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Cutting Challenging Behaviour by 60% - New Support Model for People with Learning Disabilities

  • Published: 2016-01-26 (Revised/Updated 2016-02-24) : Dimensions UK (www.dimensions-uk.org).
  • Synopsis: Randomised controlled trial shows new approach to support for people with learning disabilities has achieved remarkable results
Learning Disability

Learning disability, learning disorder and learning difficulty are often used interchangeably, but they differ in several ways.

In the United States and Canada, the terms learning disability and learning disorder (LD) refer to a group of disorders that affect a broad range of academic and functional skills including the ability to speak, listen, read, write, spell, reason, organize information, and do math. A person's IQ must be average or above to have a learning disability or learning disorder.

Learning Disability - Defined as a classification that includes several areas of functioning in which a person has difficulty learning in a typical manner, usually caused by an unknown factor or factors. Learning disability is an official clinical diagnosis, whereby the individual meets certain criteria, as determined by a professional (psychologist, pediatrician, etc.).

Learning Disorder - Defined as having significant learning problems in an academic area.

In the UK, terms such as specific learning difficulty, Developmental Dyslexia, Developmental coordination disorder and dyscalculia are used to cover the range of learning difficulties referred to in the United States as "learning disabilities". In the UK, the term "learning disability" refers to a range of developmental disabilities or conditions that are almost invariably associated with more severe generalized cognitive impairment.

Main Document

Quote: "We implemented a new model of support in the experimental group, and the control group services continued to use Dimensions' existing model of support."

A new approach to support for people with learning disabilities has achieved some remarkable results. In randomised controlled trials the approach, dubbed Dimensions Activate, resulted in:

  • A 60% drop in challenging behaviour
  • A 25% increase in meaningful activity
  • A 33% increase in active support
  • A considerable increase in staff job satisfaction

The research, conducted by Dimensions in association with the University of Kent's Tizard Centre and the Challenging Behaviour Foundation, and funded by the NIHR School for Social Care Research, points the way to a step change in the way providers should support people with learning disabilities and autism.

Lisa Hopkins, Managing Director of Dimensions, said, "This was a randomised control trial, one of very few in our sector, and the study was carried out over two years in 24 homes supportingĀ one to eight people. We implemented a new model of support in the experimental group, and the control group services continued to use Dimensions' existing model of support."

Activate improves the quality of social care provided in a personalised way. There are several components to the model:

Support is co-produced and designed in partnership with the people who are being supported, their families, and their support teams.

We set challenging goals in eight key areas known to affect a person's quality of life.

Support teams help people to achieve their goals using two techniques: Active Support, and Positive Behaviour Support. Periodic Service Reviews are a formal tool we then use to set standards, monitor progress, and provide performance feedback. They help determine if the people we support are achieving the outcomes they want to, provide the evidence base for continuous improvement, and also provide data for commissioners.

Hopkins added, "Activate is not a quick fix. It will require extensive retraining of all Dimensions support teams, using a mix of practical and classroom based training, together with widespread change to management systems. But as we implement the changes through 2016 and beyond, it will lead to a real step change in the quality of life for the people we support. We hope other organisations will also make use of the publicly available research findings."

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  1. Young Adults with Autism - PEERS Social Skills Help - UCLA Semel Institute for Neuroscience and Human Behavior
  2. Tactile Defensiveness and the Autism Spectrum - Disabled World
  3. People with Autism: Communication and Conflict Resolution - Disabled World


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