Abstract
This study investigated community care staff's acceptability and effectiveness ratings of six commonly used interventions for treating challenging behaviour in people with learning disabilities. Case descriptions of four challenging behaviours:- self-injurious behaviour, physical aggression, verbal aggression and stereotypical behaviour were given to staff followed by descriptions of six possible interventions:- redirection, counselling, differential reinforcement of other behaviour, time out, medication and restraint. Staff were asked to rate each intervention for each of the four behaviours in terms of acceptability of intervention and effectiveness of intervention. This was done by using a shortened form of the 'Behavior Intervention Rating Scale'. Staff's knowledge of behavioural principles was also assessed using a shortened form of 'The Knowledge of Behavioural Principles as Applied to Children'. Factors such as job type (manager, team leader, education officer, care staff or night staff), length of experience of challenging behaviours, number of training courses attended, perceived importance of involvement in behavioural programming, actual involvement in behavioural programming and knowledge of behavioural principles were also examined to see if they influenced staffs ratings of acceptability and effectiveness of behavioural interventions. The findings indicated that with one exception, time out, accelerative techniques (i. e. redirection, DRO and counselling) were rated as more acceptable than reductive techniques (i. e. restraint and medication). Redirection was rated as the most acceptable/effective intervention and restraint the least acceptable/effective intervention for all four challenging behaviours. Reductive techniques were rated as more acceptable when applied to a severe behaviour (i. e. self-injurious behaviour or physical aggression) than when applied to a mild behaviour (i. e. verbal aggression and stereotypical behaviour). Acceptability and effectiveness ratings were found to be positively correlated for both accelerative and reductive interventions. Knowledge of behavioural principles was lower than expected for all job types. Actual involvement in behavioural programming was found to be negatively correlated to acceptability scores in that the more involved a staff member is in behavioural programming the less acceptable they rate behavioural interventions. These results were discussed in relation to previous acceptability/effectiveness research and implications for community services and clinical practice were highlighted.