Abstract
Prevalence studies of challenging behaviors among children with disabilities have a potential value, as they provide information for intervention and evaluation. However, the results from these studies seem to vary according to the population involved, the behaviors explored and the selected methodological procedures and instruments used. The purpose of this study was to identify the prevalence data of challenging behaviors considering the behaviors assessed, how the behavior is measured and which procedures are used to collect the prevalence of these behaviors among school-aged participants with disabilities. We performed a systematic review and selected 20 studies for analysis according to their methodological characteristics. The findings indicated that the most common behaviors studied were aggression and self-injury. Moreover, a wide disparity with respect to procedures and methods (e.g., sampling methods and instruments) to assess the prevalence of challenging behavior was identified. Recommendations for addressing these issues are presented, and implications and suggestions for future research are discussed.
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References
Abdel-Fattah, M. M., Asal, A., Al-Asmary, S. M., Al-Helali, N. S., Al-Jabban, T. M., & Arafa, M. A. (2004). Emotional and behavioral problems among male Saudi school children and adolescents prevalence and risk factors. German Journal of Psychiatry, 1, 1–9.
Achenbach, T. M., Dumenci, L., & Rescorla, L. A. (2003). Are American children’s problems still getting worse? A 23-year comparison. Journal of Abnormal Child Psychology, 31, 1–11. https://doi.org/10.1023/A:1021700430364.
Achenbach, T. M., & Rescorla, L. A. (2001). Manual for the ASEBA school-age forms & profiles. Washington, DC: Library of Congress: Vermont.
*Akram, B., Batool, M., Rafi, Z., & Akram, A. (2017). Prevalence and predictors of non-suicidal self-injury among children with autism spectrum disorder. Pakistan Journal of Medical Sciences, 33(5), 1225–1229. https://doi.org/10.12669/pjms.335.12931.
Aman, M. G., Tassé, M. J., Rojahn, J., & Hammer, D. (1996). The Nisonger CBRF: A child behavior rating form for children with developmental disabilities. Research in Developmental Disabilities, 17, 41–57. https://doi.org/10.1016/0891-4222(95)00039-9.
Bedford, S., Melzer, D., & Guralnik, J. (2001). Problem behavior in the last year of life: Prevalence, risks, and care receipt in older Americans. Journal of the American Geriatrics Society, 49, 590–595. https://doi.org/10.1046/j.1532-5415.2001.49119.x.
*Beernink, A.-C. E., Swinkels, S. H. N., & Buitelaar, J. K. (2007). Problem behavior in a community sample of 14-and 19-month-old children. European Child and Adolescent Psychiatry, 16, 271–280. https://doi.org/10.1007/s00787-007-0600-9.
Borsa, J. C., Souza, D. S. D., & Bandeira, D. R. (2011). Prevalência dos problemas de comportamento em uma amostra de crianças do Rio Grande do Sul. [Prevalence of behavior problems in a sample of children from Rio Grande do Sul.]. Psicologia: Teoria e Prática, 13, 15–29.
Chou, K. L. (2003). Emotional autonomy and problem behavior among Chinese adolescents. The Journal of Genetic Psychology, 164, 473–480. https://doi.org/10.1080/00221320309597890.
Chung, Y. C., & Cannella-Malone, H. I. (2010). The effects of presession manipulations on automatically maintained challenging behavior and task responding. Behavior Modification, 34, 479–502. https://doi.org/10.1177/0145445510378380.
Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Applied behavior analysis (2nd ed.). Upper Saddle River, NJ: Prentice Hall.
Cooper, S. A., Smiley, E., Jackson, A., Finlayson, J., Allan, L., Mantry, D., et al. (2009). Adults with intellectual disabilities: Prevalence, incidence and remission of aggressive behaviour and related factors. Journal of Intellectual Disability Research, 53, 217–232. https://doi.org/10.1111/j.1365-2788.2008.01127.x.
*Dekker, M. C., Koot, H. M., van der Ende, J., & Verhulst, F. C. (2002). Emotional and behavioral problems in children and adolescents with and without intellectual disability. Journal of Child Psychology and Psychiatry, 48, 498–507. https://doi.org/10.1111/1469-7610.00235.
Dionne, G., Tremblay, R., Boivin, M., Laplante, D., & Perusse, D. (2003). Physical aggression and expressive vocabulary in 19- month-old twins. Developmental Psychology, 39, 261–273. https://doi.org/10.1037/0012-1649.39.2.261.
