The association between pain and challenging behaviour in people with intellectual disability

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Eden, Kate Elizabeth (2013). The association between pain and challenging behaviour in people with intellectual disability. University of Birmingham. Ph.D.

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Abstract

Pain is difficult to identify in individuals with intellectual disability. In addition to alleviating discomfort, it is important to recognise pain in these individuals as it may be associated with challenging behaviour.

A number of studies were conducted, which demonstrate a positive association between pain and challenging behaviour in people with intellectual disability. Gastro-oesophageal distress was associated with increased rates of challenging behaviour. Individuals with Tuberous Sclerosis Complex, a genetic syndrome associated with painful tumours, were shown to engage in higher rates (although not statistically significant) of challenging behaviour compared to individuals with Down syndrome, a low-risk pain group. Several psychometric properties of observational pain measures; the FLACC, NCCPC-R and direct pain behavioural codes, were appraised. The most robust pain measures were used to further demonstrate the association between pain and challenging behaviour and to examine the difference in pain scores between individuals with environmentally functional compared to non-functional challenging behaviour. The temporal relationship between behavioural indicators of pain and self injury was also assessed. Results indicated that pain may precede self injury in some individuals.

The results reported in this thesis demonstrate the importance of addressing the influence of pain and environmental factors when assessing and treating challenging behaviour.

Type of Work:

Thesis (Doctorates > Ph.D.)

Award Type:

Doctorates > Ph.D.

Supervisor(s):