04 - PBS Interventions

Positive Behaviour Support : 

Positive Behaviour Support Educational methods Systems change methods To… Teach new skills Create environments which support appropriate behaviour and are associated with low likelihoods of behaviours that challenge (Page 8)

Behaviour and Skill Deficits : 

Behaviour and Skill Deficits People with intellectual disabilities by definition have… “significant limitations both in intellectual functioning and in adaptive behaviour which covers many everyday social and practical skills” (AAIDD, 2010)

Behaviour and Skill Deficits : 

Behaviour and Skill Deficits Skills deficits as risk factors for behaviours that challenge Severity of intellectual disability (adaptive skill deficits) Communication difficulties In addition… Some genetic disorders Acquired brain injuries Mental health difficulties

Behaviour and Skill Deficits : 

Behaviour and Skill Deficits If someone can’t meet needs or cope with the environment using appropriate behaviours Try to meet needs using what behaviours are available to them Behaviours that may be… Simpler & easier to produce more effective These behaviours however, may be considered to be challenging to service provision

Behaviour and Skill Deficits : 

Behaviour and Skill Deficits Exercise 2 (Pause DVD)

Behaviour as Communication : 

Behaviour as Communication Behaviour... Directly communicates what the person needs or wants (it has a communicative message) Indirectly communicates The presence of an unmet need Person lacks the skills to help them communicate or cope with their environment

Behaviour as Communication : 

Behaviour as Communication “Rehab Group is committed to positively supporting persons with behaviours that challenge by recognising that behaviours that challenge serve a communicative function.” (Page 1)

Behaviour as Communication : 

Behaviour as Communication Exercise 3 (Pause DVD)

Behaviour and Skill Deficits Behaviour as Communication : 

Behaviour and Skill Deficits Behaviour as Communication Consider the following quote… “If someone doesn’t know how to read.. we teach If someone doesn’t know how to swim.. we teach If someone doesn’t know how to drive.. we teach If someone doesn’t know how to behave.. we teach? We punish?? Why can’t we finish the last sentence as automatically as we do the others?” (Horner, 1998)

Behaviour and Skill Deficits Behaviour as Communication : 

Behaviour and Skill Deficits Behaviour as Communication Consider the following quote… “If someone doesn’t know how to read.. we teach If someone doesn’t know how to swim.. we teach If someone doesn’t know how to drive.. we teach If someone doesn’t know how to behave.. we teach? We punish?? Why can’t we finish the last sentence as automatically as we do the others?” (Horner, 1998)

Positive Behaviour Support : 

Positive Behaviour Support Educational methods Systems change methods To… Teach new skills Create environments which support appropriate behaviour and are associated with low likelihoods of behaviours that challenge (Page 8)

Environments role in BTC & “Goodness of Fit” : 

Environments role in BTC & “Goodness of Fit” Responsibility for BTC rests not within the individual but within the environment .....the environment has to change. What is the implication? “People are not simply placed in existing services and expected to adjust, rather the service strives to adjust to the person.” (Routledge and Sanderson, 2001). Person centred Environments “Good fit” between the service user and the service they receive.

Environments role in BTC & “Goodness of Fit” : 

Environments role in BTC & “Goodness of Fit” Meet the person’s support needs Capitalise on the person’s strengths Take account of the person’s preferences e.g. for interactions, activities, programmes, people, places etc. Avoid or modify triggers Take account of the persons sensitivities

Environments Role in BTC“Goodness of Fit” : 

Environments Role in BTC“Goodness of Fit” Exercise 4 (Pause DVD) “Problem behaviour can not be treated in problem environments” (Reid & Parsons, 2004)

“Goodness of Fit” : 

“Goodness of Fit” Appropriate service set up Environment Groupings of service users Staffing levels, training and skills Good daily support plans Which take account of the person’s support needs, strengths, needs & sensitivities and person centred programmes Good person centred planning and action

“Goodness of Fit”The Role of Direct Support Workers : 

“Goodness of Fit”The Role of Direct Support Workers Effective person-centred planning & action Identification of mismatches Building on strengths & preferences Creative problem solving Advocacy in terms of additional supports which may be needed

Causes of & Solutions to BTCKey Points : 

Causes of & Solutions to BTCKey Points What are two of the main causes for BTC? Skill deficits & mismatches with the environment What else influence can behaviour? Mental health problems, acquired brain injuries, specific syndromes What are two key PBS interventions? Teaching the person skills to communicate their needs and cope with their environment Creating supportive , person centred environments based on the SUs strengths, needs, preferences and sensitivities