Positive Behaviour Support (PBS) is a framework which has arisen from the field of behavioural science. Since its emergence over the past 20 years, it has become the basis for providing individualised, evidence-based strategies in order to reduce behaviour which challenges and increase socially relevant behaviours (Allen, 2009).
At the core of the PBS ethos is the aim of providing support which is person-centred, goal-focused and has a proven scientific efficacy (Allen et al., 2011). this usually has a focus on the reduction of behaviour which challenges.
PBS is the practical application of developing and delivering intervention which can demonstrate behavioural change in a data-driven manner; allowing for a real-time measurement of whether the chosen intervention is effective.
The impact of this is that ineffective interventions can be altered early in the intervention process and that it is clear when the intervention has been effective as targeted behavioural goals are reached.
Although there can be differences between implementation of PBS, it is generally regarded that all PBS approaches include a Functional Behaviour Assessment (FBA); a change to the environment in which the behaviour occurs; active teaching of new skills; a change in the behaviour being targeted and also consistent use of positive reinforcement (Sugai et al., 2000).
PBS has been proven to be effective in reducing challenging behaviour in children which includes, but is not limited to aggression, destruction, disruption and self-injury (Dunlap & Fox, 1999; Koegel et al., 1998; Moes & Frea, 2002). Alongside this, in line with the PBS ethos, it has been found to be effective in teaching new skills e.g. independent implementation of morning and bathroom routines (Clarke et al., 1999; Vaughn et al., 1997), play skills and communication skills (Moes & Frea, 2000).
PBS has also been found to be effective in teaching skills in the community such as shopping independently and going to restaurants (Vaughn et al., 1997, Vaughn et al., 2002; Lucyshun et al., 1997). A multicomponent framework is used in order to teach these new skills and is rooted in behavioural science and other complementary strategies. They include schedules of reinforcement, visual strategies, teaching of social skills, social stories and comic strip conversations, prompting, pairing and both receptive and expressive communication skill development (Lucyshun et al., 2007).
The Positive Behaviour Support framework is split into three key stages: assess, manage and prevent. Let’s look at each step in detail:
Stage 1: Assess
ABC’s of behaviour: breaking down challenging behaviour in children.
As noted in the ‘Positive Behaviour Support’ section of this website, ‘assess’ is the first key aspect of the PBS framework used in the Behaviour Help programme. An integral part of PBS is the recording of direct observations of behaviour into a three-term contingency framework commonly referred to as the ‘ABC’s’ of behaviour (Cooper et al., 2007). ‘ABC’ is an acronym for ‘antecedent’, ‘behaviour’ and ‘consequence’ where:
- ‘Antecedent’ refers to what happened immediately before the behaviour,
- ‘Behaviour’ refers to direct observations of the behaviour itself,
- ‘Consequence’ refers to what happened immediately after the behaviour occurred.
Where a behaviour which challenges is identified as requiring intervention, each time this is observed, it should be recorded on an ABC chart (Figure 1). Repeated logs of the behaviour and its antecedent and consequence will then allow for a functional assessment of the behaviour (Gore et al., 2013).
Figure 1: ABC chart example
|What happens immediately before the behaviour.||What the behaviour is:
||What happens immediately after the behaviour.|
|Child is playing a game on their iPad in the living room. Parent asks child to turn off their iPad as screen time has ended.||Child shouts ‘no’, screams and kicks out at parent:
Parent gives the child 5 more minutes on their iPad.
In this way, the ‘ABC’ framework then allows the behaviour to be broken down, assessed through use of a functional analysis and a plan for intervention, developed in an individualised manner. It is important that as much information as possible is captured in the ABC chart in order to inform the intervention pathway (PBS plan).
Functional assessment of behaviour/functions of behaviour which challenges.
After behavioural data has been gathered on an ABC chart, this information can then be used to complete a functional analysis of the behaviour which has been identified as being a challenge. Functional behaviour assessments (FBA) allow for a hypothesis to be made regarding the reasons for or ‘function of’ the behaviour being observed (Cooper et al., 2007).
As explained in ‘ABC’s of behaviour’, the reasons why behaviour occurs are rooted in a three-term contingency (commonly known as ABC’s of behaviour) which is directed by reinforcement at the consequence stage. PBS also draws upon a fourth contingent ‘Modus Operandi’ (MO), which refers to the motivation of an individual at that given moment and determines the extent to which both the antecedent and consequence impact upon the behaviour (Gore et al., 2013).
