A total population study of challenging behaviour in the county of Hedmark, Norway: prevalence, and risk markers.
Norwegian adults with ID show somewhat lower severe challenging-behaviour rates than Anglo-American norms, yet autism and communication deficits still signal highest risk.
01Research in Context
What this study did
Børge and colleagues counted every adult with intellectual disability (ID) in Hedmark county, Norway.
They asked carers to report any severe challenging behaviour such as self-injury, aggression or property destruction.
The goal was to see how common these behaviours are and who is most at risk.
What they found
Severe challenging behaviour was slightly less common than earlier Anglo-American surveys had suggested.
Autism and poor communication skills were still the strongest red flags, even in this Norwegian sample.
How this fits with other research
Smith et al. (2010) later repeated the same head-count across all of Norway and found the same pattern: rural areas and certain regions show lower registered ID rates, so Hedmark may not be unusual.
Lambrechts et al. (2009) warn that staff surveys like this can miss or over-count behaviours depending on who fills the form; their reliability study says always check more than one reporter.
Lyall et al. (2012) add a twist for very young clients: in toddlers with ASD, higher mental age can mean more behaviour problems, so risk markers flip with age.
Why it matters
If you assess adults with ID in Norway, expect slightly lower base rates of severe challenging behaviour than UK or US textbooks quote, but keep the same priority flags: autism plus limited communication.
Always triangulate carer reports with direct observation, and remember that regional service gaps can hide true prevalence.
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02At a glance
03Original abstract
Studies in Britain and the US indicate that 10-15% of people with mental retardation show challenging behaviour, like attacking others (aggression), self-injurious behaviour, destruction, and other difficult, disruptive or socially unacceptable acts. Most researchers indicate that challenging behaviour is more common among adolescents and young adults, among males, is associated with autism, and increases with lack of communication skills and severity of mental retardation. These factors can be understood as risk markers, and some of them can be decreased by preventive and treatment interventions, at least in principle. The present study confirmed most of the previous findings, with some exceptions: the prevalence of more demanding challenging behaviour was somewhat lower in the present study, and no association between gender and challenging behaviour was found. We also concluded that declining prevalence of challenging behaviour at older ages is not a result of a young age structure of the population.
Research in developmental disabilities, 2006 · doi:10.1016/j.ridd.2005.06.001