TTAUSNZ Recognising and supporting behaviour triggers for individuals with disabilities

5 minute read…

As human beings, we can all get triggered sometimes: certain situations, people, conversations, or even words can elicit strong feelings internally, leading to reactions and behaviour externally. Being triggered by our experiences is a normal human response, and, for the most part, we are able to navigate these occasions without incident.

For the individuals with disabilities that we care for in our services, different triggers can sometimes lead to behaviour that needs support. It’s our responsibility, then, to carry out Functional Behaviour Assessments (FBAs) to help us recognise and anticipate potential behaviour triggers. We can then use what we know about an individual – and their disability – to create bespoke plans, and decide on the best, most appropriate, support.

What do we mean by behaviour triggers?

Simply put, a behaviour trigger is a cue, prompt, or call to action that results in a powerful emotion such as fear, anxiety, or frustration. Often stemming from previous experiences, behaviour triggers can, over time, result in deeply-ingrained, habitual responses that are repeated over and over again.

For example, it might be that a service user with a learning disability has had a negative experience of receiving personal care in the past. Now, every time a staff member tries to get close to them, to attend to their personal care needs, the individual becomes highly distressed: they may scratch, bite, or lash out; they might scream, or become verbally aggressive; or they may completely shut down.

This is because they are subconsciously associating a previous negative experience with the current one, triggering an automatic response.

How disability may influence behaviour triggers

Behaviour triggers vary widely from person to person, and affect all of us, whether we have a disability or not. However, there may be a correlation between the nature and severity of an individual’s disability, and the type of experience they find triggering. For example:

• a person with a visual impairment might find crowded, cluttered environments challenging to navigate safely.
• someone with a profound and multiple learning difficulty (PMLD) may have trouble communicating their needs to their care team or wider support network, resulting in feelings of frustration or anger.
• if sensory overwhelm is an issue for an individual, they may struggle to cope and stay regulated in loud, chaotic environments.
• an individual with mobility difficulties might not be able to independently remove themselves from a situation that is making them feel uncomfortable.

By taking the nature of an individual’s disability into account, we can become more attuned to the types of behaviour trigger they may experience, and use this as a valuable source of information to interrupt the cycle of experiences, feelings, and reactions that lead to behaviour.

Ultimately, the aim is to give individuals more choice and control over their lives, and we can only be successful in this if we understand what drives their behaviour in the first place.

The importance of recognising individuals’ behaviour triggers

Once we carry out Functional Behaviour Assessments to understand and recognise different people’s triggers, we can formulate options around appropriate next steps.

Sometimes, the temptation is to avoid, reduce, or eliminate the trigger altogether, as a way of lowering risk, and mitigating the likelihood of behaviour that needs support. And in certain circumstances, this may well be the best course of action, especially where there is an immediate risk of harm, either to the individual, or to others around them.

However, this approach often does little to effect lasting change; it enables us to manage individuals’ behaviour, rather than support it in the longer term. Not all triggers can be avoided, reduced, or eliminated in day-to-day life, so we need to empower our disability community to grow their tolerance in different situations, and develop resilience when exposed to new, exciting experiences.

Practical ways to support individuals with disabilities

So, what practical steps can we take to recognise and support behaviour triggers for individuals with disabilities?

1: Recognising baseline behaviours

A baseline behaviour is a behaviour that is typical for an individual. Naturally, this can look very different for different people, and baseline behaviours that appear ‘extreme’ for one person, are simply functional for another, allowing them control and choice over various aspects of their lives e.g. attracting the attention of carers or staff members, removing demands, or expressing pain or discomfort.

Once we identify what an individual’s baseline behaviour looks like, we can be alert to any subtle shifts or changes, and intervene promptly with appropriate support, where necessary.

2: Building strong relationships

Familiarity is a key component of successful disability care. Individuals tend to thrive when they are supported by caregivers they know, trust, and like. Of course, this can be challenging against the backdrop of recruitment and retention issues, and a revolving door of agency staff, in and out of our organisationssettings.

By taking the time to forge strong, enduring relationships built on trust, we can get to know individuals at a deeper level, and gain a better understanding of their triggers. While this might not always be practical, with ever-changing shift patterns and staff rotas, we can help service users to build rapport with multiple team members, so that they feel as comfortable, safe, and secure as possible.

3: Using supports and communication aids

If an individual’s disability means that communication is a barrier, we need to ensure that we are incorporating different supports and communication aids into our interactions. This can help us address a range of cognitive or physical impairments that may inhibit a service user’s ability to articulate their needs in a way that is clearly understood.

Depending on the context, we could use various AAC methods, both aided (objects of reference, symbols, picture cards, and electronic devices, for example) and unaided (body language, gesture, facial expressions, signing, and so on) to facilitate clear, unambiguous communication.

Tuning into an individual’s unique communication preferences, and employing a range of total communication strategies to meet their unique needs, increases the likelihood of us being able to recognise and support behaviour triggers.

4: Planning gradual exposure to triggers

Rather than reducing exposure to triggers, we might consider creating opportunities for individuals to encounter them in a safe, supportive environment, guided by an emotionally available practitioner. This enables them to safely explore the associated feelings, and gradually learn strategies to move through triggering experiences.

Over time, gradual exposure to triggers reduces the intensity of the reaction and the subsequent behaviour. By downgrading the severity of the response, we enable individuals to tolerate more and more each time.

Reframing behaviour triggers as experiences

Individuals with disabilities often face the greatest challenges in everyday life, and navigating triggers is just one of those challenges. However, handled sensitively, patiently, and compassionately, we can help reframe behaviour triggers as experiences to be embraced, and support individuals to develop agency over their own lives. That way, every person – no matter what their disability – can expect to be treated with dignity and respect, and have the best chance of leading a happy, fulfilling, and rich life.