Challenging Behaviour in Adults: Causes, Prevention, and Support

If you’ve ever worked in health or social care, you’ll know that what we call “challenging behaviour” is really a moment of human distress — a person trying to communicate something that words can’t quite capture.

And if you haven’t, imagine this: someone suddenly shouts or throws a mug when their favourite programme is turned off, or starts pacing when dinner is a few minutes late. It can feel tense, even frightening, but underneath that reaction is always a reason — a story waiting to be understood.

That’s what draws me to behaviour analysis. Every action has meaning, even when it’s hard to see at first. For me, it’s not about labelling or judging — it’s about listening in a different way. Maybe that’s the mathematician in me speaking; I like finding order and logic where most people see chaos. But in this work, the “pattern” isn’t data on a graph — it’s a person’s lived experience, expressed the only way they can in that moment.

What Does “Challenging Behaviour” Mean in Adults?

The term comes from Eric Emerson’s work (1995, 2001), which described challenging behaviour as any behaviour that “poses a risk to the person or others, or limits access to ordinary community settings.”

That definition does two very important things:

It removes blame from the individual.
It puts responsibility on us — the supporters, carers, practitioners — to understand and adapt the environment.

It’s not “their behaviour” versus “our expectations.” It’s an interaction between the two.
And once you start seeing it that way, the whole idea of “managing” behaviour starts to shift — from control to compassion.

Common Causes of Challenging Behaviour in Adults

I once read a study (McGill et al., 2018) showing that in adults with learning disabilities, the most common functions of behaviour are escape, attention, and access to items or activities.

But before we get too clinical, let’s unpack that like normal humans.

Escape or avoidance — Sometimes, an adult behaves in a challenging way to avoid something that feels unbearable: noise, confusion, physical pain, emotional overload, or even boredom.
Attention — We all crave connection. When attention is rare or inconsistent, people might seek it the only way that guarantees a reaction.
Access to things — A favourite activity, food, or item might be locked behind requests or rules they don’t fully understand.
Sensory or internal reinforcement — Some behaviours (like rocking, humming, or self-injury) meet sensory or emotional needs directly.

These aren’t “bad choices.” They’re functional responses — ways of coping when communication or control feel limited.

Prevention: The Art of Proactive Support

If you’ve ever tried to cook dinner while three children ask different questions at once, you already understand setting events.
They’re the background factors — stress, tiredness, hunger, pain — that make everything else harder to handle.

In behaviour analysis, we say:

Preventing behaviour starts long before it happens.

That means noticing early signs, adjusting the environment, and reinforcing positive moments before crisis hits.

Here’s what that can look like in adult support settings (and, honestly, in family life too):

Predictability. Schedules, visual aids, or consistent routines reduce anxiety. (I live by my Google Calendar, so I get it.)
Choice and control. Giving adults options — what to eat, where to sit, what to watch — builds autonomy and prevents frustration.
Clear communication. Using plain language, visuals, or AAC devices can reduce misunderstandings that escalate behaviour.
Sensory regulation. Access to quiet areas, movement breaks, or calming music could help people manage overstimulation.

Evidence backs this up. Positive Behaviour Support (PBS), which applies behavioural science within a person-centred framework, has shown significant reductions in incidents across UK services (Gore et al., 2013; Hastings et al., 2018).

Basically: it’s about getting things right before they go wrong.

A Little Kitchen Analogy (Because I Can’t Help Myself)

If a recipe doesn’t turn out quite right, we don’t blame the ingredients.
We look at the conditions — the timing, the tools, the environment we created.

Behaviour is similar: when someone is struggling, it’s a sign that something around them isn’t supporting them yet.
So instead of focusing on changing the person, we focus on what we can adjust — the environment, expectations, and support.

I’ve had plenty of kitchen experiments go sideways (and yes, takeaway nights still count as data).
The lesson’s the same: every attempt gives us information. Every response — ours and theirs — is feedback that helps us do better next time.

Supporting Adults During Challenging Behaviour

Even with the best prevention, behaviour sometimes escalates. When it does, safety and dignity come first.

The UK’s Restraint Reduction Network and BILD PBS standards are clear:

Use least restrictive approaches.
Prioritise de-escalation and communication.
Restore trust and learning afterward.

Here are a few simple principles that have guided me:

Stay calm — but genuine. People pick up on tone and body language more than words.
Use minimal language. During high stress, short, clear phrases are easier to process.
Offer space, not pressure. Some people need quiet to regulate; others need gentle reassurance.
Reinforce recovery. A calm return is a learning opportunity — not an “aftershock” of punishment.
Reflect later, not during. Support is most effective once everyone feels safe again.

Post-Incident Reflection: The Bit We Often Skip

After a challenging episode, there’s a temptation to move on quickly — for everyone’s sake.
But reflection is where growth happens.

In ABA, we use Functional Behaviour Assessment (FBA) to look at patterns:

What happened before? (antecedents)
What was the behaviour?
What happened after? (consequences)

This isn’t about blame — it’s about data-informed empathy.
When we understand the function, we can teach a better alternative.

And those small, consistent changes? They add up.
One less incident. One calmer morning. One person feeling more understood.

That’s where the work really matters.

Why This Matters to Me

Working in behaviour support isn’t about fixing people — it’s about kindness in action. It’s about creating the conditions where someone feels safe enough to grow.

That’s what drew me to Applied Behaviour Analysis in the first place. Beneath all the data and definitions is a science of compassion — of noticing what helps, and adjusting until life feels a little easier for the person in front of us.

I still spend far too many mornings with a coffee in one hand and a research paper in the other, not because I love academic jargon, but because I love what it can do when it’s translated into real, human change.

I’m a fairly quiet person by nature, but I’ve learned that quietness can be powerful. It gives space for listening, for understanding before acting — and that, to me, is the heart of good behavioural support.

References

Emerson, E. (1995, 2001). Challenging Behaviour: Analysis and Intervention in People with Severe Intellectual Disabilities. Cambridge University Press.

Gore, N. J., et al. (2013). Definition and scope for Positive Behavioural Support. International Journal of Positive Behavioural Support, 3(2), 14–23.

Hastings, R. P., et al. (2018). Supporting staff and services in Positive Behaviour Support implementation. International Journal of Positive Behavioural Support, 8(2), 3–13.

McGill, P., et al. (2018). The function of challenging behaviour in adults with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities, 31(5), 1–10.