Acquired Brain Injury and Challenging Behaviours

People who have had an acquired brain injury (ABI) can present with challenging behaviours which may include verbal aggression such as making loud noises and shouting angrily, inappropriate social behaviours and/or sexual behaviours, swearing and other behaviours of concern.   ABI can be caused by many health conditions such as a cardiac arrest, seizure or external such as a car accident. Strategies to manage these behaviours are adapted from the learning theory such as operant learning with positive and negative reinforcement and applied behaviour analysis to create a change in behaviour by understanding the function of the behaviour such as tired, hungry, lonely, sensory, escape or avoid an aversive stimulus.  A robust assessment is needed to help understand the function of the behaviour for a positive outcome and assessment needs to be ongoing as people and environment is never static.  The implication for these assessments and strategies is to increase the person with ABI to have a better quality of life, reduce or avoid the use of restrictive practice and reduce risk to people supporting and around the person with ABI.  There is ongoing reserach in creating behaviour change for people with ABI including the integration of neurobehavioral rehabilitation and positive behaviour support.  Positive behaviour support is an important component as it helps understand the function of the behaviour, trains the support network how to implement the strategies and about the condition and works towards meeting the needs of the person who is struggling to communicate these needs due to neurological challenges.  As a result, a design of creative strategies will help the person with ABI live with dignity, remain safe together with their support network.