image1 Speaker 

David Simó Pinatella   

Associate Professor at Ramon Llull University, Barcelona.
He also works at Ampans providing support to people who engage in problem behaviour.
His main interests lie in positive behaviour support and functional behavioural assessment


Exploring Problem Behaviour Exhibited by Children and Young Adults: Prevalence, Risk Markers and Antecedent Events Associated With Its Occurrence

Problem behavior is a concern that is addressed in all educational agendas. The presence of these behaviours among children and young adults has an impact on the professionals who attend to the children, and on the quality of life of both the children and their families. Therefore, in order to obtain a better understanding of the nature of problem behaviours and to provide more positive environments for all children, a significant amount of research has been conducted over the last decades. When focusing on children and young adults, it is imperative to know the exact prevalence of problem behaviours, as this knowledge provides information that may be used to define types and numbers of services needed for this population. Moreover, the identification of risk markers as well as antecedent events provide us with information enabling the creation of more preventive and ecological educational settings.


The present work is divided into two main parts. The first part examines those studies that have explored the prevalence of problem behaviour exhibited by children with and without disabilities over the last 16 years. Thus, it points out some critical concerns (theoretical and methodological) about how the prevalence of problem behaviour exhibited by children is explored. The second part presents results from two different researches. The first explores risk markers associated with the occurrence of problem behaviour among people with intellectual disabilities and the second focuses on the respective antecedent events (discriminative stimuli and setting events) that are associated with the occurrence of problem behaviour.


Exploring the Prevalence of Problem Behaviour

The study of the prevalence of problem behaviours among children has been of particular interest in literature. The prevalence rates of these behaviours among children are highly heterogeneous throughout the different studies (ranging from 2.6% to 62% for children without disabilities and from 7.3% to 100% for children with disabilities). Thus, when conducting this type of study, some theoretical and methodological issues may arise. Theoretically, problem behaviour conceptualization and operationalization may lead to a wide range of prevalence rates (Lowe et al., 2007), as they can be over- or underestimated, depending on the definition of the problem behaviour adopted when assessing it. The identification of problem behaviour may be related to its definition (i.e. form, intensity and frequency) and it also may be subjective depending on respondent’s experience with problem behaviour. Methodologically, Koritsas and Iacono (2012) noted in their study on the prevalence of problem behaviours among people (children and adults) with intellectual disabilities that the process studies usually obtain various data across studies. For example, some studies have used validated instruments, others solely a few questions within a questionnaire, etc. Hence, when interpreting the results from these studies, we must consider several aspects such as the type of instruments used, the adopted definition of the behaviour, the specific behaviours assessed, and the procedures implemented to assess problem behaviour prevalence. The sampling methods and procedures that are used to ensure the validity of the respondent’s description of problem behaviours in children or adolescents are examples of variables that must be considered for analytic purposes.


Therefore, we performed a systematic review (Simó-Pinatella et al., under review) and selected 35 studies for analysis according to their theoretical and methodological characteristics. Results underline the fact that we have to ensure reliable prevalence estimation procedures with the necessity to standardize both sampling and assessment methods (such as assessment criteria, informants, etc.). The reliability of the collected data becomes crucial for leading the decision-making process. Future research must therefore test and delve into contextually tailored procedures to guarantee rigorous assessments of the prevalence rates of problem behaviours. Finally, if the targeted population includes both people with and without disabilities, future research should explore the use of instruments intended for all children and young adults.


As a result of the above-mentioned literature review, we present a two-step process that could be used in order to clearly identify problem behaviour in school settings. The instruments used in this research were (a) Challenging Behaviour Prevalence in Educational Settings: School Information which is divided into four parts: (1) demographic school information, (2) demographic student information, (3) contextual setting information related to problem behaviour occurrence, and (4) definitions, examples and counterexamples of the type of behaviours that could be defined as problematic; and (b) the Challenging Behaviour Prevalence in Educational Settings: Individual Information, which explores the following eight categories of problem behaviours: self-injury behaviour, stereotypic behaviour, aggressive/destructive behaviour, disruptive behaviour, withdrawn behaviour, non-collaborative behaviour, sleep problems and eating problems. Moreover, social validity from professionals who took place in this process is presented.


Risk Markers and Antecedent Events Associated with the Occurrence of Problem Behaviour


Research has also emphasized that specific factors (for example gender or certain diagnostic conditions such as ASD) are associated with the presence of problem behaviour. However, current studies offer different results regarding the type of variables that may act as risk markers for children with ID. Also, the extent to which a certain variable influences the occurrence of problem behaviour is unclear. It is imperative to keep exploring and analyzing the association between personal factors and problem behaviours among people with intellectual disabilities. Consequently, we present results of a study that aims to assess whether certain personal variables, such as type of disability, gender or place of residence, influence the occurrence of certain behaviours as aggression, stereotype, self-injury, disruption, withdrawal, and non-collaboration in educational settings.


Results of the study suggest that the type of disability, i.e. visual and motor impairment, autism spectrum disorder, attention deficit and hyperactivity disorder, language and communication disorder as well as place of residence and age were found to predict the presence of CBs among children with intellectual disabilities. Finally, we present preliminary results of a research that aims to identify antecedent events that are especially related to children and young adults with intellectual disabilities attending a special school.



We need to be precise in the identification of problem behaviour, risk markers and antecedent events. The identification of all these variables will help us to design preventive educational contexts.




Koritsas, S., & Iacono, T. (2012). Challenging behaviour and associated risk factors: An overview (Part I). Advances in Mental Health and Intellectual Disabilities, 6, 199-214.

Lowe, K., Allen, D., Jones, E., Brophy, S., Moore, K., & James, W. (2007). Challenging behaviours: Prevalence and topographies. Journal of Intellectual Disability Research, 51, 625-636.

Simó-Pinatella, D., Mumbardó-Adam, C., Font-Roura, J., Alomar Kurz, E., Sugai, G., & Simonsen, B. (subm.). Prevalence of problem behaviors exhibited by children and young adults: Mapping the process. Manuscript submitted for publication.

Simó-Pinatella, D., Mumbardó-Adm, C., Montenegro-Montenegro, E., Cortina, A., Mas, J., Baqués, N., Adam-Alcocer, A.L. (in press). Prevalence and risk factors of challenging behavior among children with disabilities. Advances in Neurodevelopmental Disorders. Doi: 10.1007/s41252-017-0022-8