Challenging behaviour, activity, and participation following acquired brain injury: a scoping review of interventions delivered by allied health professionals

Background. This scoping review aimed to identify literature describing allied health interventions used to address challenging behaviour for adults with an acquired brain injury (ABI) living in community settings and identify the impact of these interventions on outcomes across the domains of behaviour, activity, and participation. Methods. The Polyglot Search Translator for scoping reviews guided the search of six databases: (1) Ovid Medline®, (2) EmCARE (Ovid), (3) CINAHL Complete, (4) Embase (Ovid), (5) Scopus, and (6) Cochrane Library to identify literature published between 1990 and 2023. Results. Of the 1748 records screened, 16 articles met the inclusion criteria. Studies commonly described therapeutic, least restrictive approaches to challenging behaviour founded on a positive behaviour support framework. Interventions were individualised, combining multiple elements to effect change in the environment, behaviour of the people providing support, and/or skills and behaviour of the person with ABI. Although most studies reported clinical gains from intervention, study designs used a range of methods and either single cases or mixed populations. Conclusions. The findings of this review suggest that allied health interventions have the potential to reduce challenging behaviour experienced by people with ABI. However, further research addressing the impact of interventions on activity and participation is required to inform clinical practice and improve long-term outcomes.