Does engagement in meaningful occupation reduce challenging behaviour in people with intellectual disabilities? A systematic review of the literature

Over several years, there has been much debate about the best way to manage challenging behaviour. Although national guidance highlights the importance of meaningful occupation, it is unclear to what extent this helps. This systematic review of the literature aimed to answer the question, 'does engagement in meaningful occupation reduce challenging behaviour in people with intellectual disability?' By searching a range of databases, electronic resources and web pages, 13 relevant articles were identified. Additionally, experts in the field were contacted, hand searches were performed and citation searches were carried out. These 13 articles were critically appraised and analysed using narrative synthesis. Although the amount of research identified was limited and the methodological quality was variable, some broad themes arose. A skilled and structured approach for carrying out occupation may be effective in reducing challenging behaviour; however, more robust research is needed before definitive conclusions can be drawn.