Screen
Screen for sensory impairments (see Vision and Hearing impairments), negative social circumstances, stressful life events (eg, abuse, neglect, bullying, and exclusion), and coping capacity (see Abuse, Exploitation and Neglect and Behaviours that Challenge).
Strongly Recommended
Empirical Ecosystem Expert Experiential
Mental health disturbances, common among adults with IDD, are associated with sensory impairments, negative life events244, lack of suitable supports (emotional, social, community, work, and recreational) 245, stress ,246 and coping capacity.107, 247
Promote inclusion and participation
Promote friendships, social networks, and accommodations for inclusion and participation to decrease isolation and loneliness.248
Strongly Recommended
Empirical Ecosystem Expert
Mental health disturbances, common among adults with IDD, are associated with sensory impairments, negative life events244, lack of suitable supports (emotional, social, community, work, and recreational) 245, stress ,246 and coping capacity.107, 247
Enhance coping skills
Engage with community services and interprofessional partners or teams to enhance coping skills.73
Strongly Recommended
Empirical Ecosystem Expert
Mental health disturbances, common among adults with IDD, are associated with sensory impairments, negative life events244, lack of suitable supports (emotional, social, community, work, and recreational)245, stress,246 and coping capacity.107, 247
Get the person’s perspective
Get the person with IDD’s perspective on their situation whenever possible. Use visual aids as well as words (eg, Books Beyond Words).24, 110
Strongly Recommended
Expert Experiential
The effects of these circumstances can best be understood by inviting and appreciating the perspectives of persons with IDD, in combination with those who support them.249-251
Beyond Words
The UK publisher Beyond Words provides books to support people who find pictures easier to understand than words. Whether you are supporting somebody with intellectual and developmental disabilities or communication difficulties, these books empower people through pictures. Watch the video What are Books Beyond Words to learn more about using picture books for communication. Topic specific book sets about Health, Health Care and Healthy Living are available.
Clinical Guidelines
The guidelines Challenging behaviour: A unified approach – update: Clinical and service guidelines for supporting children, young people and adults with intellectual disabilities who are at risk of receiving abusive or restrictive practices from the Royal College of Psychiatrists in London UK (2016) provide guidance on best practice to support people with behaviours that challenge.
Learn how to implement these guideline recommendations into your practice from selected articles in the special issue on primary care of adults with intellectual and developmental disabilities in Canadian Family Physician, Vol 64 (suppl 2): S1-78, April 2018:
HELP for behaviours that challenge in adults with intellectual and developmental disabilities
24. Bradley E, Hollins S. Books beyond words: Using pictures to communicate. Journal on Developmental Disabilities. 2013;19(1):24-32.
37. Banks R, Bush A, Other Contributors. Challenging behaviour: A unified approach – update: Clinical and service guidelines for supporting children, young people and adults with intellectual disabilities who are at risk of receiving abusive or restrictive practices. London, UK: The Royal College of Psychiatrists; 2016 April.
107. Hartley SL, MacLean Jr. WE. Stressful social interactions experienced by adults with mild intellectual disability. Am J Intellect Dev Disabil. 2009;114(2):71-84.
110. Hall SA. Community involvement of young adults with intellectual disabilities: Their experiences and perspectives on inclusion. Journal of Applied Research in Intellectual Disabilities. 2017;30(5):859-71.
244. Hulbert-Williams L, Hastings R, Owen DM, Burns L, Day J, Mulligan J, et al. Exposure to life events as a risk factor for psychological problems in adults with intellectual disabilities: A longitudinal design. Journal of Intellectual Disability Research. 2014;58(1):48-60.
245. Scott HM, Havercamp SM. Mental health for people with intellectual disability: The impact of stress and social support. American Journal on Intellectual and Developmental Disabilities. 2014;119(6):552-64.
246. Lunsky Y, Bramston P. A preliminary study of perceived stress in adults with intellectual disabilities according to self-report and informant ratings. J Intellect Dev Disabil. 2006;31(1):20-7.
247. Hartley SL, MacLean Jr. WE. Depression in adults with mild intellectual disability: Role of stress, attributions, and coping. Am J Intellect Dev Disabil. 2009;114(3):147-60.
248. Gilmore L, Cuskelly M. Vulnerability to loneliness in people with intellectual disability: An explanatory model. Journal of Policy and Practice in Intellectual Disabilities. 2014;11(3):192-9.
249. Skotko BG, Levine SP, Goldstein R. Having a brother or sister with down syndrome: Perspectives from siblings. Am J Med Genet A. 2011;155A(10):2348-59.
250. Skotko BG, Levine SP, Goldstein R. Having a son or daughter with down syndrome: Perspectives from mothers and fathers. Am J Med Genet A. 2011;155A(10):2335-47.
251. Skotko BG, Levine SP, Goldstein R. Self-perceptions from people with down syndrome. Am J Med Genet A. 2011;155A(10):2360-9.
