In order to examine the importance of a range of potential risk factors for behaviour problems in children with severe intellectual disability, a sample was identified by the administration of a screening version of the Vineland Adaptive Behaviour Scales (VABS) to the parents of children aged 4-11 years attending six special needs schools in three adjacent inner London boroughs. Parents whose children had a VABS standard score of < or = 50 were interviewed using the Disability Assessment Schedule and both parents and teachers completed the Aberrant Behaviour Checklist. Most behaviour problems were more common in ambulant children, but problems less dependent on the ability to walk, such as sleeping difficulties, screaming and self-injury, were equally common in ambulant and non-ambulant children. Among ambulant children, there were few significant associations between the severity of the child's behaviour problems and the age or sex of the child, the presence or absence of epilepsy, and various indices of socio-economic disadvantage. Sleeping difficulties, overactivity, self-injury, destructive behaviour and autistic features, such as social withdrawal and stereotypies, were strongly associated with skills deficits, but aggression, temper tantrums and general disruptive behaviour were not. Limitations in daily living skills were better predictors of behaviour problems than were poor communication skills.

Need for, and receipt of, respite care services were examined in a representative sample of 103 5±11-year-old children with severe intellectual disability and their families. Children for whom respite care was wanted had signi®cantly more severe disabilities and behaviour problems than those whose parents felt they did not need it; their parents also reported signi®cantly higher levels of stress. However, among those who wanted respite care, none of these factors appeared relevant to whether or not they had received it. The results suggest the need for greater account to be taken of the severity of the child's behaviour problems and intellectual disabilities in the allocation of respite care services, and also for measures to improve the supply of respite care placements capable of managing children with more challenging behaviour.