Effects of positive behaviour support delivered by direct staff on challenging behaviours and quality of life of adults with intellectual disabilities: A multicentre cluster-controlled trial

Eke Bruinsma*, Barbara J. van den Hoofdakker, Pieter J. Hoekstra, Gerda M. de Kuijper, Annelies A. de Bildt

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

27 Downloads (Pure)


Background: Effects of staff provided positive behaviour support (PBS) for individuals with intellectual disabilities are unclear. 

Method: Using a multicentre non-randomised cluster controlled design, 26 teams of residential group homes, including 245 staff members of 167 individuals with intellectual disabilities, were allocated to a PBS or control group. Conducting multilevel analyses (n = 123) we examined individuals' changes in irritability, other challenging behaviours and quality of life. 

Results: Compared to controls, irritability did not significantly decrease more in the intervention group, but lethargic behaviours did. Personal development and self-determination significantly increased. Irritability of individuals in the PBS group with higher levels of irritability or lower levels of intellectual disability significantly reduced more compared to controls. 

Conclusions: PBS was effective in reducing irritability of individuals with severe levels of irritability or intellectual disabilities. Moreover, PBS decreased lethargic behaviours and improved several domains of quality of life.

Original languageEnglish
Article numbere13164
Number of pages13
JournalJournal of Applied Research in Intellectual Disabilities
Issue number1
Publication statusPublished - Jan-2024


  • challenging behaviours
  • intellectual disabilities
  • positive behaviour support
  • quality of life
  • staff
  • training

Cite this