Physical conditions and challenging behaviour in people with intellectual disability: a systematic review

Background  Challenging behaviour is a major problem among people with intellectual disabilities. Physical factors may be an important cause. The aim of the present systematic review was to determine the physical conditions associated with challenging behaviour. Methods  A literature search was cond...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Journal of intellectual disability research 2011-07, Vol.55 (7), p.675-698
Hauptverfasser: de Winter, C. F., Jansen, A. A. C., Evenhuis, H. M.
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 698
container_issue 7
container_start_page 675
container_title Journal of intellectual disability research
container_volume 55
creator de Winter, C. F.
Jansen, A. A. C.
Evenhuis, H. M.
description Background  Challenging behaviour is a major problem among people with intellectual disabilities. Physical factors may be an important cause. The aim of the present systematic review was to determine the physical conditions associated with challenging behaviour. Methods  A literature search was conducted in PubMed and the Cochrane systematic review database for empirical studies published between 1990 and 2008. The quality of all the studies that met the inclusion criteria was assessed using the SIGN‐50 methodology checklists. Results  The search identified 45 studies, which looked at general medical conditions, motor impairment, epilepsy, sensory impairment, gastrointestinal disease, sleep disorders, dementia and others. There were four high‐quality observational studies, seven well‐conducted observational studies, 21 observational studies of low methodological quality and 13 non‐analytical studies. There were significant and independent associations between challenging behaviours and urinary incontinence, pain related to cerebral palsy and chronic sleep problems, and between self‐injurious behaviour and visual impairment. No association was found with hearing impairment, bowel incontinence, mobility impairment or epilepsy. Many other physical conditions were not addressed at all. Conclusion  Medical conditions can play a role in challenging behaviour, and this should be evaluated in the clinical setting. So far, the level of evidence is generally low, and longitudinal studies are completely lacking. We recommend a systematic approach to research examining the role of physical conditions in challenging behaviour, the ultimate aim being to establish a basis for the development of clinical guidelines.
doi_str_mv 10.1111/j.1365-2788.2011.01390.x
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_896179943</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><ericid>EJ929161</ericid><sourcerecordid>881695931</sourcerecordid><originalsourceid>FETCH-LOGICAL-c6310-b149d214cf0328629bfd0209eb1c9c92a2b8061e76c7a4d529adbe584dbd7bf13</originalsourceid><addsrcrecordid>eNqNkktv1DAUhSMEotPCP0DIQkJlk-B3bCQWqCpDS1UeBXVp2Y7T8ZBJhjjpTP49TjMMEguoN7F1v3N0c-9JEoBghuJ5vcwQ4SzFuRAZhghlEBEJs-2DZLYvPExmUHKaYk7IQXIYwhJCyBHlj5MDHCmeMzRL_OfFELzVFbBNXfjON3UAui6AXeiqcvWNr2-AcQt965u-Bb4Ga9esKwc2vlvEZ-ciZbs-GhQ-aOMr3w1vgAZhCJ1b6c5b0Lpb7zZPkkelroJ7uvseJd_fn347-ZBefJqfnby7SC0nCKYGUVlgRG0JCRYcS1MWEEPpDLLSSqyxEfE3XM5trmnBsNSFcUzQwhS5KRE5So4n33Xb_Oxd6NTKBxvb1LVr-qCE5CiXkpL_kwJxySS5h2eO4qgRzyP56p8kEgRjStkd-uIvdBlHXMfZRD_KcgbJ2KOYINs2IbSuVOvWr3Q7KATVmAW1VOPK1bhyNWZB3WVBbaP0-c6_NytX7IW_lx-BlztAh5iAstW19eEPRzGjkNPIPZs413q7L5-eSywRH23eTuWNr9xw7_7U-dnX8Rb16aT3MTHbvV63P1ScUs7U9eVcXX78Iq7m8FpdkV_32OeI</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>874575033</pqid></control><display><type>article</type><title>Physical conditions and challenging behaviour in people with intellectual disability: a systematic review</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>Applied Social Sciences Index &amp; Abstracts (ASSIA)</source><source>Education Source</source><creator>de Winter, C. F. ; Jansen, A. A. C. ; Evenhuis, H. M.</creator><creatorcontrib>de Winter, C. F. ; Jansen, A. A. C. ; Evenhuis, H. M.