Formal versus informal interventions for challenging behaviour in persons with intellectual disabilities

Area of Science:

• Behavioral Science
• Intellectual Disabilities Research
• Healthcare Quality Improvement

Background:

• Effective treatments for challenging behaviors in individuals with intellectual disabilities (ID) are available.
• Limited research exists on the formal documentation of interventions for persons with ID.

Purpose of the Study:

• To investigate the prevalence of formal versus informal interventions for challenging behaviors in individuals with ID.
• To assess the characteristics and outcomes associated with formal and informal interventions.

Main Methods:

• Interviews were conducted with caregivers of 625 individuals with ID living in various settings in Ontario, Canada.
• The study examined 2506 interventions for 1464 target behaviors.

Main Results:

• 55% of interventions were informal, lacking professional input, written plans, or systematic evaluation.
• Informal interventions were more common for behavioral interventions and psychotherapy, while formal interventions were more associated with behavior control medications for dangerous behaviors.
• Formal interventions correlated with better reported behavioral improvement, higher agreement on behavior descriptions, and increased caregiver training and supervision.

Conclusions:

• Low accountability, training, and supervision in interventions may heighten risks for clients with challenging behaviors.
• The study's findings prompted the development of province-wide standards for interventions, though implementation is pending.