# Changes in Challenging Behaviors Accompanying Transition to a New Facility in Individuals with Intellectual Disabilities

## TL;DR

A new facility design for individuals with intellectual disabilities led to significant reductions in challenging behaviors like aggression and self-injury.

## Contribution

The study demonstrates how facility restructuring can effectively reduce challenging behaviors in individuals with intellectual disabilities.

## Key findings

- Residents showed significant reductions in aggressive and self-injurious behaviors after the facility restructuring.
- Stereotyped and targeted behaviors, such as head-hitting and fecal smearing, also decreased significantly.
- The new facility design included private rooms and a unit care system, which helped reduce destructive stimuli.

## Abstract

Challenging behavior (CB), the most common example being extreme self-injurious or aggressive/destructive behavior, is often observed as a major behavior issue in individuals with severe intellectual disabilities. This study investigated how CB changed among residents of a facility for people with disabilities before and after it was restructured from a traditional format single room shared by two to three individuals with approximately 20 residents lived together to a format featuring private areas with two rooms per resident and a unitcare system. Twenty-one residents of Care Home A, which was rebuilt in the new care format, were selected. Care staff completed a questionnaire one month before, one month after, and six months after residents moved to the new facility. Scores were compared among each time point. The results revealed significant reductions in residents’ aggressive, stereotyped, and targeted behaviors, such as hitting their own head and fecal smearing. The major features of the restructured facility were a living space consisting of two private rooms per resident and a shift to unit care for the entire ward. These new features enabled residents to reduce destructive stimuli and made it easier to understand what to do in each private room.