</creatorcontrib><description>Background  Challenging behaviour is a major problem among people with intellectual disabilities. Physical factors may be an important cause. The aim of the present systematic review was to determine the physical conditions associated with challenging behaviour. Methods  A literature search was conducted in PubMed and the Cochrane systematic review database for empirical studies published between 1990 and 2008. The quality of all the studies that met the inclusion criteria was assessed using the SIGN‐50 methodology checklists. Results  The search identified 45 studies, which looked at general medical conditions, motor impairment, epilepsy, sensory impairment, gastrointestinal disease, sleep disorders, dementia and others. There were four high‐quality observational studies, seven well‐conducted observational studies, 21 observational studies of low methodological quality and 13 non‐analytical studies. There were significant and independent associations between challenging behaviours and urinary incontinence, pain related to cerebral palsy and chronic sleep problems, and between self‐injurious behaviour and visual impairment. No association was found with hearing impairment, bowel incontinence, mobility impairment or epilepsy. Many other physical conditions were not addressed at all. Conclusion  Medical conditions can play a role in challenging behaviour, and this should be evaluated in the clinical setting. So far, the level of evidence is generally low, and longitudinal studies are completely lacking. We recommend a systematic approach to research examining the role of physical conditions in challenging behaviour, the ultimate aim being to establish a basis for the development of clinical guidelines.</description><identifier>ISSN: 0964-2633</identifier><identifier>EISSN: 1365-2788</identifier><identifier>DOI: 10.1111/j.1365-2788.2011.01390.x</identifier><identifier>PMID: 21366751</identifier><identifier>CODEN: JIDREN</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Adult and adolescent clinical studies ; Aggression ; Attention Deficit and Disruptive Behavior Disorders - epidemiology ; Behavior ; Behavior Problems ; Biological and medical sciences ; Cerebral Palsy ; Challenging behaviour ; Child clinical studies ; Correlation analysis ; Dementia ; Developmental disorders ; Epilepsy ; Fecal Incontinence - epidemiology ; Hearing Impairments ; Humans ; Intellectual deficiency ; intellectual disability ; Intellectual Disability - epidemiology ; Learning disabilities ; Learning disabled people ; Longitudinal Studies ; Medical conditions ; Medical sciences ; Mental disorders ; Mental Retardation ; Motor Skills Disorders - epidemiology ; Observational research ; Pain ; Physical Disabilities ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Self Destructive Behavior ; Self-Injurious Behavior - epidemiology ; self-injurious behaviour ; Sleep ; Sleep disorders ; Systematic review ; Urinary Incontinence - epidemiology ; Visual Impairments</subject><ispartof>Journal of intellectual disability research, 2011-07, Vol.55 (7), p.675-698</ispartof><rights>2011 The Authors. Journal of Intellectual Disability Research © 2011 Blackwell Publishing Ltd</rights><rights>2015 INIST-CNRS</rights><rights>2011 The Authors. Journal of Intellectual Disability Research © 2011 Blackwell Publishing Ltd.</rights><rights>Copyright Blackwell Publishing Ltd. Jul 2011</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c6310-b149d214cf0328629bfd0209eb1c9c92a2b8061e76c7a4d529adbe584dbd7bf13</citedby><cites>FETCH-LOGICAL-c6310-b149d214cf0328629bfd0209eb1c9c92a2b8061e76c7a4d529adbe584dbd7bf13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1365-2788.2011.01390.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1365-2788.2011.01390.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,30978,30979,45553,45554</link.rule.ids><backlink>$$Uhttp://eric.ed.gov/ERICWebPortal/detail?accno=EJ929161$$DView record in ERIC$$Hfree_for_read</backlink><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=24254064$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21366751$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>de Winter, C. F.