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The purpose of this paper is to consider the needs of children and young people with an intellectual disability and behaviours described as challenging in light of the article “The Ealing Intensive Therapeutic and Short Breaks service: An Update Five Years On”.

Contemporary literature associated with the provision of support to children and young people with an intellectual disability and behaviours described as challenging is considered. Some of the recent challenges associated with the provision of effective and timely support in light of current research, policy and practice are highlighted.

The Ealing service’s continued success is discussed within the context of new ways of working required to meet the needs of the client group and their families/carers.

The commentary reinforces the need to evolve service models that can provide specialist, timely and intensive support. The importance of early intervention is highlighted.

The purpose of this paper is to provide a commentary on issues raised in the paper “A family’s battle to understand ‘challenging behaviour’”.

Drawing on literature associated with issues identified in the paper this commentary will reflect on the evidence associated with providing specialist support to people with intellectual disabilities and challenging behaviour.

Families, individuals and services are unable to access timely and appropriate specialist support for individuals with intellectual disabilities and challenging behaviour. As individuals go on to develop behaviours associated with a lack of intervention their levels of vulnerability increase due to their exclusion from services and their local communities.

The commentary provides a discussion on the issues faced by individuals and their families in relation to intellectual disabilities and challenging behaviour.

Drawing on the experiences of healthcare professionals in one paediatric hospital, this paper explores the influence of context and organisational behaviour on the implementation of a person-centred transition programme for adolescents and young adults (AYA) with long-term conditions.

A single embedded qualitative case study design informed by a realist evaluation framework, was used. Participants who had experience of implementing the transition programme were recruited from across seven individual services within the healthcare organisation. The data were gathered through semi-structured interviews (n = 20) and analysed using thematic analysis.

Implementation of the transition programme was influenced by the complex interaction of macro, meso and micro processes and contexts. Features of organisational behaviour including routines and habits, culture, organisational readiness for change and professional relationships shaped professional decision-making around programme implementation.

There exists a significant body of research relating to the role of context and its influence on the successful implementation of complex healthcare interventions. However, within the area of healthcare transition there is little published evidence on the role that organisational behaviour and contextual factors play in influencing transition programme implementation. This paper provides an in-depth understanding of how organisational behaviour and contextual factors affect transition programme implementation.