Many people with severe learning disabilities don’t have good communication. People with severe learning disabilities sometimes use challenging behavior as a method of communication. They’ve not learned either to express themselves very clearly or to understand what other people are saying to them. And if they then can’t say to us, back off a minute, give me a break, they might cast around for a way which works a way that they can use, which stops us doing what we are doing, and that way might be hitting us or screaming at us. What we think happens in most cases is that these things develop almost accidentally in childhood, but people respond to them and so they work, and people use them over and repeatedly. Let us consider two scenarios:



Person X was asphyxiated at birth and the first night of his life, he fitted consistently, and they found it difficult to control the seizures. So, the outlook looked bleak, but I was told that they wouldn’t know the extent of any damage if there were any damage. It was his development that would actually identify what his difficulties might be. As Person X  grew, Mary  began what would become a regular pattern of adapting her behavior routine and home to accommodate his changing needs. Initially, it was just hair pulling and curtain pulling. And as he got older and with the changes in terms of his support and I guess a lack of consistency in the way he was supported, he started to become destructive and disruptive as well. So he didn’t just pull curtains down and pull hair anymore. He actually destroyed rooms. He, he swept everything through things, broke things, and quite big things. It can be something as big as a microwave that he might throw if he’s in the kitchen. The new skills he was learning with more difficult behaviors got responses, so it was effective. Hair pulling obviously didn’t work as well, whereas throwing something had a better impact and got the response may be that he needed.


Lifestyle Plan

This is Person X’s essential lifestyle plan. It tells us what makes him happy. It tells us what makes him upset, and it tells us what his important routines are. It’s a living document. It helps Person X by providing good information to the people that support him, information that he’s not able to share himself because he’s not able to talk, I guess he does know what makes a good day because he’s going to be happy, but if you’ve not seen him have a good day, how are you going to know what makes a good day? There has to be a way of, recording all of that rich knowledge and experience and, and that’s what this plan is. On the whole, if Person X’s lifestyle is implemented and he’s well supported and has a busy active life, not allowing him to be bored, not allowing him to become hungry, not allowing him to be overstimulated is just as bad as being bored.

What do Families need?

 Families need, broadly speaking, two things. First, they need practical support and there’s plenty of evidence of families often don’t get the practical support they need. That support needs to be 24/ 7. It’s no good. Providing support to families that’s only available in office hours. Practical, not just advice over a telephone, but the ability to be able to send a couple of people to help out if someone is smashing up the home or whatever. The second thing that families need is they need access to short breaks. Of course, people need the opportunity to take a break from what is often a very demanding task. But for these people, often their son or daughter is excluded from the short break services that do exist. So people are told, well, we, do have a short break service, but you can’t have it because your son or daughter is so difficult to support that it would raise health and safety issues.

More help for Families

For families, there are really three things that you need to do. First of all, you need to help the family members to provide the support they provide in a way that reduces the likelihood of the problem arising and helps people move on from needing to use that challenging behavior. The second thing that should be happening is they should be getting that practical help and the people providing that help need to be working in the same way. It’s no good putting unskilled, untrained domiciliary care staff into this sort of situation because they could easily make things worse. And then the third thing that the family need are they need constant access to the specialists in the community learning disability team. And in many places, there will be a specialist team focused on challenging behavior. And those people are important to the family because they’re going to be the people who can help review what’s going on, advise people about how things are, are, are going and adapt and develop the method of supporting the individual.



These are people who, because of the severity of their disability and the nature of their problems,

They are going to be in receipt of social care services all their lives. Note! So, we should never turn away from them and stop paying attention to what they need. Professional service delivery that meets the needs of persons with disability is key Q1 Care.

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