</creatorcontrib><creatorcontrib>Jansen, A. A. C.</creatorcontrib><creatorcontrib>Evenhuis, H. M.</creatorcontrib><title>Physical conditions and challenging behaviour in people with intellectual disability: a systematic review</title><title>Journal of intellectual disability research</title><addtitle>J Intellect Disabil Res</addtitle><description>Background  Challenging behaviour is a major problem among people with intellectual disabilities. Physical factors may be an important cause. The aim of the present systematic review was to determine the physical conditions associated with challenging behaviour. Methods  A literature search was conducted in PubMed and the Cochrane systematic review database for empirical studies published between 1990 and 2008. The quality of all the studies that met the inclusion criteria was assessed using the SIGN‐50 methodology checklists. Results  The search identified 45 studies, which looked at general medical conditions, motor impairment, epilepsy, sensory impairment, gastrointestinal disease, sleep disorders, dementia and others. There were four high‐quality observational studies, seven well‐conducted observational studies, 21 observational studies of low methodological quality and 13 non‐analytical studies. There were significant and independent associations between challenging behaviours and urinary incontinence, pain related to cerebral palsy and chronic sleep problems, and between self‐injurious behaviour and visual impairment. No association was found with hearing impairment, bowel incontinence, mobility impairment or epilepsy. Many other physical conditions were not addressed at all. Conclusion  Medical conditions can play a role in challenging behaviour, and this should be evaluated in the clinical setting. So far, the level of evidence is generally low, and longitudinal studies are completely lacking. We recommend a systematic approach to research examining the role of physical conditions in challenging behaviour, the ultimate aim being to establish a basis for the development of clinical guidelines.</description><subject>Adult and adolescent clinical studies</subject><subject>Aggression</subject><subject>Attention Deficit and Disruptive Behavior Disorders - epidemiology</subject><subject>Behavior</subject><subject>Behavior Problems</subject><subject>Biological and medical sciences</subject><subject>Cerebral Palsy</subject><subject>Challenging behaviour</subject><subject>Child clinical studies</subject><subject>Correlation analysis</subject><subject>Dementia</subject><subject>Developmental disorders</subject><subject>Epilepsy</subject><subject>Fecal Incontinence - epidemiology</subject><subject>Hearing Impairments</subject><subject>Humans</subject><subject>Intellectual deficiency</subject><subject>intellectual disability</subject><subject>Intellectual Disability - epidemiology</subject><subject>Learning disabilities</subject><subject>Learning disabled people</subject><subject>Longitudinal Studies</subject><subject>Medical conditions</subject><subject>Medical sciences</subject><subject>Mental disorders</subject><subject>Mental Retardation</subject><subject>Motor Skills Disorders - epidemiology</subject><subject>Observational research</subject><subject>Pain</subject><subject>Physical Disabilities</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Self Destructive Behavior</subject><subject>Self-Injurious Behavior - epidemiology</subject><subject>self-injurious behaviour</subject><subject>Sleep</subject><subject>Sleep disorders</subject><subject>Systematic review</subject><subject>Urinary Incontinence - epidemiology</subject><subject>Visual Impairments</subject><issn>0964-2633</issn><issn>1365-2788</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNqNkktv1DAUhSMEotPCP0DIQkJlk-B3bCQWqCpDS1UeBXVp2Y7T8ZBJhjjpTP49TjMMEguoN7F1v3N0c-9JEoBghuJ5vcwQ4SzFuRAZhghlEBEJs-2DZLYvPExmUHKaYk7IQXIYwhJCyBHlj5MDHCmeMzRL_OfFELzVFbBNXfjON3UAui6AXeiqcvWNr2-AcQt965u-Bb4Ga9esKwc2vlvEZ-ciZbs-GhQ-aOMr3w1vgAZhCJ1b6c5b0Lpb7zZPkkelroJ7uvseJd_fn347-ZBefJqfnby7SC0nCKYGUVlgRG0JCRYcS1MWEEPpDLLSSqyxEfE3XM5trmnBsNSFcUzQwhS5KRE5So4n33Xb_Oxd6NTKBxvb1LVr-qCE5CiXkpL_kwJxySS5h2eO4qgRzyP56p8kEgRjStkd-uIvdBlHXMfZRD_KcgbJ2KOYINs2IbSuVOvWr3Q7KATVmAW1VOPK1bhyNWZB3WVBbaP0-c6_NytX7IW_lx-BlztAh5iAstW19eEPRzGjkNPIPZs413q7L5-eSywRH23eTuWNr9xw7_7U-dnX8Rb16aT3MTHbvV63P1ScUs7U9eVcXX78Iq7m8FpdkV_32OeI</recordid><startdate>201107</startdate><enddate>201107</enddate><creator>de Winter, C. F.