Abstract
Aggression and violence are a subset of challenging behaviors seen in individuals with neurodevelopmental and intellectual disabilities, which can impact services and lifestyles of individuals. Aggressive behavior carries the risk of physical and emotional harm to caregivers, family members, self, and community. This chapter focuses on aggression in the form of physical acts against self, others, and property, excluding specialty areas such as suicide and criminal or sexual violence. We review the prevalence of violence-aggression in the IDD population, the adverse impact on services, safety, health and well-being to self and others, and quality of life. The chapter introduces behavioral risk assessment, distinguished from other forensic assessment practices, and as a complement to functional behavior assessment suitable for cases with risk for violence and aggression. Behavioral risk assessment evaluates factors such as (a) unusual forms of aggression (topography), (b) the intensity and frequency of aggression, (c) the potential targets and location of occurrences, and (d) the presence of any complicating features that increase risk. Understanding these variables helps clinicians and agencies develop more options for risk prevention or mitigation than functional assessment alone. A comprehensive approach to assessment based on record review and clinical interview is described. Findings can be used to develop individualized risk reduction strategies, prevention, and staffing decisions.
Published Version
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