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Communication and challenging behaviour

Jill Bradshaw, Lecturer in Learning Disability, The Tizard Centre, University of Kent at Canterbury.

Many people with learning disabilities have some difficulties with communication; this may be in understanding what other people are "saying" or in being able to express themselves. Challenging behaviour is very commonly associated with such difficulties and an understanding of the issues around communication may help to explain why challenging behaviour occurs. Improving communication may be helpful in reducing or preventing challenging behaviour.

People who have more severe learning disabilities are more likely to have more difficulties in communicating, and those people who have less communication skills seem more likely to have more frequent challenging behaviour. Communication is one of the most important ways in which we control our environment and influence other people. If a child's communication skills limit this control, frustration is likely and challenging behaviour may follow. If such behaviour is effective at getting what the child wants or needs, it may be more likely to occur again in the future.

Common Communication Difficulties

Difficulties understanding

People may experience difficulties in understanding what other people are saying. Many people use the context and situation (for example, knowing what usually happens in that situation), rather than the actual words used, to make sense of what is expected of them. Understanding skills are frequently overestimated. This may lead to confusions, for example, if someone doesn't know what they are being asked to do or if they receive the "wrong message". Difficulties in understanding may be exacerbated by unrecognised hearing loss. As the latter is very common in children and adults with learning disabilities it is very important to investigate this and, if possible, get treatment.

Abstract concepts (referring to things that cannot be seen or touched), negatives ( e.g.,"not" "don't"), and time concepts (e.g., "yesterday", "this afternoon") are particularly difficult to understand and may lead to people not receiving the intended message. For example,

Teacher's Message - "Sam, you're not going in the car ". Message understood by Sam - "I'm going out in the car". Sam does not understand "not " so thinks that he is going by car and becomes distressed when he realises he will have to walk. The message would have been clearer to Sam if the teacher had told him what he was going to do e g., "Sam, you're going for a walk".

People may also have difficulties because they are given too much language to process and are only understanding key words. Many people need to have information given to them in a simple structure. For example,

Mother 's Message - "Hannah, you can have a drink after you've tidied your room ". Message understood by Hannah - "I'm having a drink and then tidying my room". In English, what we say first is usually what we want the person to do first. Hannah becomes upset when she is expected to tidy her room and has not yet had her drink.

Another difficulty people may have is in interpreting language literally. We use many phrases whose intended meaning is not reflected in the actual words used. For example, if someone has done something that we find irritating we might say "Oh, that's great!", when we actually mean the opposite. Understanding the intended meaning of such communication requires attention to tone of voice, facial expression and body language. These may not be understood by the child.

Difficulties in sending messages

Many factors may contribute to the difficulties people with learning disabilities have in getting other people to understand them. The child may have difficulties in articulating speech or forming clear signs. They may lack the words necessary to convey the message they want to convey or they may use the right words but in the wrong order or without the appropriate supporting body language.

Such problems may be particularly crucial with certain sorts of messages. For example, indicating that an adult's request hasn't been understood, expressing a preference, letting someone know how you feel. If such important messages cannot be communicated, frustration is very likely and may lead to challenging behaviour. For example,

John is asked to go shopping. He is unable to tell people that he isn't in the mood to do this as he has had a busy morning. He would probably be happy to go after he has had a rest. He is unable to communicate these things and becomes upset and starts to scream when he is given his coat.

What can be done?

It is essential to have a good understanding of the ways in which a particular child or adult communicates and of the ways in which information needs to be presented to them to facilitate their understanding. Challenging behaviour may be more likely to occur in situations where people either do not understand what is being expected or are unable to use communication to control their environment.

Other people need to make sure that they are communicating in a way that the person understands. This may include using simple, short sentences and trying to avoid saying something which could be misunderstood. Objects, pictures and symbols are particularly useful as ways of reminding people what will be happening throughout the day (being able to anticipate events is often important) and of supplementing spoken language, as is signed communication.

It is also important to respond consistently to what the person is trying to communicate (particularly when their means of communication is unclear). It may be possible to teach the individual an easier way of communicating e.g., by using visual communication. Additional vocabulary may need to be introduced e.g., teaching the person how to ask for a rest.

Communication interventions need to include all aspects of the individual's life and must include those people who regularly communicate to the person. This should include thinking about the communication issues overall and not just around situations where challenging behaviours may occur.

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