Non-pharmacological interventions for challenging behaviours of adults with intellectual disabilities: A meta-analysis

J Intellect Disabil Res. 2020 Aug;64(8):561-578. doi: 10.1111/jir.12736. Epub 2020 Jun 17.

Abstract

Background: Non-pharmacological interventions are recommended for the treatment of challenging behaviours in individuals with intellectual disabilities by clinical guidelines. However, evidence for their effectiveness is ambiguous. The aim of the current meta-analysis is to update the existing evidence, to investigate long-term outcome, and to examine whether intervention type, delivery mode, and study design were associated with differences in effectiveness.

Method: An electronic search was conducted using the databases Medline, Eric, PsychINFO and Cinahl. Studies with experimental or quasi-experimental designs were included. We performed an overall random-effect meta-analysis and subgroup analyses.

Results: We found a significant moderate overall effect of non-pharmacological interventions on challenging behaviours (d = 0.573, 95% CI [0.352-0.795]), and this effect appears to be longlasting. Interventions combining mindfulness and behavioural techniques showed to be more effective than other interventions. However, this result should be interpreted with care due to possible overestimation of the subgroup analysis. No differences in effectiveness were found across assessment times, delivery modes or study designs.

Conclusions: Non-pharmacological interventions appear to be moderately effective on the short and long term in reducing challenging behaviours in adults with intellectual disabilities.

Keywords: Challenging behaviour; Intellectual disabilities; Meta-analysis; Non-pharmacological interventions.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Behavior Therapy*
  • Child
  • Humans
  • Intellectual Disability / physiopathology
  • Intellectual Disability / rehabilitation*
  • Middle Aged
  • Mindfulness*
  • Outcome Assessment, Health Care* / statistics & numerical data
  • Problem Behavior*
  • Young Adult