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Cited by 676Down syndrome and intellectual disability researchBehavioral and Psychological StudiesAutism Spectrum Disorder Research

Risk markers associated with challenging behaviours in people with intellectual disabilities: a meta-analytic study

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McClintock, K., Hall, S., Oliver, C.·2003·Journal of Intellectual Disability Research
DOI 10.1046/j.1365-2788.2003.00517.x
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Abstract

A meta-analysis of prevalence and cohort studies conducted over the last 30 years was carried out to identify risk markers for challenging behaviour shown by individuals with intellectual disabilities (IDs). A total of 86 potential studies was identified from the review, with 22 (25.6%) containing sufficient data to enable a statistical analysis to be conducted. Results indicated that males were significantly more likely to show aggression than females, and that individuals with a severe/profound degree of ID were significantly more likely to show self-injury and stereotypy than individuals with a mild/moderate degree of ID. Individuals with a diagnosis of autism were significantly more likely to show self-injury, aggression and disruption to the environment whilst individuals with deficits in receptive and expressive communication were significantly more likely to show self-injury. In most cases, tests for heterogeneity were statistically significant, as expected. The meta-analysis highlighted the paucity of methodologically robust studies of risk markers for challenging behaviours and the lack of data on incidence, prevalence and chronicity of challenging behaviour in this population.

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  • Communication impairments constitute an important individual risk factor for challenging behaviour.

    “Communication impairments constitute an important individual risk factor (22, 23) alongside insufficient adaptive problem-solving, and self-help abilities (24), sensory hypersensitivities (4), self-stimulation (3), physical discomfort or pain (25), symptom severity (26), comorbid psychiatric disorders (27), or intense need for care (14).”

    From ProVIA-Kids - outcomes of an uncontrolled study on smartphone-based behaviour analysis for challenging behaviour in children with intellectual and developmental disabilities or autism spectrum disorder (2024) · cites this paper as [23]

    The Discussion associates communication deficits with self-injury and, for expressive communication, aggression. But it calls poor communicative ability a possible risk marker and the findings tentative; it does not establish communication impairment as an important independent risk factor. (LLM, conf=0.88)

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  • Autistic symptom severity predicts the severity and frequency of stereotyped forms of NSSI seen in adults with learning disabilities.

    “Indeed, the fact that autistic symptom severity predicts the severity and frequency of the ‘stereotyped’ forms of NSSI seen in adults with learning disabilities [42] motivates investigation of autistic symptom severity as a predictor of the form of NSSI described by Maddox et al.”

    From A 'choice', an 'addiction', a way 'out of the lost': Exploring self-injury in autistic people without intellectual disability (2019) · cites this paper as [42]

    The Results report that people diagnosed with autism were more likely to show self-injury than those without that diagnosis. But the Discussion says no data were available on the association between autism and stereotyped behaviour. The paper does not establish that autistic symptom severity predicts the severity or frequency of stereotyped NSSI in adults. (LLM, conf=0.89)

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Research works printed but not linked: 6

  1. Abramson, J.H. (1994). Making Sense of Data: A Self-Instructional Manual on the Interpretation of Epidemiological Data (2nd Ed.). Oxford: Oxford University Press.
  2. Emerson, E. (2000). Challenging behavior. Analysis and intervention in people with intellectual disabilities (2 nd ed.). Cambridge: Cambridge University Press.
  3. Hall, S., Oliver, C. & Murphy, G. (2001). Early development of self-injurious behavior: An empirical study. American Journal on Mental Retardation, 106, 189-199.
  4. In J.K. Luiselli, J.L. Matson & N.N. Singh (Eds.), Self-injurious Behavior: Analysis, Assessment, and treatment. New York: Springer-Verlag.
  5. Oliver, C. (1993). Self-injurious behaviour: From response to strategy. In C. Kiernan (Ed.), Research to Practice?: Implications of Research on the Challenging Behaviour of People with Learning Disability (pp. 135-188). Clevedon, Bristol: BILD Publications. Risk Markers for Challenging Behaviour 22
  6. Schroeder, S.R., Bickel, W.K. & Richmond, G. (1986). Primary and secondary prevention of self-injurious behaviors: A lifelong problem. In K.D. Gadow (Ed.), Advances in Learning and Behavioral Disabilities (Vol. 5). Greenwich, CT: JAI Press.

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Authors
McClintock, K., Hall, S., & Oliver, C.
Affiliations
University of Birmingham (GB)
Corresponding author
Oliver, C.
ORCID
Venue
Journal of Intellectual Disability Research
Publisher
Wiley
Published
2003-08-15
Volume
47
Issue
6
Pages
405-416
ISSN
  • 0964-2633 (ISSN-L)
  • 1365-2788
DOI
10.1046/j.1365-2788.2003.00517.x
OpenAlex
W1975575139
Cited by
675
References
46
Citations by year
2026: 13 · 2025: 10 · 2024: 32 · 2023: 28 · 2022: 30 · 2021: 38 · 2020: 37 · 2019: 39 · 2018: 41 · 2017: 34 · 2016: 46 · 2015: 36 · 2014: 48 · 2013: 42 · 2012: 34
FWCI
1.34
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Journal of Intellectual Disability Research (publishedVersion)
  • PubMed (publishedVersion)
  • University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Down syndrome and intellectual disability research
  • Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
Keywords
behavioral problems, intellectual disability, risk indicators, aggression, self-harm, stereotypy, autism spectrum disorder, communication difficulties, sex differences, severity of intellectual disability, environmental disturbance
MeSH terms
Adolescent, Adult, Aggression, Child, Humans, Intellectual Disability, Risk Factors, Social Behavior, Self-Injurious Behavior

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