Toward trauma-informed positive behavior support for individuals with intellectual and developmental disabilities: a social-ecological model and recommendations for practitioners and service leaders

Trauma can profoundly impact the lives and learning of people with intellectual and developmental disabilities (IDD), yet research on its prevalence and effects remains limited. Evidence suggests that up to 70% of individuals with IDD experience at least one potentially traumatic event, with many encountering multiple such events throughout their lives. These experiences can contribute to the development and maintenance of challenging behavior. Although positive behavior support (PBS) practitioners and service leaders often work with individuals displaying these behaviors, there are few resources to guide trauma-informed approaches. This paper integrates research from various fields to propose a social-ecological model for understanding trauma within the context of IDD and challenging behavior. We begin by defining trauma and discuss its prevalence and effects. We then provide an overview of trauma-informed principles and how they might be incorporated into the PBS framework. Finally, we describe risk and protective factors at personal, interpersonal, organizational, and societal/cultural levels and provide practical recommendations to help practitioners and service leaders reduce trauma-related risk factors and enhance protective factors, supporting the implementation of trauma-informed PBS.