A meta-analysis of intervention effects on challenging behaviour among persons with intellectual disabilities.
Interventions for challenging behavior in ID work, but newer meta-analyses show we can now expect even larger gains, especially for self-injury and in school settings.
01Research in Context
What this study did
Heyvaert et al. (2010) pooled 30 studies that tried to reduce challenging behavior in people with intellectual disabilities.
They used meta-analysis to find one overall effect size, no matter what brand of intervention each paper used.
What they found
The average effect was medium and solid. Any well-run behavior plan is likely to help, but it will not wipe out the problem overnight.
How this fits with other research
van der Miesen et al. (2024) now supersedes this result. Their newer meta-analysis on self-injury in the same ID group shows a very large effect and adds 11 years of data.
Lory et al. (2020) extends the story to inclusive classrooms. They found a very large effect (Tau-U = 0.94) when the same kinds of plans are run by teachers and peers.
Adriaanse et al. (2026) looks like a contradiction at first. Their meta-analysis on transition-related challenging behavior found mixed overall results. The difference is scope: they studied only transition behaviors, while Mieke cast a wider net.
Why it matters
You can still trust the 2010 paper as a green light: pick an evidence-based plan and expect a medium drop in problem behavior. For self-injury, aim higher—van der Miesen et al. (2024) shows we now get very large reductions, even when parents run the program at home. In school, push for inclusive class plans; the payoff is even bigger there. If the issue is transition refusal, add clear consequences to your visual schedule—Adriaanse et al. (2026) shows signaling alone is too weak.
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02At a glance
03Original abstract
BACKGROUND: Persons with intellectual disabilities (ID) often show challenging behaviour. We review distinct interventions that are applied to treat these challenging behaviours, and analyse intervention effects and moderating variables. METHODS: A literature search was conducted using the databases ERIC, PsycINFO, Web of Science and Medline. A random-effects meta-analysis was carried out, supplemented with sensitivity, subgroup, meta-regression and publication bias analyses. RESULTS: Eighty potential articles were identified, from which 30 contained sufficient data to enable statistical meta-analysis. From these 30 studies, 18 described a biological, 13 a psychotherapeutic and nine a contextual intervention, either applied alone or combined. The overall standardised mean difference was 0.671 (SD = 0.051). As shown by sensitivity analysis, this summary effect size is robust. Assessed through subgroup and meta-regression analysis, all tested moderators showed no statistically significant association with the treatment effects. After applying a funnel plot-, a fail-safe N-, and Duval's and Tweedie's trim and fill-analysis, we conclude that our meta-analysis does not suffer much from publication bias effects. CONCLUSIONS: Several biological, psychotherapeutic and contextual interventions effectively reduce challenging behaviours among persons with ID.
Journal of intellectual disability research : JIDR, 2010 · doi:10.1111/j.1365-2788.2010.01291.x