Relationship of challenging behavior and sensory processing function in children with severe intellectual disabilities

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Relationship of challenging behavior and sensory processing function in children with severe intellectual disabilities


Author: Choy, Wing-yan
Title: Relationship of challenging behavior and sensory processing function in children with severe intellectual disabilities
Degree: M.Sc.
Year: 2010
Subject: Children with mental disabilities.
Children with mental disabilities -- Behavior modification.
Sensorimotor integration -- Therapeutic use
Hong Kong Polytechnic University -- Dissertations
Department: Dept. of Rehabilitation Sciences
Pages: x, 90 leaves : ill. ; 30 cm.
Language: English
Abstract: Background: Challenging behavior affects a person's social competence and community integration. Some studies indicated that challenging behavior of people with intellectual disabilities is a mean to fulfill sensory needs. This study aims to identify the common types of challenging behavior observed in children with severe intellectual disabilities and to investigate if relationship exits between challenging behavior and sensory processing function. Method: The Behavior Problem Inventory (BPI-01) and The Chinese Sensory Profile were adopted by this study. The Behavior Problem Inventory has three sub-scales: 14 items for self-injurious behaviors, 24 items for stereotyped behaviors and 11 items for aggressive behaviors. The Chinese Sensory Profile contains eight factors: sensory seeking behavior, emotional reactiveness, low endurance/tone, oral sensory sensibility, inattention/distractibility, poor registration, sensory sensitivity and fine motor or perceptual skills. It was designed to analyze a person's three sensory processing functions including tactile, vestibular and proprioceptive function registered from the environment. Four registered occupational therapists from four special schools completed the data collection using two instruments.
Results: A total of 25 subjects with severe intellectual disabilities from four special schools aged from 6-13 years old and exhibited at least one form of challenging behavior in the preceding two months participated in this study. The result showed that the most common type of self-injurious behavior was self-biting, whereas rocking back and forth was the most common stereotyped behavior. The results indicated that the severity of self-injurious behavior and stereotyped behavior were little among the 25 subjects. Aggressive behavior was not common because less than 15% of the subjects were found to exhibit aggressive behavior. Tactile processing function was found to have significant association with 6 types of self-injurious behavior (E.g. self-scratching (Z=0.552, p<0.01); self pinching (Z=0.570, p<0.05)); 13 types of stereotyped behavior (E.g. spinning own body (Z=0.5, p<0.05); yelling and screaming (Z=0.5, p<0.05)) and 5 types of aggressive behavior (E.g. pushing others (Z=0.533, p<0.01); biting others (Z=0.500, p<0.05)). Vestibular processing function was found to have significant association with 3 types of self-injurious behavior (E.g. hitting head with hands or body parts (Z=0.532, p<0.05); pica (Z=0.505, p<0.05)) and 6 types of stereotyped behavior (E.g. rocking back and forth (Z=0.768, p<0.01); turning around on spot (Z=0.578, p<0.01)). However, no significant association was found between vestibular processing function and aggressive behavior. Prioprioceptive processing function was found to have significant association with three types of self-injurious behavior (E.g. self pinching (Z=0.515, p<0.01); pica (Z=0.508, p<0.01)); twelve types of stereotyped behavior (E.g. rubbing self (Z=0.515, p<.0.01) ; clapping hand (Z=0.586, p<0.01)) and one type of aggressive behavior (hitting other (Z=0.514, p<0.01)). Discussion: The findings from this study indicated that self-injurious behavior, stereotyped behavior and aggressive behavior were not severe among children with severe intellectual disabilities. Challenging behaviors such as yelling, screaming or kicking others were presented to get rid of some undesirable tactile stimulus from the environment. Challenging behaviors such as rocking back and forth, pica and engaging in repetitive movement were applied to seek for vestibular and proprioceptive stimulus from the environment. In this study, association was found between challenging behaviors and sensory processing dysfunction in people with severe intellectual disabilities. This evidence suggested that sensory integration treatment should be applied to reduce challenging behaviors that are caused by sensory processing dysfunction. This study indicated that treatment focus on tactile defensiveness should be applied for client's yelling and screaming behavior. Treatment focus on vestibular stimulation should be applied on clients with rocking behavior.

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