title: Challenging behavior and related factors in people with intellectual disability living in residential care centers in Israel.
abstract: BACKGROUND
  Adults with intellectual disabilities have higher rates of mental ill-health and problem behaviors than the general population.
  
  
  METHODS
  In this study, we present data on trends in challenging behavior in residential care centers in Israel from 1998 to 2008 and further data on trends in employment of psychiatrists from 1998 to 2009 and psychotropic medication use from 1998 to 2008. Data was collected from annual questionnaires sent out to all residential care centers in Israel, from the Office of the Medical Director, Division for Intellectual and Developmental Disabilities, Ministry of Social Affairs and Social Services.
  
  
  RESULTS
  Rates of challenging behaviors in people with intellectual disabilities living in residential care centers in Israel continues to rise. Alongside this, trends in regular psychotropic medication use also continues to increase.
  
  
  CONCLUSIONS
  Consideration of biological, psychological, social, and environmental factors in the assessment and management of people with intellectual disabilities and challenging behaviors is important. This is best conducted using a multidisciplinary approach, which may include psychiatric assessment. Non-pharmacological interventions should always be considered either alongside, or instead of medication.
authors.affiliation: National Institute of Child Health and Human Development, Office of the Medical Director, Health Services, Division for Intellectual and Developmental Disabilities, Ministry of Social Affairs and Social Services Jerusalem, Israel.
authors.forename: Amanda
authors.initials: A
authors.lastname: Sinai
authors.affiliation: National Institute of Child Health and Human Development, Office of the Medical Director, Health Services, Division for Intellectual and Developmental Disabilities, Ministry of Social Affairs and Social Services Jerusalem, Israel ; Division of Pediatrics, Hadassah Hebrew University Medical Center, Mount Scopus Campus Jerusalem, Israel.
authors.forename: Ariel
authors.initials: A
authors.lastname: Tenenbaum
authors.affiliation: National Institute of Child Health and Human Development, Office of the Medical Director, Health Services, Division for Intellectual and Developmental Disabilities, Ministry of Social Affairs and Social Services Jerusalem, Israel.
authors.forename: Shoshana
authors.initials: S
authors.lastname: Aspler
authors.affiliation: National Institute of Child Health and Human Development, Office of the Medical Director, Health Services, Division for Intellectual and Developmental Disabilities, Ministry of Social Affairs and Social Services Jerusalem, Israel ; Department of Physical Therapy, Ariel University of Samaria Ariel, Israel.
authors.forename: Meir
authors.initials: M
authors.lastname: Lotan
authors.affiliation: National Institute of Child Health and Human Development, Office of the Medical Director, Health Services, Division for Intellectual and Developmental Disabilities, Ministry of Social Affairs and Social Services Jerusalem, Israel ; Yaski Community Medical Center, Ben-Gurion University of the Negev and Clalit Health Services Beer-Sheva, Israel ; Kentucky Children's Hospital, University of Kentucky Lexington, KY, USA.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Morad
authors.affiliation: National Institute of Child Health and Human Development, Office of the Medical Director, Health Services, Division for Intellectual and Developmental Disabilities, Ministry of Social Affairs and Social Services Jerusalem, Israel ; Division of Pediatrics, Hadassah Hebrew University Medical Center, Mount Scopus Campus Jerusalem, Israel ; Kentucky Children's Hospital, University of Kentucky Lexington, KY, USA.
authors.forename: Joav
authors.initials: J
authors.lastname: Merrick
keywords: Israel; challenging behavior; intellectual disability; mental health; psychotropic medication; residential care