ABSTRACT
This chapter focuses on issues that define challenging behaviour and describes a framework to guide the process of intervention. It considers variability between researchers regarding what constitutes challenging behaviour, and some indication that thresholds are different for families. Any starting point for managing challenging behaviour after traumatic brain injury is deciding if behaviour is challenging to the point that merits intervention. Despite the extensive literature on management of neurobehavioural disability, there is surprisingly little consideration about what constitutes challenging behaviour. Determining the immediate physical, mental and emotional harm of the behaviour will further influence the likelihood of labelling behaviour as challenging and is often the chief objective of formal risk assessment. Consideration of these factors within the context of the prevailing legislative framework further influences decisions about the challenging element of behaviour and whether intervention is necessary. The goal of assessment is to identify factors that drive and maintain challenging behaviour to create a formulation regarding its function.
