Reducing ‘Challenging’ Behavior By Training Support Staff to Promote Dignity and Respect

Posted on July 7, 2020

By Carli Friedman, CQL Director of Research

Behavior is a form of communication. People with intellectual and developmental disabilities (IDD) who exhibit behavior that is considered ‘challenging’ may actually be experiencing a range of conditions which cause that behavior. For example, ‘challenging’ behavior may be the result of mental or physical health issues. It may be a way for people to express they are being abused. Or it may also be a way to express that their needs are not being met.

Since ‘challenging’ behavior is often related to environmental causes, we were interested in exploring if, and how, treating people with dignity and respect reduces instances of ‘challenging’ behavior. Support staff in particular play an important role in promoting dignity and respect. For these reasons, CQL | The Council on Quality and Leadership conducted this study which examined the relationship between support staff being trained to promote dignity and respect and to recognize each person as a unique individual, and the number of ‘challenging’ behaviors exhibited by people with IDD. To do so, we analyzed Basic Assurances^® data from 74 organizations that supported approximately 7,000 people with IDD.

Our findings revealed a relationship between support staff being trained to promote dignity and respect, and ‘challenging’ behavior, regardless of the agency size or geographic location. People with IDD exhibited significantly fewer ‘challenging’ behaviors when supported by an agency that trained support staff to promote dignity and respect, compared to those people with IDD supported by agencies that did not train support staff to promote dignity and respect – a difference of 61% (see figure).

The Relationship Between Training Support Staff to Promote
Dignity and Respect, and ‘Challenging’ Behavior

“While not all ‘challenging’ behavior may be reduced by staff being trained to promote dignity and respect alone, findings from our study suggest this training may be one mechanism to reduce the incidence of ‘challenging’ behaviors, and by extension, the need for behavior intervention services which are costly, and, in some forms, controversial. However, regardless of if, or how, dignity or respect reduces incidences of ‘challenging’ behaviors, all people with IDD are entitled to respect” (Friedman, 2020, p. 12).