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When supporting older adults with learning disabilities and behaviours of concern, we recognise the behaviour being presented is a form of communication; an individual who is trying to communicate how they are feeling, or that they have an unmet need. Once we can better understand functions of behaviours and associated drivers, we can put plans in place to support them.
To enable effective positive behaviour support plans to be implemented, one of the elements we don’t always consider is the experiences individuals in our care bring with them from childhood into adulthood, and how these experiences could be influencing the behaviours of concern being presented as adults.
We need to consider the impact some of these past experiences have had on individuals, and if psychological trauma has been a part of those experiences, in particular relational trauma.
Relational trauma would suggest that the individual has experienced difficult things in relation to another person. It is important to remember that not all individuals who have experienced relational trauma throughout their lives will be traumatised, and the experiences will differ from one person to the next. These potentially traumatic experiences can be significantly increased for someone with a learning disability, as the individual may not fully understand why the experience or trauma is happening, if it will happen again, and if so, when.
The relationships around us are important. They can make us feel safe and help us to learn about ourselves and others. Children learn how to receive care by prompting adults around them to respond to cues, such as crying or holding arms out. This promotes physical closeness and helps safe and fulfilling relationships to flourish, otherwise referred to as attachment.
The difficulties some primary caregivers of children with disabilities come up against is finding it challenging or confusing to respond to cues fast enough, or missing them entirely, making secure attachments more difficult to achieve in early childhood. Examples of these may include:
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