According to the science of behaviour, all observable and measurable behaviour has a function. These functions can be broken down into the following categories (Cooper et al., 2007):
- Escape / Avoidance,
As mentioned, reinforcement occurs at the ‘consequence’ stage of the ABC’s of behaviour (see Figure 1) and has historically been the focus of behavioural intervention, specifically Applied Behaviour Analysis (ABA). Although PBS does utilise the power of reinforcement for behaviour change, in PBS, much more focus is placed at the ‘antecedent’ stage of the ABC’s of behaviour as part of an overall multicomponent framework (Bosco et al., 2019). In this way, skills are developed and proactive strategies put in place in order to prevent the targeted challenging behaviour from occurring at all. The manner in which this is brought about and the plan for implementation of this is known as a Positive Behaviour Support Plan (PBS plan).
Stage 2: Manage
Positive Behaviour Support Plan for challenging behaviour
Integral to the implementation of PBS in practice is the formation of a Positive Behaviour Support Plan (PBS) plan. As PBS exists within a multicomponent framework, so must the PBS plan (Dunlap & Carr, 2007; LaVigna & Willis, 1992).
In developing a PBS plan, the data collected as part of the functional assessment of behaviour is utilised in order to create a structure for targeted behavioural intervention (Luiselli et al., 2005).
However, in order to fulfil its multicomponent ethos PBS plans must also include an understanding of the challenging behaviour the child presents with within the context of four-term contingency of behaviour; input from other individuals who have importance in the child’s everyday life e.g. parents, teachers, doctors, occupational therapists, speech and language therapists or social workers; clear, measurable behavioural goals; a means to establish, implement and measure the of effectiveness of the PBS plan (Gore et al., 2013).
PBS plans assess the individualised factors which were found to influence behaviour which challenges and make data-driven recommendations regarding proactive and reactive strategies. Proactive strategies are those which seek to work at the ‘antecedent’ level, prior to the behaviour occurring. Such examples are teaching of pro-social, independent or functionally equivalent skills. Reactive strategies are those which seek to manage challenging behaviour through intervention at the ‘consequence’ stage of the four-term contingency. This may include schedules of reinforcement or other strategies to manage behaviour which challenges after this occurs.
Behaviour escalation cycle: how behaviour which challenges occurs
The behaviour escalation cycle can be used in conjunction with the traffic light system in order to aid understanding of the manner in which challenging behaviour occurs (Colvin & Sugai, 1989).
Figure 2 illustrates how behaviour moves from ‘baseline’ (calm), is initiated by a trigger, accelerates to a ‘peak’ of escalation and then de-escalates to post-crisis stage and finally, return to baseline (recovery). In the context of the traffic light system, ‘calm’ can be situated as ‘green’, ‘trigger’ and ‘escalation’ as ‘amber’ and ‘peak’ as ‘red’. ‘de-escalation’ is also categorised as an ‘amber’ behaviour as at this stage of the behaviour escalation cycle, acceleration can re-occur.
‘Post-crisis’ is not always observed but refers to a presentation of ‘low’ mood in the aftermath of a behavioural escalation, prior to a return to baseline. An effective PBS plan should give guidance on how to respond at each stage of this cycle, although data should be recorded for each episode of challenging behaviour to allow for ongoing analysis of the efficacy of the PBS plan.
Iceberg model of challenging behaviour
The iceberg model of challenging behaviour can also be utilised to aid behavioural understanding and support with proactive interventions (Lavan, 2017). The iceberg model posits that observable behaviour exists above the surface; however, many unseen factors lie beneath the surface.
This theory lends itself to PBS in that PBS not only take observable and measurable factors into account but also recognise the existence of other behavioural influences alongside social, situational, developmental and environmental variables.
Stage 3: Prevent
Proactive strategies for managing challenging behaviour in children
As previously mentioned, PBS plans place emphasis on the ‘antecedent’ element of the four-term contingency. In practice, this means that the majority of guidance in a PBS plan should be housed within the ‘green’ behaviour section, i.e. to be put in place prior to challenging behaviour occurring. Examples of this include:
- Social stories (Scattone et al., 2002),
- Comic book conversations (Gray, 1994),
- Proactive emotional regulation strategies (Barnes et al., 2008),
- Visual schedules (Schneider & Goldstein, 2010),
- Visual communication strategies (Bondy & Frost, 2011),
- Teaching of new skills with a social emphasis (Lewis et al., 2002),
- Removal or minimisation of situational and environmental triggers.
Any proactive strategies used to support children presenting with challenging behaviour should be person-centred and evidence-based with a clear rationale based upon the outcome of the child’s functional behaviour assessment.
While these strategies are being implemented, behavioural data should be collected, and the results compared with baseline measurements of behaviour in order to assess effectiveness. If the pro-active intervention chosen is not found to be effective from the data collected, the PBS plan should be reviewed.
Hopefully this article has answered the question 'what is Positive Behaviour Support' for you and given you an insight into the three main stages of any PBS plan. We have loads more information on PBS including this introduction to Positive Behaviour Support and Challenging Behaviour as well as a range of resources to help you manage challenging behaviour and behavioural conditions / disorders all created with the PBS framework.