“Behaviours of concern” are behaviours of such intensity, frequency or duration that the physical safety of the person or others is placed in serious jeopardy, or behaviours which are likely to seriously limit or deny access to the use of ordinary community facilities (Emerson, 1995).
Behaviours of concern can include a wide range of behaviours.
Ten different example behaviours of concern
This is a list of example behaviours of concern, it isn’t exhaustive by any means but gives you a broad range of ideas that covers most types.
1. Physical Aggression
2. Verbal Aggression
Verbal aggression towards others which can include shouting, making threats or calling names.
3. Self Injury
Actions where an individual causes harm to themselves, such as head-banging, cutting or self-biting.
4. Property Destruction
Damaging property or belongings, either of their own or of others. Examples include punching walls, breaking windows or throwing objects.
5. Non Compliance
Refusing to follow rules or instructions, which can disrupt activities or routines.
6. Withdrawal or Isolation
Avoiding interaction with others, not participating in group activities, or showing signs of social disengagement.
7. Repetitive or Obsessive Actions
Engaging in repetitive behaviours or focusing excessively on specific interests or topics.
8. Inappropriate Social Behaviour
Acting in ways that are socially unacceptable or inappropriate for the context, such as undressing in public or using offensive language.
9. Sexualised Behaviour
Non-consensual touch, sexually explicit language or exposing one's genitals in inappropriate settings.
10. Food Related
Food related behaviours of concern is a broad group in itself and can include binge eating (eating very large quantities of food in a short period), vomiting after eating, refusing to eat or eating inedible things.
PICA behaviour where the individual eats things not usually considered edible, for example buttons, magnets or grass, can be very dangerous.
These are just examples of some common behaviours of concern that are observed often in schools, care or in family settings. A behaviour of concern doesn’t have to fit into one of these ten examples. Any behaviour could be considered concerning if it reaches a certain frequency, intensity or duration and is unsafe.
Frequency, Duration and Intensity
These measures of frequency, intensity, duration and safety considerations are used to assess behaviours of concern.
If the behaviour occurs frequently and persists over an extended period.
For example, ‘Alex’ head bangs more than 2-3 times per hour.
When the severity of the behaviour is excessive and / or disproportionate to the situation it is considered concerning.
For example, ‘Luke’ has been causing a lot of destruction to property at school, smashing windows and damaging computer equipment in an intensely aggressive way as if he is in a rage to what may appear to others as minor triggers.
When the behaviour persists for a period of time that significantly interferes with a person's daily life, functioning, and overall well-being it is concerning.
For example, ‘Joanne’ has been regularly withdrawing from others to spend time alone and has not been engaging in social activities for some time now. Over the last six months Joanne has been spending the majority of her day in her room every day.
Common causes of behaviours of concern
People may exhibit behaviours of concern for various reasons and it's important to understand that behaviour is complex and can be influenced by a combination of factors.
These behaviours are often a form of communication, especially in individuals who may have difficulty expressing their needs, feelings, or frustrations in more conventional ways.
Understanding underlying causes or triggers of these behaviours is crucial for addressing them effectively. Causes can include environmental factors, psychological distress, medical issues, or unmet needs.
Here are some common reasons why individuals may engage in behaviours of concern:
1. Communication Difficulties
Individuals who struggle with verbal communication may use behaviours of concern to express themselves. This could be due to developmental disorders like autism or in situations where language barriers exist. Behaviours such as aggression or self-harm can be manifestations of their inability to convey feelings of frustration, pain, or need for assistance.
2. Unmet Needs
Behaviours of concern often stem from basic unmet needs. For instance, a child might act out when hungry or tired, while an adult may exhibit challenging behaviours if they feel isolated or neglected. Sensory needs are also significant; some individuals might seek specific sensory input (like certain textures or movements) or may be overwhelmed by sensory overload, leading to distress and problematic behaviours.
3. Lack of Social Skills
Difficulty in social interactions can lead to frustration and behaviours of concern. This is particularly true for those with social skill deficits, such as individuals on the autism spectrum. They might struggle with understanding social cues, leading to inappropriate responses or interactions that are perceived as problematic.
4. Emotional Regulation
Individuals who have trouble managing their emotions, such as those with anxiety, depression, or certain neurodevelopmental disorders, might display behaviours of concern as a coping mechanism. Emotional dysregulation can result in outbursts, aggression, or withdrawal as a way of dealing with overwhelming feelings.
5. Environmental Factors
The surrounding environment plays a crucial role in behaviour. Chaotic, loud, or unpredictable settings can be overwhelming, especially for those with sensory sensitivities. Conversely, environments that are too unstimulating can also lead to behaviours of concern as individuals seek to create stimulation or excitement.
6. Learning and Cognitive Challenges
People with neurodevelopmental disorders, learning disabilities, or cognitive impairments (e.g. Dementia or Acquired Brain Injury) may find it difficult to understand and navigate their environment. This can lead to frustration and behaviours of concern, as they might not fully grasp social norms or might find routine tasks challenging.
