Low arousal approaches to manage behaviours of concern
Intended for healthcare professionals
Evidence and practice    

Low arousal approaches to manage behaviours of concern

Andy McDonnell Director of Studio3 and visiting professor of autism studies, Birmingham City University, England; Roy Deveau, honorary research associate, Tizard Centre, University of Kent and research consultant Studio3

Background Behaviours of concern restrict opportunities and choices for some people with learning disabilities and autism spectrum conditions and often lead to potentially harmful, restrictive and costly interventions. Immediate interventions, for example de-escalation, to manage behaviours of concern are required to complement behaviour support plans which may take some time to be effective. Low arousal is one de-escalation approach, which is attuned to the needs of people with learning disabilities. A low arousal approach relies on a change in the beliefs, emotional responses, opinions about the cause of the behaviour and practices of direct support staff.

Aim To explore the internal consistency and concurrent validity of the Staff Perceptions of Challenging Behaviour Questionnaire (SPCBQ) – a measure of low arousal.

Method A cross-sectional survey of direct support staff included measures of mindfulness, the belief that people can control behaviours of concern (attribution of controllability), self-efficacy and a measure of physical and non-physical interventions used to manage behaviours of concern.

Results Staff attitudes to low arousal approaches were associated positively with mindfulness and associated negatively with attribution of controllability. Staff perceptions were not associated with self-efficacy. One form of restrictive intervention was used less by staff who showed more positive attitudes to low arousal approaches. The staff perceptions measure showed weak internal consistency.

Conclusion Further development of the SPCBQ, as a measure of low arousal approaches, has the potential to support interventions and understanding of staff practice that limit the use of restrictive approaches.

Learning Disability Practice. doi: 10.7748/ldp.2018.e1882


McDonnell A, Deveau R, (2018) Low arousal approaches to manage behaviours of concern. Learning Disability Practice. doi: 10.7748/ldp.2018.e1882

Peer review

This article has been subject to external double-blind peer review and checked for plagiarism using automated software



Conflict of interest

None declared

Published online: 13 September 2018

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