Dynamic Patterns of Three Staff Members Interacting with a Client with an Intellectual Disability and Challenging Behavior: Suggestions for Coaching.

In relationships between staff members and clients with intellectual disabilities (ID) and challenging behavior (CB) it is important to study their bidirectional dynamic interactions. In the present study three staff members were recorded on video during a daily bathing session with the same client with ID and CB. The video codings were analyzed using Cross Recurrence Quantification Analysis (CRQA) and based on the categories of Leary and Banjamin's interpersonal models. CRQA analyses demonstrated different synchronization levels of the three dyads with respect to affiliation and control. The dyads also differed in who (staff or client) was leading or following regarding affiliation and control. Furthermore, the nature of the staff-client interaction on a short time scale looked different from that on a longer time scale. We recommend that when coaching staff members regarding dynamic interactions with a client, the emphasis should be on the balance between staff interpersonal active and reactive behavior, applying principles of similarity and complementarity, and changing the amount and timing of taking the lead or following during interactions.