</creator><creator>Jansen, A. A. C.</creator><creator>Evenhuis, H. M.</creator><general>Blackwell Publishing Ltd</general><general>Wiley-Blackwell</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>7SW</scope><scope>BJH</scope><scope>BNH</scope><scope>BNI</scope><scope>BNJ</scope><scope>BNO</scope><scope>ERI</scope><scope>PET</scope><scope>REK</scope><scope>WWN</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7TK</scope><scope>7X8</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope></search><sort><creationdate>201107</creationdate><title>Physical conditions and challenging behaviour in people with intellectual disability: a systematic review</title><author>de Winter, C. F. ; Jansen, A. A. C. ; Evenhuis, H. M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c6310-b149d214cf0328629bfd0209eb1c9c92a2b8061e76c7a4d529adbe584dbd7bf13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult and adolescent clinical studies</topic><topic>Aggression</topic><topic>Attention Deficit and Disruptive Behavior Disorders - epidemiology</topic><topic>Behavior</topic><topic>Behavior Problems</topic><topic>Biological and medical sciences</topic><topic>Cerebral Palsy</topic><topic>Challenging behaviour</topic><topic>Child clinical studies</topic><topic>Correlation analysis</topic><topic>Dementia</topic><topic>Developmental disorders</topic><topic>Epilepsy</topic><topic>Fecal Incontinence - epidemiology</topic><topic>Hearing Impairments</topic><topic>Humans</topic><topic>Intellectual deficiency</topic><topic>intellectual disability</topic><topic>Intellectual Disability - epidemiology</topic><topic>Learning disabilities</topic><topic>Learning disabled people</topic><topic>Longitudinal Studies</topic><topic>Medical conditions</topic><topic>Medical sciences</topic><topic>Mental disorders</topic><topic>Mental Retardation</topic><topic>Motor Skills Disorders - epidemiology</topic><topic>Observational research</topic><topic>Pain</topic><topic>Physical Disabilities</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Self Destructive Behavior</topic><topic>Self-Injurious Behavior - epidemiology</topic><topic>self-injurious behaviour</topic><topic>Sleep</topic><topic>Sleep disorders</topic><topic>Systematic review</topic><topic>Urinary Incontinence - epidemiology</topic><topic>Visual Impairments</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>de Winter, C. F.</creatorcontrib><creatorcontrib>Jansen, A. A. C.</creatorcontrib><creatorcontrib>Evenhuis, H. M.</creatorcontrib><collection>Istex</collection><collection>ERIC</collection><collection>ERIC (Ovid)</collection><collection>ERIC</collection><collection>ERIC</collection><collection>ERIC (Legacy Platform)</collection><collection>ERIC( SilverPlatter )</collection><collection>ERIC</collection><collection>ERIC PlusText (Legacy Platform)</collection><collection>Education Resources Information Center (ERIC)</collection><collection>ERIC</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index &amp; Abstracts (ASSIA)</collection><collection>Neurosciences Abstracts</collection><collection>MEDLINE - Academic</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><jtitle>Journal of intellectual disability research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>de Winter, C. F.</au><au>Jansen, A. A. C.