*Dworschak, W., Ratz, C., & Wagner, M. (2016). Prevalence and putative risk markers of challenging behavior in students with intellectual disabilities. Research in Developmental Disabilities, 58, 94–103. https://doi.org/10.1016/j.ridd.2016.08.006.
Eden, K. E., de Vries, P. J., Moss, J., Richards, C., & Oliver, C. (2014). Self-injury and aggression in tuberous sclerosis complex: Cross syndrome comparison and associated risk markers. Journal of Neurodevelopmental Disorders, 6, 1–11. https://doi.org/10.1186/1866-1955-6-10.
Einfeld, S. L., & Tonge, B. J. (1995). The Developmental Behavior Checklist: The development and validation of an instrument to assess behavioral and emotional disturbance in children and adolescents with mental retardation. Journal of Autism and Developmental Disorders, 25, 81–104. https://doi.org/10.1007/BF02178498.
Embregts, P. J., Didden, R., Schreuder, N., Huitink, C., & van Nieuwenhuijzen, M. (2009). Aggressive behavior in individuals with moderate to borderline intellectual disabilities who live in a residential facility: An evaluation of functional variables. Research in Developmental Disabilities, 30, 682–688. https://doi.org/10.1016/j.ridd.2008.04.007.
Emerson, E. (2001). Challenging behaviour. Analysis and intervention in people with severe intellectual disabilities (2nd ed.). Cambridge: University Press.
Emerson, E., Blacher, J., Einfeld, S., Hatton, C., Robertson, J., & Stancliffe, R. J. (2014). Environmental risk factors associated with the persistence of conduct difficulties in children with intellectual disabilities and autistic spectrum disorders. Research in Developmental Disabilities, 35, 3508–3517. https://doi.org/10.1016/j.ridd.2014.08.039.
Emerson, E., Kiernan, C., Alborz, A., Reeves, D., Mason, H., Swarbrick, R., et al. (2001). The Prevalence of challenging behaviors: A total population study. Research in Developmental Disabilities, 22, 77–93. https://doi.org/10.1016/S0891-4222(00)00061-5.
*Emerson, E., Robertson, J., & Wood, J. (2005). Emotional and behavioural needs of children and adolescents with intellectual disabilities in an urban conurbation. Journal Intellectual Disability Research, 49, 16–24. https://doi.org/10.1111/j.1365-2788.2005.00658.x.
Faeh, D., Viswanathan, B., Chiolero, A., Warren, W., & Bovet, P. (2006). Clustering of smoking, alcohol drinking and cannabis use in adolescents in a rapidly developing country. BMC Public Health, 6, 1–8. https://doi.org/10.1186/1471-2458-6-169.
Farmer, C., & Aman, M. (2009). Development of the children’s scale for hostility and aggression: Reactive/proactive. Research in Developmental Disabilities, 30, 1155–1167. https://doi.org/10.1016/j.ridd.2009.03.001.
Farmer, C., & Aman, M. (2010). Psychometric properties of the children’s scale of hostility and aggression: Reactive/proactive (C-SHARP). Research in Developmental Disabilities, 31, 270–280. https://doi.org/10.1016/j.ridd.2009.09.014.
*Farmer, C. A., & Aman, M. G. (2011). Aggressive behavior in a sample of children with autism spectrum disorders. Research in Autism Spectrum Disorders, 5, 317–323. https://doi.org/10.1016/j.rasd.2010.04.014.
Feeney-Kettler, K. A., Kratochwill, T. R., & Kettler, R. J. (2011). Identification of preschool children at risk for emotional and behavioral disorders: Development and validation of a universal screening system. Journal of School Psychology, 49, 197–216. https://doi.org/10.1016/j.jsp.2011.02.001.
Gopal, D. V. V., & Ashok, A. (2012). Prevalence of emotional and behavioral problems among tribal and non-tribal adolescents. Journal of the Indian Academy of Applied Psychology, 38, 63–67.
*Hartley, S. L., Sikora, D. M., & McCoy, R. (2008). Prevalence and risk factors of maladaptive behaviour in young children with autistic disorder. Journal of Intellectual Disability Research, 52, 819–829. https://doi.org/10.1111/j.1365-2788.2008.01065.x.
Healy, O., Lydon, S., & Murray, C. (2014). Aggressive behavior. In P. Sturmey & R. Didden (Eds.), Evidence-based practice and intellectual disabilities (pp. 103–132). Oxford: Wiley.
*Jang, J., Dixon, D. R., Tarbox, J., & Granpeesheh, D. (2011). Symptom severity and challenging behavior in children with ASD. Research in Autism Spectrum Disorders, 5, 1028–1032. https://doi.org/10.1016/j.rasd.2010.11.008.
