The influence of the indoor environment on people displaying challenging behaviour: A scoping review

BACKGROUND: The care sector for persons with disabilities considers the physical environment relevant for the quality of life of people with intellectual disabilities. However, scientific evidence is limited. OBJECTIVE: To obtain evidence regarding comforting and encouraging environments and to develop an overview of studies addressing the effect of the physical environment on people with intellectual disabilities. METHODS: A scoping review, accompanied by expert panels and case findings combining scientific evidence and knowledge from practice, was performed to investigate the interaction between challenging behaviour and the physical environment. Between January and March 2020, several scientific databases were searched in the English, Dutch, and German language for relevant studies. Social media, care professionals, and experts in building physics were consulted. RESULTS: Studies on building-related factors as passive interventions and care- or therapy-related interventions could be distinguished. The majority of the studies report on building-related factors such as sound, acoustics, light, and colours and their influence on behaviour. Specific guidelines are lacking on how to adjust the indoor environment to an environment that is safe, comforting and encouraging for people displaying challenging behaviour. Proposed solutions are case-based. CONCLUSION: In future studies individual cases could be studied in a more in-depth manner, aligned and categorised to the building-related factors and to the expressions of challenging behaviour.