Revealing interdyad differences in naturally occurring staff reactions to challenging behaviour of clients with severe or profound intellectual disabilities by means of Clusterwise Hierarchical Classes Analysis (HICLAS)
Blackwell Scientific on behalf of the Royal Society for Mentally Handicapped Children and Adults
Journal of Intellectual Disability Research vol:58 issue:11 pages:1045-1059
BACKGROUND. Investigating interdyad (i.e., couples of a client and their usual caregiver) differences in naturally occurring patterns of staff reactions to challenging behavior (e.g., self-injurious, stereotyped, and aggressive/destructive behavior) of clients with severe or profound intellectual disabilities is important to optimize client-staff interactions. Most studies, however, fail to combine a naturalistic setup with a person-level analysis, in that they do not involve a careful inspection of the interdyad differences and similarities.
METHOD. In this study, the recently proposed Clusterwise Hierarchical Classes Analysis (HICLAS) method is adopted and applied to data of Lambrechts, Van Den Noortgate, Eeman, and Maes (2010) in which video fragments (recorded in a naturalistic setting) of a client showing challenging behavior and the staff reacting to it were analyzed. In a Clusterwise HICLAS analysis, the staff-client dyads are grouped into a number of clusters and the prototypical behavior-reaction patterns that are specific for each cluster (i.e., interdyad differences and similarities) are revealed.
RESULTS. Clusterwise HICLAS discloses clear interdyad differences (and similarities) in the prototypical patterns of clients’ challenging behavior and the associated staff reactions, complementing and qualifying the (general) results of Lambrechts et al. (2010).
CONCLUSIONS. The usefulness and clinical relevance of Clusterwise HICLAS is demonstrated. In particular, Clusterwise HICLAS may capture idiosyncratic aspects of staff-client interactions, which may stimulate direct support workers to adopt person-centered support practices that take the specific abilities of the client into account.