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Inappropriate sexual behaviour (ISB) is just one of the possible behavioural consequences of both progressive neurological conditions (PNC) and acquired brain injury (ABI).Often overlooked in comparison to other challenging behaviours such as agitation and aggression, inappropriate sexual behaviour can manifest itself in many different forms and with varying stimuli.
The impact of inappropriate sexual behaviour on individuals and their carers, friends, family and fellow patients can be significant and pervasive, and in some cases, destructive. Unclear definitions of inappropriate sexual behaviour and its context limits objectivity and accuracy. This not only causes reduced formalised reporting of incidents, but a lack of universal agreement on what constitutes inappropriate sexual behaviour and its severity amongst individuals.
From a clear need for a satisfactory conceptual framework, St Andrew’s Healthcare has developed the St Andrew’s Sexual Behaviour Assessment (SASBA)© scale, which allows continuous observation of inappropriate sexual behaviour within an in-patient setting where a high frequency of challenging behaviour is exhibited.
The scale has evolved from, and can work with, the Overt Aggression Scale – Modified for Neurorehabilitation (OAS-MNR).
The SASBA scale was recently published in Neuropsychological Rehabilitation.
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“St Andrew’s mission as a charity is to help patients as much as we can. We do this by providing the best care, but also through innovation in our leading specialist services. Much good practice has been developed at St Andrew’s over the years, and spread to other providers.
For example, a large part of the brain injury rehabilitation sector has been founded by people from St Andrew’s, sharing our effective treatment programmes to benefit a wider group. We have also innovated in outcome tools such as OAS-MNR and HoNOS-secure. However SASBA represents the best researched and most innovative development yet – a tool for assessment of inappropriate sexual behaviour – one of the most difficult areas of clinical challenge.
It is part of a wider stream of work for the charity, crystallising our specialist knowledge into defined tools and training packages, which can carry good practice so effectively from one service to another. Many congratulations are due to the team that has worked so hard to develop SASBA, which looks set to become the national standard.”
— Dr Philip Sugarman
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