophy and beliefs behind all these methodologies is the individual and collective reflection of the practices we carry out in our relationships with people with disabilities.

The environments of control, limitations or restrictions, which we sell ourselves as “it is for their own good” is not always so, as we limit the person’s ability to make their own decisions and sometimes make their own mistakes.

Who has not enjoyed the pleasure of a junk food even knowing that it is unhealthy?

Summary

If we endow life with meaning, any other behavior that does not lead us to our purposes will be meaningless.

Each of us, even if not explicitly, has a life project, a plan, values and we direct our lives towards them, even going through situations that are not pleasant in order to achieve goals that are meaningful to us.

People with high support needs, like anyone else, have those values, those goals, but, like everyone else, they need support, opportunities, possibilities to choose, to make mistakes?

In short, to guide their own life, as they want it to be.