Behavioral problems in people with intellectual disability (ID) are frequent and represent a lot of discomfort in the families and environments that suffer from them.
It is estimated that up to 60% of people with ID may have behavioral problems. When we talk about behavioral problems, we mean: self-harm, aggression towards others, not respecting the rules, stealing, breaking, tearing, destroying, picking fights, shouting, offending, lying, manipulating... among others.
These problems must be of an intensity, frequency and duration that may compromise the integrity of the person or others, or limit the person's activities or significantly restrict their participation in the community.
They can have several causes:
- They may be a symptom of a psychiatric disorder, where a careful psychological and psychiatric evaluation will be necessary to determine the diagnosis. For example, if a person with ID attacks others, shouts, breaks things, etc. it should be assessed and determined if it could be suffering from a psychotic episode, or if it could be a depressive picture.
- It can also happen that the person with ID has a medical problem (such as a toothache, headache, etc.) and their way of expressing this pain is through disruptive behaviors.
- People with ID can sometimes express distress or suffering due to some event in their environment (such as a change in routine) through auto- and hetero-aggressive behaviors, and in people with severe ID, self-injury can represent a way of self-stimulation.
- Behavioral problems can also represent a feature of the phenotype of some genetic syndromes that run with ID, that is, disruptive behavior can be a typical feature of a syndrome.
Once the cause of the behavior problem is identified, we can establish different strategies to help us prevent these situations:
- One of the most used is the adaptation of the environment, in order to create an environment adapted to the needs, interests and capacities of the person with ID; that helps them plan space and time; to anticipate; that favors communication and fosters their autonomy. It is also important to identify the indicators or stimuli that can cause problematic behaviors to withdraw them.
- We have to work on the input of information through different senses. Often, it can be useful to reinforce the message we say verbally with visual stimuli (pictograms, drawings, etc.), as well as with tactile or proprioceptive experiences, creating a communicative situation through simple bodily experiences
- Finally, it is necessary to help the person with ID develop strategies related to the identification of emotions and their consequences in various social situations, as well as to recognize the indicators or warning signs that warn of the appearance of a problem It is important to influence expressing the emotions we feel, develop empathy towards the other, understand the socially accepted norms and interpersonal and emotional relationships, in order to promote a better understanding and to be able to give an adjusted response to the interaction with their environment An example of such an activity could be using cartoons or sequences to illustrate the consequences of different inappropriate behaviors and the emotions that result from these actions.
In conclusion, behavioral problems can improve with psychological attention and, depending on the case, with pharmacological treatment, always under continuous review to be able to adjust it depending on the evolution. When we meet a person with ID who presents behavioral problems, it is necessary to be able to carry out an accurate psychiatric and psychological diagnosis that helps us understand their cause or origin in order to establish a set of guidelines or strategies to follow to help the person and their environment to achieve a good quality of life.