</au><au>Evenhuis, H. M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><ericid>EJ929161</ericid><atitle>Physical conditions and challenging behaviour in people with intellectual disability: a systematic review</atitle><jtitle>Journal of intellectual disability research</jtitle><addtitle>J Intellect Disabil Res</addtitle><date>2011-07</date><risdate>2011</risdate><volume>55</volume><issue>7</issue><spage>675</spage><epage>698</epage><pages>675-698</pages><issn>0964-2633</issn><eissn>1365-2788</eissn><coden>JIDREN</coden><abstract>Background  Challenging behaviour is a major problem among people with intellectual disabilities. Physical factors may be an important cause. The aim of the present systematic review was to determine the physical conditions associated with challenging behaviour. Methods  A literature search was conducted in PubMed and the Cochrane systematic review database for empirical studies published between 1990 and 2008. The quality of all the studies that met the inclusion criteria was assessed using the SIGN‐50 methodology checklists. Results  The search identified 45 studies, which looked at general medical conditions, motor impairment, epilepsy, sensory impairment, gastrointestinal disease, sleep disorders, dementia and others. There were four high‐quality observational studies, seven well‐conducted observational studies, 21 observational studies of low methodological quality and 13 non‐analytical studies. There were significant and independent associations between challenging behaviours and urinary incontinence, pain related to cerebral palsy and chronic sleep problems, and between self‐injurious behaviour and visual impairment. No association was found with hearing impairment, bowel incontinence, mobility impairment or epilepsy. Many other physical conditions were not addressed at all. Conclusion  Medical conditions can play a role in challenging behaviour, and this should be evaluated in the clinical setting. So far, the level of evidence is generally low, and longitudinal studies are completely lacking. We recommend a systematic approach to research examining the role of physical conditions in challenging behaviour, the ultimate aim being to establish a basis for the development of clinical guidelines.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>21366751</pmid><doi>10.1111/j.1365-2788.2011.01390.x</doi><tpages>24</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0964-2633
ispartof Journal of intellectual disability research, 2011-07, Vol.55 (7), p.675-698
issn 0964-2633
1365-2788
language eng
recordid cdi_proquest_miscellaneous_896179943
source MEDLINE; Wiley Online Library Journals Frontfile Complete; Applied Social Sciences Index & Abstracts (ASSIA); Education Source
subjects Adult and adolescent clinical studies
Aggression
Attention Deficit and Disruptive Behavior Disorders - epidemiology
Behavior
Behavior Problems
Biological and medical sciences
Cerebral Palsy
Challenging behaviour
Child clinical studies
Correlation analysis
Dementia
Developmental disorders
Epilepsy
Fecal Incontinence - epidemiology
Hearing Impairments
Humans
Intellectual deficiency
intellectual disability
Intellectual Disability - epidemiology
Learning disabilities
Learning disabled people
Longitudinal Studies
Medical conditions
Medical sciences
Mental disorders
Mental Retardation
Motor Skills Disorders - epidemiology
Observational research
Pain
Physical Disabilities
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Self Destructive Behavior
Self-Injurious Behavior - epidemiology
self-injurious behaviour
Sleep
Sleep disorders
Systematic review
Urinary Incontinence - epidemiology
Visual Impairments
title Physical conditions and challenging behaviour in people with intellectual disability: a systematic review
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-23T08%3A06%3A41IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Physical%20conditions%20and%20challenging%20behaviour%20in%20people%20with%20intellectual%20disability:%20a%20systematic%20review&rft.jtitle=Journal%20of%20intellectual%20disability%20research&rft.au=de%20Winter,%20C.%20F.&rft.date=2011-07&rft.volume=55&rft.issue=7&rft.spage=675&rft.epage=698&rft.pages=675-698&rft.issn=0964-2633&rft.eissn=1365-2788&rft.coden=JIDREN&rft_id=info:doi/10.1111/j.1365-2788.2011.01390.x&rft_dat=%3Cproquest_cross%3E881695931%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=874575033&rft_id=info:pmid/21366751&rft_ericid=EJ929161&rfr_iscdi=true