*Kanne, S. M., & Mazurek, M. O. (2011). Aggression in children and adolescents with ASD: Prevalence and risk factors. Journal of Autism and Developmental Disorders, 41, 926–937. https://doi.org/10.1007/s10803-010-1118-4.
Ketller, R. J., Glover, T. A., Albers, C. A., & Feeney-Kettler, K. A. (2014). Universal screening in educational settings. Washington, DC: American Psychological Association.
Kiernan, C., & Qureshi, H. (1986). Setting interview. Manchester: Hertern Adrian Research Centre, University of Manchester.
Koritsas, S., & Iacono, T. (2012). Challenging behaviour and associated risk factors: An overview (part I). Advances in Mental Health and Intellectual Disabilities, 6, 199–214. https://doi.org/10.1108/20441281211236643.
Kushlick, A., Blunden, R., & Cox, G. (1973). A method of rating behaviour characteristics for use in large scale surveys of mental handicap. Psychological Medicine, 3, 455–478. https://doi.org/10.1017/S0033291700054271.
Lang, R., O’Reilly, M., Sigafoos, M., Machalicek, W., Rispoli, M., Lancioni, G. E., et al. (2010). The effects of an abolishing operation intervention component on play skills, challenging behavior and stereotypy. Behavior Modification, 34, 267–289. https://doi.org/10.1177/0145445510370713.
Laye-Gindhu, A., & Schonert-Reichl, K. A. (2005). Nonsuicidal self-harm among community adolescents: Understanding the “whats” and “whys” of self-harm. Journal of Youth and Adolescence, 34, 447–457. https://doi.org/10.1007/s10964-005-7262-z.
*Lecavalier, L. (2006). Behavioral and emotional problems in young people with pervasive developmental disorders: Relative prevalence, effects of subject characteristics, and empirical classification. Journal of Autism and Developmental Disorders, 36, 1101–1114. https://doi.org/10.1007/s10803-006-0147-5.
Lecavalier, L., Leone, S., & Wiltz, J. (2006). The impact of behaviour problems on caregiver stress in young people with autism spectrum disorders. Journal of Intellectual Disability Research, 50, 172–183. https://doi.org/10.1111/j.1365-2788.2005.00732.x.
*Lowe, K., Allen, D., Jones, E., Brophy, S., Moore, K., & James, W. (2007). Challenging behaviours: Prevalence and topographies. Journal of Intellectual Disability Research, 51, 625–636. https://doi.org/10.1111/j.1365-2788.2006.00948.x.
McAuley, L., Pham, B., Tugwell, P., & Moher, D. (2000). Does the inclusion of grey literature influence estimates of intervention effectiveness reported in meta-analyses? The Lancet, 356, 1228–1231. https://doi.org/10.1016/S0140-6736(00)02786-0.
*McTiernan, A., Leader, G., Healy, O., & Mannion, A. (2011). Analysis of risk factors and early predictors of challenging behavior for children with autism spectrum disorder. Research in Autism Spectrum Disorders, 5, 1215–1222. https://doi.org/10.1016/j.rasd.2011.01.009.
Miltenberg, R. G. (1998). Methods for assessing antecedent influences on challenging behavior. In J. K. Luiselli & M. J. Cameron (Eds.), Antecedent control: Innovative-approaches to behavioral support (pp. 47–65). Baltimore: Paul H. Brookes Publishing Co.
*Murphy, O., Healy, O., & Leader, G. (2009). Risk factors for challenging behaviors among 157 children with autism spectrum disorder in Ireland. Research in Autism Spectrum Disorders, 3, 474–482. https://doi.org/10.1016/j.rasd.2008.09.008.
*Newman, I., Leader, G., Chen, J. L., & Mannion, A. (2015). An analysis of challenging behavior, comorbid psychopathology, and Attention-Deficit/Hyperactivity Disorder in Fragile X Syndrome. Research in Developmental Disabilities, 38, 7–17. https://doi.org/10.1016/j.ridd.2014.11.003.
*Pavlovic, M., Zunic-Pavlovic, V., & Glumbic, N. (2013). Students’ and teachers’ perceptions of aggressive behaviour in adolescents with intellectual disability and typically developing adolescents. Research in Developmental Disabilities, 34, 3789–3797. https://doi.org/10.1016/j.ridd.2013.07.035.
