What Are Challenging and Complex Behaviours - Fact Sheet

Challenging behaviours are common following Acquired Brain Injury. It is often caused by damage to parts of the brain that give us the tools to control impulses and regulate our emotions. Frequent challenging behaviour can lead to social exclusion, restriction of access to community services, and family breakdown.

What is acceptable and unacceptable behaviour is often socially determined. We tend to judge each other through our behaviour, and anyone acting outside the accepted boundaries is in danger of being excluded. There are literally thousands of ‘rules’ that people may break unknowingly after acquiring a brain injury. Behaviours labelled as problematic are often breaking a social norm or rule.

This can include:

• how close to stand to other people
• when it is appropriate to interrupt another person who is speaking
• when and how to show emotions
• how to interpret and respond to nonverbal communication
• what parts of a person’s body may be seen naked or touched, and under what circumstances
• when to speak, and how to get a point across.

A working definition of Challenging Behaviour

Simply put, problems occur when behaviours could result in harm for the person with a brain injury or harm toward others, or could restrict access to the community. Eric Emerson, a behavioural specialist, describes this as:

“Culturally abnormal behaviour of such intensity, frequency or duration that the physical safety of the person or others is placed in serious jeopardy [and] . . . behaviour which is likely to seriously limit or deny access to the use of ordinary community facilities." (Emerson 1995)

A challenging behaviour is one that we find hard to accept; it literally challenges our ability to understand why it is happening. A complex behaviour is one which makes it difficult to initially see the reasons for the behaviour. We will use these terms as interchangeably as they are usually strongly linked together in the context of a brain injury.

Examples of challenging & complex behaviours:

• Physical or verbal aggression
• Self-injury
• Property destruction
• Disinhibition
• Hypersexuality
• Impulsivity
• Aggressive behaviour.

Why not just say ‘bad behaviour’?

Why use the terms challenging behaviour and complex behaviour? Why not say bad behaviour, throwing a tantrum, or being difficult? The problem is that when we use negative and judgmental words our actions tend to follow suit, and the behaviour will only deteriorate in response. But if we use objective terms like challenging behaviour then we are more likely to be objective in our thoughts and actions.

Is a behaviour really ‘bad’? Consider the driver who is doing the speed limit but everyone else is speeding about 15 kmh over the limit. Despite obeying the law, this driver will probably get the horn, some tailgating, the finger and other inducements to speed up. We believe that normal behaviour is simply what most of us do; if someone starts behaving outside the ordinary then it doesn’t take long for that behaviour to challenge our understanding.

While this distinction between words might look like political correctness gone mad, it’s actually crucial to supporting positive behaviour. If her family sees Sarah as bitchy, temperamental and wilfully disruptive, these negative perceptions will hinder any positive strategies, damage the relationship with Sarah, and make the family more likely to react than act.