People with developmental disabilities (DD) may be unable to verbalize the presence of pain. Affected individuals may hit themselves in the affected area (e.g., in the ears if experiencing an ear infection). They also may become aggressive toward other people, owing to frustration over having to endure pain or in an attempt to protect a painful area from intrusion from the outside.

Individuals with DD also may have sensory difficulties that lead to an intolerance of certain environmental conditions that are generally acceptable to the non-DD population. Examples include

• crowding
• loud noises
• lights
• food
• the touch of clothing
• taking a bath
• cutting hair or nails

When confronted with these subjectively aversive environmental stimuli, individuals with sensory difficulties may express behaviors that are aggressive, self-abusive, or both.

Adapted from: Sudhalter V. Problem behaviors in individuals with developmental disabilities. In: Devinsky O and Westbrook LE, eds. Epilepsy and Developmental Disabilities. Boston: Butterworth-Heinemann; 2001;165–174.
With permission from Elsevier (www.elsevier.com).
Reviewed and revised May 2004 by Steven C. Schachter, MD, epilepsy.com Editorial Board.