What is Behaviour of Concern? Ten examples and common causes.

Article explaining what behaviours of concern are, providing examples of behaviours of concern, considering causes and effects.

a child and mother having a sensory story together

 

“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

Physical aggression towards others, which can include hitting, biting or kicking.

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.

Frequency

If the behaviour occurs frequently and persists over an extended period.

For example, ‘Alex’ head bangs more than 2-3 times per hour.

Intensity

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.

Duration

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.

10. Reinforcement

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.

At Work

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.

With Friends

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.

Learn more about Positive Behaviour support and Functional Behaviour Assessments.

Managing Behaviours of Concern with  Behaviour Management Apps

Behaviours of Concern are more easily managed now with the help of apps on your phone or computer.

The Behaviour Help App is designed to help you assess, manage and prevent behaviours of concern.  The app is a hugely valuable tool for caregivers, educators, parents and practitioners.

If you are worried about behaviours of concern, of any type, using the Behaviour Help App can really help prevent harmful impacts in the long term.  Here’s how the app can help:

Addressing Behaviours of Concern with Assess Manage Prevent

To address concerning behaviours we use a three step process called Assess, Manage, Prevent.

Assess

Assessment starts with data collection. The app allows you to quickly and easily record when behaviours of concern take place.  You can note down the time, location and environmental factors.

This information helps build a picture of the triggers for the behaviour of concern and it’s really important to capture it in the moment before we forget or the passage of time clouds our memory of the details.

For example, use the app to record "Flopping behavior occurred at 9:30 AM in the classroom when transitioning from free time to group activity."

In addition to recording incidents, you can also create questionnaires that users can complete to assess and identify potential triggers, frequency of behaviours and the emotional state of the individual.

These questionnaires can then be shared around collaborators such as parents, youth workers, educators or practitioners.

ABC (Antecedent - Behaviour - Consequence) charts are a great way to log information about behaviours of concern and the app facilitates this too.  What happened before, during and after the behaviour?  This is key to identifying patterns and triggers.

The assess stage is all about behavioural function identification.  The app helps you collect data (assess) to help identity why a behaviour is occurring.

Manage

So now you know (thanks to your guided assessment in the app) why the behaviour of concern is happening, how are you going to manage it going forward?

The Behaviour Help App provides suggestions for immediate interventions based on the behaviour you have assessed.

For example, the app might suggest that you offer choices, provide sensory tools or move to a quieter space.

This personalised plan helps ensure that all contributors to the individual’s care can follow the plan and provide consistent interventions.

Prevent

The last step is to put in place strategies to prevent the behaviour of concern from happening at all.

The Behaviour Help App makes collecting data about the behaviour really easy and over time, the app can analyse and highlight patterns.

This enables us to predict potential triggers so you can enact early interventions and prevent the behaviour of concern happening.

For example: “Flopping behaviour is most likely to occur during transitions after lunch.  Try using a visual schedule to support smoother transitions.”

The app can also suggest proactive strategies like implementing sensory diets, modifying the environment or teaching coping skills.

For example: “Encouraging breaks before the behaviour occurs or using preferred activities to motivate cooperation.”

Reinforcement is key and rewards can help reinforce.

How the Behaviour Help App Makes Behaviour Management So Easy

  • Accessible Across Devices: Use the app on your phone, tablet and computer to for ultimate flexibility when logging data and tracking progress.
  • Collaborative Capabilities: Multiple users (teachers, parents, therapists) can access and update the same behaviour plan, ensuring consistency across all settings.
  • Customisable Profiles: Users can create individualised profiles with detailed behavior plans, preferences, triggers, and proactive strategies.
  • Reports and Data Visualization: The app can generate reports and charts to visually display the effectiveness of interventions and progress over time.

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