Somatic conditions in challenging behaviour

In people with intellectual disabilities, somatic conditions can be a major cause of challenging behaviour such as self-injurious behaviour or aggression. CCE believes this kind of behaviour in clients is never an isolated phenomenon: it always occurs in a specific context.

This context includes both a client’s social environment (the people involved in the client’s life) and their physical surroundings (the settings in which they live or work). Challenging behaviour is the result of a negative interaction between the client – with his or her specific limitations – and the context. As a client’s behaviour is defined as being challenging by the people involved, context is always a factor. In this respect, CCE follows the definition of challenging behaviour used by the European Association on Mental Health in Intellectual Disabilities (EAMHID, 2007).

It is important to identify the factors which cause or perpetuate challenging behaviour in both the client and their environment, and in the interaction between the two. On the individual client’s level, CCE distinguishes between biological and psychological factors that can cause or perpetuate challenging behaviour. On the contextual level, CCE makes a further distinction between the social setting, the physical setting and the organization involved.

In this document, the focus will be on somatic conditions – on biological factors, therefore. People often overlook the fact that challenging behaviour can be caused by somatic conditions.

Somatic conditions cause visible symptoms, but can cause hidden symptoms, as well: sometimes, complaints are not expressed by the client nor are symptoms recognised by the people involved. To assist in understanding a client's behaviour, we at CCE have designed a Model for a step-by-step analysis. Once that process has been completed, you can zoom in on a selection of seventy of the most common somatic conditions that can cause challenging behaviour. The description of each condition covers the following areas:

• What is the condition?
• What are the symptoms/complaints associated with this condition?
• How often does the condition occur in the general population, and in people with intellectual disabilities (stated in percentages).

You can search  this selection of seventy of the most common somatic conditions by condition or by symptom/complaint.