7. Health Related Issues
Physical discomfort, illness, or mental health issues can manifest as behaviours of concern. For example, a person in pain might become irritable or aggressive, while someone with a mental health issue like depression might withdraw or exhibit self-injurious behaviour.
8. Attention Seeking
Some individuals might engage in behaviours of concern to attract attention. This can be due to feeling neglected or overlooked; in such cases, even negative attention can be perceived as better than no attention at all.
9. Modelling Behaviour
Behaviors can be learned through observation and imitation. If an individual is frequently exposed to certain behaviors, especially in family or close social circles, they might mimic these, even if they are problematic.
Behaviours that are reinforced, either positively or negatively, are likely to be repeated. For example, if a child throws a tantrum and is then given what they want, they learn that this behaviour is an effective way to get their needs met.
11. Lifestyle Factors
Lifestyle choices like lack of sleep, excessive screen time, poor diet, and a sedentary lifestyle can all contribute to behaviours of concern. Fatigue, low energy, and lack of physical activity can lead to irritability, lack of focus, and general disengagement.
12. Social Environment
Changes in family dynamics, routine, or social settings can trigger behaviours of concern. This includes situations like family disharmony, bullying, or trouble at school. These changes can create feelings of instability, stress, or insecurity, leading to challenging behaviours as a way to cope with the emotional turmoil.
Impacts of behaviour of concern on the individual
The impacts of behaviours of concern can be far-reaching and affect various aspects of an individual's life, including education, work, home life, relationships with family and friends, and even interactions with the legal system.
At School / In Education
At school and in education generally, disruptive behaviours can interfere with learning and can often lead to academic underachievement. Behaviours of concern often prevent the individual, and to a lesser extent those around them, from focussing in class and engaging with the learning.
If the behaviour leads to disciplinary actions such as suspensions or detention (often to protect the learning of others in the classroom) then the individual’s learning is obviously adversely affected.
The stigmatisation that often follows such actions sometimes leads the individual to be labeled by teachers and peers as ‘badly behaved’ and this can lead to lowered self esteem and isolation further damaging the person’s relationship with school and learning.
The behaviour of concern itself and associated stigmitisation, detentions and/or suspensions can all lead to problems making and maintaining friendships. Having a positive social experience at school or in any education setting leads to positive academic outcomes and the opposite is often true as well.
Similarly to school, behaviours of concern affect performance at work, workplace relationships and may even lead to disciplinary action.
If the behaviour of concern hinders or prevents the individual from doing their work well, or doing their work at all this is likely to limit career opportunities or even result in concerns being raised by colleagues.
In a team setting, the behaviour itself and / or lack of productivity could strain workplace relationships or even lead to conflicts with colleagues and supervisors.
Ultimately, the culmination of these factors could lead to disciplinary action or dismissal. None of this helps to address the behaviour of concern and its underlying cause.
At Home / With Family
Behaviours of concern can place significant stress on family relationships. For example, parents might find their relationship strained by behaviours of concern in a child or young person in their care. The potential breakdown of the family unit is a real concern.
Family members are often in the role of ‘caretaker’ and they may experience increased levels of personal stress, burnout or mental health issues of their own in the course of caring for and managing someone exhibiting behaviours of concern.
In severe cases, behaviours like aggression or self-harm can pose safety risks to the individual and family members.
Behaviours of concern often lead to social isolation because they can disrupt the course of making and maintaining friendships. Peers may reject the individual if they find their behaviour offensive or unsafe. This has a significant emotional and well-being impact on the person.
Limited social interactions can then lead to limited opportunities for getting out into community or wider society, meeting new opportunities or forming healthy romantic relationships.
In Wider Society
Aggression, violence, physical damage to property, sexualised and inappropriate behaviours can have consequences with the law. For adolescents, repeated behavioural issues may result in involvement with the juvenile justice system.
There is a risk of criminalising behaviours, particularly in cases where mental health issues are the underlying cause.
On the flip side, some behaviours of concern may cause an individual to become vulnerable to new threats from society such as emotional manipulation or social fraud in person or online.
This can take place if an individual becomes socially vulnerable through peer rejection and social isolation as a result of their behaviour.
Functional Behaviour Assessments and Positive Behaviour Support
Understanding the underlying causes of behaviours of concern is crucial for developing effective strategies to address and manage it.
The approach to addressing behaviours of concern is called Positive Behaviour Support. It's often beneficial to work with professionals such as psychologists, behaviour support practitioners, allied health professionals, educators and other professionals to create tailored strategies for individuals exhibiting behaviours of concern.
Teachers, parents, care givers and health professionals can also collaborate on Functional Behaviour Assessments. These help to identify behaviours of concern, address them and evaluate the effectiveness of the intervention in a consistent way through school and home life.