The role of music, movement, and play in stress regulation for people with severe intellectual disabilities and challenging behaviour: insights from a concept mapping study with five stakeholder perspectives

Background Understanding why and how music, movement, and play may help people with severe intellectual disabilities and challenging behaviour manage stress is crucial for developing effective interventions. This study explores stakeholder perspectives on the pathways through which music, movement, and play may support stress regulation in people with severe intellectual disabilities and challenging behaviour.Method Using a concept mapping design, 39 participants from five stakeholder groups—relatives (n = 8), direct support staff (n = 6), creative arts and movement-based practitioners (n = 8), allied health and behavioral professionals (n = 11), and managers (n = 6)—joined online sessions to generate, cluster, and rate statements about the role of creative modalities. Statements were synthesized into group-specific concept maps and interpreted by a panel of experts (n = 6).Results 352 statements were grouped into six clusters per stakeholder group, highlighting themes such as connectedness and relationship formation, emotional and physiological regulation, structure and safety, and positive experience and empowerment.Conclusions Creative modalities support stress management through integrated relational, bodily, structural, and affective processes. These insights may inform future intervention development and research with this population.