Recommendation ID

Interventions to reduce the frequency and extent of moderate to severe behaviour that challenges in community settings:- Are interventions based on the science and practice of applied behaviour analysis or antipsychotic medication, or a combination of these, effective in reducing the frequency and severity of behaviour that challenges shown by adults with a learning disability?

Any explanatory notes
(if applicable)

Why this is important:- Behaviour that challenges is common in adults with a learning disability and can have a considerable impact on them and their family members or carers. It is also a common reason for hospital or residential placement. There is limited evidence for the effectiveness of either applied behaviour analysis or antipsychotic medication, or a combination of these in community settings. Little is known about which people respond best to which interventions or about the duration of the interventions. There is considerable evidence of the over use of medication and of limited skills and competence in delivering behavioural interventions.
The question should be addressed by a programme of research evaluating these interventions that includes:
- developing a protocol for assessing moderate to severe behaviour that challenges that:
              - characterises the nature and function of the behaviour

              - assesses all coexisting problems that may contribute to the behaviour developing or being maintained

- developing protocols for delivering and monitoring the interventions to be tested (including how any currently provided interventions will be stopped)
- assessing the feasibility of the formal evaluation of the interventions in a randomised controlled trial (in particular, recruitment)
- testing the comparative clinical effectiveness (including moderators and mediators) and cost effectiveness of the interventions in a large-scale randomised controlled trial.

Source guidance details

Comes from guidance
Challenging behaviour and learning disabilities: prevention and interventions for people with learning disabilities whose behaviour challenges
Date issued
May 2015

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No