Self-injurious, aggressive and destructive behaviour in children with severe intellectual disability: prevalence, service need and service receipt in the UK

Research output: Contribution to journalArticlepeer-review


  • Loraine Ruddick
  • Louise Davies
  • Monique Bacarese-Hamilton
  • Chris Oliver

Colleges, School and Institutes

External organisations

  • Children's Hospital NHS Foundation Trust; Birmingham West Midlands UK
  • Cerebra Centre for Neurodevelopmental Disorders
  • Child and Adolescent Mental Health Service: Learning Disability Team
  • The Birmingham Children’s Hospital NHS Foundation Trust


Children with severe intellectual disabilities are at increased risk of presenting with self-injurious, aggressive and destructive behaviour. Severity of these behaviours is an important predictor of psychological and behavioural service use by people with intellectual disabilities. However, studies suggest that the needs of children with intellectual disabilities and their families are not being met. The aims of the present study were to: (1) describe the self-injurious, aggressive and destructive behaviours and subsequent support needs of children with severe intellectual disabilities attending special schools in one major city within the UK, (2) compare teacher and primary carer ratings of behaviour and service need and (3) explore the extent to which the needs of children with intellectual disabilities are being met in terms of contact with relevant specialist services. Questionnaires were completed by teachers and primary family carers of children with a severe intellectual disability. Results indicated that at least 5.3% and 4.1% of children showed at least one behaviour at a clinically significant frequency and management difficulty respectively. Primary carers identified more children with significant behaviour difficulties and support needs than teachers. The odds for children presenting with high levels of the behaviours of interest for having a service need for behavioural intervention were at least 13 times those for children not showing the behaviours, yet only doubled for contact with a specialist relevant health-care professional. These results quantify the magnitude of the substantial gap between level of need and relevant support received.

Bibliographic note

Copyright © 2015 Elsevier Ltd. All rights reserved.


Original languageEnglish
Pages (from-to)307-315
Number of pages9
JournalResearch in Developmental Disabilities
Early online date27 Aug 2015
Publication statusPublished - Oct 2015


  • Aggression, Destruction, Intellectual disability, Prevalence, Self-injury, Service need, Service receipt