The understanding of problem behaviors is complicated. Behaviors that appear similar can serve varying functions.31 For example, one individual may hit his head because he has a headache, another because she is having a seizure, a third because his roommate is bothering him, and a fourth because she does not want to perform the task with which she is being confronted. Mason and Iwata32 demonstrated that self-injurious behavior appeared to be an attention-getting response in one person, stereotypic behavior in a second person, and an escape response in a third.

Additionally, Oliver and Head33 recognized that varied problem behaviors can emerge from the same external conditions. For example, when confronted with having to perform a disliked task, one person may hit her or his head, a second may hit the teacher, a third may scream, and a fourth may try to run away.

To discover effective treatments, a careful and individualized analysis of the behavior, the person, and the environment must be performed. Major theorists in the area of behavioral analysis have argued that problem behaviors exhibited by individuals with developmental disabilities are functional.34 They serve specific purposes for affected individuals. If this were not the case, the behaviors would have been extinguished. The biopsychosocial model provides a method of analyzing behaviors and determining the functions that specific behaviors perform for individuals.

The role of clinicians, therefore, is to identify the biological, psychological, and social factors that trigger and reinforce the behavior, so as to understand the function provided by the behavior. A biopsychosocial model of problem behavior is designed to do just that. This model divides the analysis of problem behaviors into the following components:35

• Events that trigger or increase the likelihood that a behavior will occur
• Events that strengthen and maintain a behavior
• Events that decrease the likelihood that a behavior will occur (therapy)

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.