Behaviours of Concern and Autism

Future Research

Summary of Current Research

• Behaviours of concern are common in autistic people and more common in autistic people with learning disabilities
• Behaviours of concern often occur when someone has problems understanding what is happening around them or communicating what they want or need
• Behaviours of concern may also be associated with a number of other factors including underlying medical conditions, mental health problems, sensory sensitivities, and specific situations that the person finds distressing
• There is very little high quality research evidence on the effectiveness of most interventions for behaviours of concern in autistic people, although this does not necessarily mean that they do not work
• There is some high quality research which suggests that some antipsychotics may help to prevent or reduce behaviours of concern in some individuals but the same research suggests that antipsychotics may also cause significant and adverse side effects
• There is some limited research evidence to suggest that undertaking a functional analysis to determine the underlying functions of (reasons for) the behaviour may result in more effective interventions being used
• There is some limited research evidence to suggest that some behavioural techniques (such as rewarding someone when they do what you want) may be helpful in helping to prevent or reduce behaviours of concern in some autistic people
• There is some limited research evidence to suggest that some forms of assistive and augmentative technology / augmentative and alternative communication (such as voice output communication aids) may be helpful in helping to prevent or reduce behaviours of concern in some autistic people
• There is insufficient research evidence to suggest that using any kind of physical restraint will help to prevent or reduce behaviours of concern.
• There is insufficient research evidence to suggest that any other types of intervention are effective

Recommendations for Future Research

There is a need for further research into behaviours of concern by autistic people and the most effective interventions to overcome those behaviours. Specifically there is a need for studies which 

• are more scientifically rigorous and robust (randomised controlled trials)
• provide more comprehensive, standardised assessment methods of challenging behaviours in autistic people 
• identify and examine the co-occurrence of challenging behaviours and co-morbidities , such as disruptive behavioural disorders, using standardised diagnostic schemes
• include autistic adults,  particularly adults with learning disabilities
• include individuals with the most severe behaviours, such as self-injurious behaviours, aggression, property destruction and tantrums
• identify the factors that may cause challenging behaviours in specific autistic individuals 
• identify the specific components of interventions which appear to be most successful in reducing behaviours of concern
• examine if any reductions in challenging  behaviours can occur in typical settings (home or school) with typical agents (parents and teachers)
• examine the effects of interventions over a much longer period (longitudinal studies)
• assess collateral gains (increased rate of learning, social relationships, improved activity patterns) following interventions
• examine the interplay between different types of intervention (such as medications and behavioural interventions)
• involve autistic people to review the ethical basis of interventions in this area

Updated

21 Sep 2022