Challenging Behaviour

The following advice is adapted from NICE Guideline CG142: Autism in adults: diagnosis and management []


Before starting any interventions for challenging behaviour, first address any triggering or maintaining factors to the behaviour. Such possible factors might be, for example


  • A physical illness
  • A mental illness
  • An issue with the person’s physical or social environment


If none of the above appears to be triggering or maintaining the behaviour, complete a functional analysis. This should aim to provide information, from a range of environments, on the following:

  • factors that appear to trigger the behaviour
  • the consequences of the behaviour (that is, the reinforcement received as a result of their behaviour)
  • identifying trends in behaviour occurrence, factors that may be evoking that behaviour, and the needs that the person is attempting to meet by performing the behaviour


When choosing an intervention, this should be based on the functional analysis and also the following:

  • the nature and severity of the behaviour
  • the person's physical needs and capabilities
  • the physical and social environment
  • the capacity of staff and families, partners or carers to provide support
  • the preferences of the person with autism and, where appropriate, their family, partner or carer(s)
  • past history of care and support


The intervention should be based on behavioural principles and should include:

  • clearly identified target behaviour(s)
  • a focus on outcomes that are linked to quality of life
  • assessment and modification of environmental factors that may contribute to initiating or maintaining the behaviour
  • a clearly defined intervention strategy
  • a clear schedule of reinforcement, and capacity to offer reinforcement promptly and contingently on demonstration of the desired behaviour
  • a specified timescale to meet intervention goals (to promote modification of intervention strategies that do not lead to change within a specified time)
  • a systematic measure of the target behaviour(s) taken before and after the intervention to ascertain whether the agreed outcomes are being met


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