A person's behaviour can be defined as "challenging" if it puts them or those around them (such as their carer) at risk, or leads to a poorer quality of life.
It can also impact on their ability to join in everyday activities. Challenging behaviour can include aggression, self-harm, destructiveness and disruptiveness.
Communication is the main way we interact and express our needs, likes and dislikes. If communication is a problem, it can be very frustrating for the person and may result in challenging behaviour. If this behaviour leads to a desired outcome, it may be repeated again and again.
Challenging behaviour is often seen in people with conditions that affect communication and the brain, such as learning disabilities or dementia.
What can you do to help?
As a carer, try to understand why the person you look after is behaving in this way. For example, they might feel anxious or bored, or in pain.
If you can recognise the early warning signs, you may be able to prevent behavioural outbursts. For example, if being in a large group of people makes the person you care for feel anxious and they become agitated, you could arrange for them to be in a smaller group or have one-to-one support.
Some people find a distraction can focus a person's energies elsewhere and prevent them displaying challenging behaviour.
The person you care for might behave in a challenging way to get your attention. If this is the case, consider not responding directly to their behaviour – although you shouldn't ignore them completely. But if their behaviour puts them or someone else at risk, you'll need to intervene as calmly as possible.
Professional help with challenging behaviour
If you're finding it hard to cope with the behaviour of the person you look after, you can ask your GP to refer you to a specialist with knowledge of challenging behaviour. You will usually be asked to keep a record of the person's behaviour to see if there are any patterns.
The specialist will want to know what situations or people trigger the behaviour, what the early warning signs are, and what happens after the event.
A specialist will try to find out what the person is aiming for in their challenging behaviour. Do they crave one-to-one attention, or do they want to be removed from a situation they find difficult? If a reason for the behaviour can be established, their needs could be met in an alternative way to prevent them resorting to challenging behaviour.
Any techniques you try must be followed consistently by all those involved in the care of the person you look after. If everyone does this, it will help the individual involved to understand what's expected of them.
In extreme circumstances – for example, if the person's behaviour is harmful to themselves or others and all methods of calming them have been tried – a doctor may prescribe medication. If you're concerned about the side effects of medication, speak to the person's GP.
Challenging behaviour – help for carers
If you care for someone who displays challenging behaviour and you find it difficult to cope, support is available. It is particularly important that you seek support if you are experiencing harm from the person you care for (whether intentional or unintentional).
Many organisations for people with learning disabilities or dementia have strategies for coping with challenging behaviour. Some of these organisations also provide opportunities for carers to connect with other people in a similar situation – for example, through family linking schemes.
Sharing your experiences – for example, with a local carers' group – can be a good way of getting support. Contact the Carers Direct helpline on 0300 123 1053 or through your carers support group.
Respite care for the person you look after enables you to take a break from your caring responsibilities. It's one of the services your local authority can provide after an assessment for the person you care for, or a carer's assessment for you. See our pages on Carers' assessments for more information. Friends and family members can also be an important source of practical and emotional support.
Sometimes you may consider "restraining" the person if you believe their behaviour is putting themselves at risk and they don't have the mental ability or capacity to make a decision. But you should not restrain the person unless it is a reasonable action to take.
Find out about Lasting Power of Attorney and restraint.
Read about tackling challenging behaviour in children.
Carer's tip from Scope
"When faced with someone who is aggressive and shouting, keep your face neutral and lower the volume and pitch of your own voice. Nine times out of ten, they will quieten down to hear what you are saying."
Sexually inappropriate behaviour in children
Sexual exploration and play is a natural part of childhood sexual development, and helps children to develop physically and emotionally. Throughout their development, every child will express themselves sexually in different ways.
A child's behaviour will depend on their age and circumstances. The NSPCC website describes the behaviours typical of each developmental stage. It is normal to see a child exhibiting behaviour that is slightly more or less mature for their age.
Read more about talking to your children about sex and relationships.
If you have concerns about a child's behaviour
There are many reasons why children may show sexual behaviour that is inappropriate or unexpected for their age. It could be related to curiosity, anxiety, a traumatic experience, or because of a learning disability or mental health problem.
If your child acts inappropriately in public, try to distract them with another activity. This can be a useful way to defuse the situation.
If you think your child's behaviour is related to an illness, speak to the healthcare professionals involved in your child's care and ask for advice on how to manage their behaviour. They may inform you of local or national organisations that could help.
If you are concerned about the safety or welfare of a child, you can contact the NSPCC 24-hour helpline on 0808 800 5000 or email the NSPCC.
Sexually inappropriate behaviour in adults who need care
Sexually inappropriate behaviour in adults who need care can be a result of a mental health or neurological condition, such as dementia. It may include undressing in public, fondling genitals, or touching someone inappropriately. For more information on sex and disabilities, call the Outsiders website helpline.
You may not be able to stop a person engaging in inappropriate sexual behaviour, but there are ways you can address the issue.
- Think about or ask the person why they are acting in a certain way. For example, if they start to undress in public, are they hot or uncomfortable?
- React calmly to their behaviour.
- Treat the situation with humour, rather than sounding angry.
- Distract their attention, rather than being confrontational. If other people are present, you could explain to them that the behaviour is because of an illness and is not directed at them personally.
- Keep a diary to see if you can find a pattern in their behaviour – for example, whether it is more likely to occur in certain situations, with the same people present, or at certain times of the day or night.
If you're finding it difficult to control the behaviour of the person you look after, speak to social services or their GP.
Your health, your choices