Pflug, V., & Schneider, S. (2015). School absenteeism: An online survey via social networks. Child Psychiatry and Human Development, 47, 417–429. https://doi.org/10.1007/s10578-015-0576-5.
*Richdale, A., Gavidia-Payne, S., Francis, A., & Cotton, S. (2000). Stress, behaviour, and sleep problems in children with intellectual disability. Journal of Intellectual and Developmental Disability, 25, 147–161. https://doi.org/10.1080/13269780050033562.
Rojahn, J., Matson, J. L., Lott, D., Esbensen, A. J., & Smalls, Y. (2001). The Behavior Problems Inventory: An instrument for the assessment of self-injury, stereotyped behavior and aggression/destruction in individuals with developmental disabilities. Journal of Autism and Developmental Disabilities, 31, 577–588. https://doi.org/10.1023/A:1013299028321.
Ross, S. W., Romer, N., & Horner, R. H. (2011). Teacher well-being and the implementation of schoolwide positive behavior interventions and supports. Journal of Positive Behavior Interventions, 14, 118–128. https://doi.org/10.1177/1098300711413820.
*Ruddick, L., Davies, L., Bacarese-Hamilton, M., & Oliver, C. (2015). Self-injurious, aggressive and destructive behaviour in children with severe intellectual disability: Prevalence, service need and service receipt in the UK. Research in Developmental Disabilities, 45, 307–315. https://doi.org/10.1016/j.ridd.2015.07.019.
Sigafoos, J., O’Reilly, M., Lancioni, G. E., Lang, R., & Didden, R. (2014). Self-injurious behavior. In P. Sturmey & R. Didden (Eds.), Evidence-based practice and intellectual disabilities (pp. 103–132). Oxford: Wiley.
Simonsen, B., Britton, L., & Young, D. (2010). School-wide positive behavior support in an alternative school setting: A case study. Journal of Positive Behavior Interventions, 12, 180–191. https://doi.org/10.1177/1098300708330495.
Simó-Pinatella, D., Font-Roura, J., Planella-Morató, J., McGill, P., Alomar-Kurz, E., & Giné, C. (2013). Types of motivating operations in interventions with problem behavior: A systematic review. Behavior Modification, 37, 3–38. https://doi.org/10.1177/0145445512448096.
Simó-Pinatella, D., Günther-Bel, C., & Mumbardó-Adam, C. (2019). Addressing challenging behaviors in children with autism: A qualitative analysis of teachers’ experiences. (Manuscript submitted for publication).
Simó-Pinatella, D., Mumbardó-Adam, C., Lowe, K., Jones, E., Cortina, A., Alomar-Kurz, E., et al. (2018). Exploring youth’s problem behavior prevalence in educational settings: Piloting the process. Advances in Neurodevelopmental Disorders, 2, 142–150. https://doi.org/10.1007/s41252-017-0042-4.
*Simó-Pinatella, D., Mumbardó-Adam, C., Montenegro-Montenegro, E., Cortina, A., Mas, J. M., Baqués, N., et al. (2017). Prevalence and risk markers of challenging behavior among children with disabilities. Advances in Neurodevelopmental Disorders, 1, 158–167. https://doi.org/10.1007/s41252-017-0022-8.
Steege, M. W., & Watson, T. S. (2009). Conducting school-based functional behavioral assessment. A practitioner’s guide (2nd ed.). New York: Guilford.
Sturmey, P., & Didden, R. (2014). Evidence-based practice and intellectual disabilities. Oxford: Wiley.
*Symons, F. J., Clark, R. D., Hatton, D. D., Skinner, M., & Bailey, D. B. (2003). Self-injurious behavior in young boys with fragile X syndrome. American Journal of Medical Genetics, 118A, 115–121. https://doi.org/10.1002/ajmg.a.10078.
*van Gameren-Oosterom, H. B. M., Fekkes, M., van Wouwe, J. P., Detmar, S. B., Oudesluys-Murphy, A. M., & Verkerk, P. H. (2013). Problem behavior of individuals with Down Syndrome in a nationwide cohort assessed in late adolescence. The Journal of Pediatrics, 5, 1396–1401. https://doi.org/10.1016/j.jpeds.2013.06.054.
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Simó-Pinatella, D., Mumbardó-Adam, C., Alomar-Kurz, E. et al. Prevalence of Challenging Behaviors Exhibited by Children with Disabilities: Mapping the Literature. J Behav Educ 28, 323–343 (2019). https://doi.org/10.1007/s10864-019-09326-9
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DOI: https://doi.org/10.1007/s10864-019-09326-9