title: Neurobehavioural approaches to the rehabilitation of challenging behaviour.
abstract: BACKGROUND
  Neurobehavioural disability (NBD) following acquired brain injury undermines capacity for independent social behaviour and results in serious long-term social handicap. The presence of challenging behaviour as a feature of NBD has obvious implications for rehabilitation and community reintegration.
  
  
  OBJECTIVE
  Behavioural approaches are seen by many as fundamental to the successful rehabilitation of challenging behaviour. This paper will a) define the nature of neurobehavioural rehabilitation; b) explore the characteristics of cases referred, and c) the outcomes achieved. Strengths, limitations and future developments of neurobehavioural approaches for challenging behaviour will be considered along with potential factors that limit generalisation and longevity of treatment gains.
  
  
  METHODS
  Literature review.
  
  
  RESULTS
  Neurobehavioural services are distinguishable from other forms of neurorehabilitation. There is considerable evidence supporting the central role of both positive behaviour supports and contingency management approaches in creating conditions that minimise neurocognitive impairment, facilitate new learning, and ensure a positive social climate in both specialised inpatient units and community settings. Possible limitations include over-reliance on evidence from successful accounts of single cases and lack of knowledge regarding generalisation.
  
  
  CONCLUSIONS
  Neurobehavioural rehabilitation is effective and can save care costs in the long term. More evidence regarding maintenance of gains is required.
authors.affiliation: Brain Injury Services, Partnerships in Care, Grafton Regis, UK. nick.alderman@partnershipsincare.co.uk
authors.forename: Nick
authors.initials: N
authors.lastname: Alderman
authors.forename: Rodger Ll
authors.initials: RL
authors.lastname: Wood
mesh_terms: D001521:Behavior Therapy; D001526:Behavioral Symptoms / Q000534:rehabilitation*; D001930:Brain Injuries / Q000534:rehabilitation*; D006801:Humans