Does engagement in meaningful occupation reduce challenging behaviour in people with intellectual disabilities? A systematic review of the literature

Abstract

Over several years, there has been much debate about the best way to manage challenging behaviour. Although national guidance highlights the importance of meaningful occupation, it is unclear to what extent this helps. This systematic review of the literature aimed to answer the question, 'does engagement in meaningful occupation reduce challenging behaviour in people with intellectual disability?' By searching a range of databases, electronic resources and web pages, 13 relevant articles were identified. Additionally, experts in the field were contacted, hand searches were performed and citation searches were carried out. These 13 articles were critically appraised and analysed using narrative synthesis. Although the amount of research identified was limited and the methodological quality was variable, some broad themes arose. A skilled and structured approach for carrying out occupation may be effective in reducing challenging behaviour; however, more robust research is needed before definitive conclusions can be drawn.

Systematic Reviews of the Health or Health care of People with Intellectual Disabilities: A Systematic Review to Identify Gaps in the Evidence Base

“…Finally, there were seven 'other' reviews of non-pharmacological interventions, of which one was the Cochrane review investigating both behavioural and cognitive-behavioural interventions for aggression (Hassiotis & Hall 2009). In addition, reviews considered the following: the role of engagement in meaningful occupation in reducing challenging behaviour (Ball & Fazil 2013); varied intervention programmes to treat behavioural problems in children (Petrenko 2013); effectiveness of augmentative and alternative communication (AAC) on challenging behaviour (Walker & Snell 2013); effectiveness of massage therapy on relaxation and challenging behaviour (Chan & Tse 2011); effect of multisensory therapy on challenging, stereotypic and positive behaviour (Chan et al 2010); and effectiveness of multisensory therapy (Snoezelen) in relation to behaviour (Lotan & Gold 2009).…”

Occupational therapy for adults with intellectual disabilities and sensory processing challenges: a Delphi study exploring practice within acute assessment and treatment units

“…Those with intellectual disabilities, autism and sensory integration difficulties are at increased risk of developing behaviour that challenges (NICE, 2015) and therefore at risk of restrictive interventions. Occupational therapy assessment that includes consideration of an individual’s sensory profile, preferences and needs fits with current NICE (2015) guidance, whilst intervention supporting participation in meaningful activity is a key element to enhance quality of life and may reduce behaviour that challenges (Ball and Fazil, 2013). Additionally, participants’ clear focus on discharge supports the agenda to minimise the number of people within in-patient settings and links with the wider role of occupational therapists as discharge facilitators across other areas of the profession (Rogers et al , 2017).…”

Cross-Cultural Adaptation, Validation and Reliability of the Spanish Satisfaction with Daily Occupations-Occupational Balance (SDO-OB): An Evaluation Tool for People with Mental Disorders

“…There were significant differences, however, regarding marital status, having children or not, educational level, and whether the person was currently working (Table 1). (22) Note: 1 1 missing value in group 1. ns. = non-significant.…”

“…Occupation can be defined as all activities that occupy a person's time, but as evidence has shown, the existence of a balance between personal care, productive activities, and leisure is essential for health and well-being of the person [1]. Theories and models in occupational therapy point to the human need to participate in meaningful activities, thus establishing that supporting occupational performance is a fundamental pillar of intervention within this discipline [2].…”