At Behaviour Help we have created ‘The Behaviour Help Cycle’ to explain the Positive Behaviour Support process step by step.
The team led by the PBS professional uses a person-centered approach which involves the individual being at the center of the decision-making process. By having the individual at the forefront, it enables the team to seek out, understand and plan services based on the individual’s needs, preferences and goals.
By using a person-centered team approach the following outcomes are achieved:
- Quality of Life: Improvement in various aspects of the individual’s well-being including physical health, mental well-being, social connections, economic security and overall satisfaction with life.
- Choice & Control: Increase in the individual’s autonomy and freedom to make decisions about the various aspects of their life and circumstances.
- Meeting Needs: Individual needs such as food, shelter, safety, healthcare, education and social belonging being met.
- Rights & Respect: Being respected for their diversity, and better safeguarding of human rights such as freedom of expression, equality before the law and the right to live free from discrimination and violence.
What is the Behaviour Help Cycle: Assessing-Managing-Preventing Behaviours of Concern?
‘The Behaviour Help Cycle’ explains the PBS process led by the PBS professional step by step. Remember in each step the PBS professional collaborates with the individual, family members, educators, medical professionals, allied health professionals and support staff.
Step 1 – Complete Assess Stage
The Assess Stage involves completing a Functional Behavioural Assessment (FBA). FBA is a systematic process of gathering information about the individual, recording behavioural data and analysing data to gain insight into the factors contributing to the behaviours of concern.
Based on this analysis, reasons why the individual may be engaging in these behaviours (i.e., the “function/s” of the behaviour) are hypothesised. The collated information helps the team better understand the individual and the reasons for their behaviours of concern.
To complete the FBA the following are completed:
- Individual’s profile: Gather information about the individual to create a comprehensive picture of the individual, their context and systems of support.
- Behaviour data collection forms: Measurable details (e.g. frequency, intensity, duration) about the behaviours of concern are recorded by observing the individual in different settings.
- Incident A-B-C: Incident details are recorded by reflecting on the antecedents (what preceded the behaviour), behaviours (describing the observable actions as they occurred) and the consequences (what happened after the behaviour).
- Hypothesis: By reflecting on both the qualitative and quantitative data the most likely purpose (i.e., function) that the behaviour of concern serves for the individual and what reinforces that behaviour to occur again can be determined. Some common functions of behaviours of concern include
- Communication: Behaviours of concern may occur as a way to communicate their needs, wants, or discomfort when they have difficulty expressing themselves verbally.
- Escape/Avoidance: Behaviours of concern may occur to escape or avoid certain situations, tasks, or demands that the individual finds overwhelming, unpleasant, or anxiety-provoking.
- Attention-Seeking: Behaviours of concern may occur to gain attention from others, whether it's positive or negative attention. This could be due to feeling neglected or seeking social interaction.
- Sensory Stimulation: Behaviours of concern may occur behaviours may provide sensory stimulation or relief from sensory overload. Individuals might engage in repetitive behaviours or self-stimulation to regulate their sensory experiences.
- Tangible/Access: Behaviours of concern may occur can occur when individuals want access to specific items, activities, or privileges that they desire but are not readily available to them.
- Self-Regulation: In some cases, behaviours of concern serve a self-regulatory function, helping individuals cope with stress, anxiety, or emotional dysregulation by providing a means of expressing and managing their emotions.
Information gleaned from the assess stage contributes to the next two stages: manage and prevent stages that together form an individualised positive behaviour support plan.
Step 2 – Complete Manage Stage
The Manage Stage in the positive behaviour support plan aims to provide a structured approach to behaviour management. This is achieved by helping the team better understand the individual’s emotional and behavioural needs, recognise the pattern in the individual’s stages of escalation and use stage specific behaviour management strategies to respond in ways that safely de-escalate the situation in the least disruptive manner.
To complete the manage stage the following are completed;
- Number of escalation stages: This helps those supporting the individual recognise the number of stages the individual typically exhibits as their emotional intensity rises (i.e., mild escalation, moderate escalation, extreme escalation and recovery stage).
- Escalation stages description: This assists those supporting the individual in recognising what nonverbal and/or verbal behaviours are exhibited in the different escalation stages and how long each escalation stage typically lasts.
- Stage-specific de-escalation: This provides stage specific de-escalation strategies to those supporting the individual to respond early in ways that can safely defuse, redirect and de-escalate the situation in the least disruptive manner. If authorised restrictive practices are to be used, then clear procedures for these practices are included.
Information gleaned from the assess and manage stage also contributes to the development of targeted interventions in the prevent stage.
Step 3 – Complete Prevent Stage
The Prevent Stage in the positive behaviour support plan aims to help the team develop consistent preventative strategies across settings that minimise or avoid triggers that prime or reinforce the behaviours of concern.
As well as enable the team members to teach and reinforce the development of new skills and alternative behaviours that serve the same function as the behaviour of concern, to maximise the individual’s participation, quality of life, independence and development across multiple domains.
To complete the prevent stage the following are completed:
- Supportive environments: Equips those supporting the individual with strategies on how to tailor indoor and outdoor spaces to support diverse sensory, accessibility, physical and emotional regulation requirements.
- Supportive activities: Equips those supporting the individual with strategies on how to tailor activity scheduling, activity resources, activity design and activity engagement to meet the individual’s needs, abilities and preferences.
- Supportive interactions: Equips those supporting the individual with strategies to promote communication that is clear, fair, empathetic, collaborative and responsive to foster respectful relationships.
- Teaching skills - Equips those supporting the individual with person-centred SMART goals, associated teaching approaches and positive reinforcement methods to help the individual learn functionally equivalent replacement behaviours (FERBs) and new skills. FERBs are contextually appropriate alternative behaviours that fulfill the same underlying need or function of the the behaviours of concern. By helping the individual develop FERBs it helps reduce the likelihood of behaviours of concern which allows for the fading out or eliminating the need for restrictive practices. Teaching the individual new skills can build their independence, participation and wellbeing. These can include communication, social, adaptive, cognitive, sensory, physical, play, academic, self-regulation, employment and daily living skills.
Step 4 – Continuous Review Cycle
Ongoing monitoring is critical to ensuring the team has a shared understanding of the effectiveness of the PBS plan. By reviewing the behaviour data collection forms, incident forms and tracking progress towards SMART goals adjustments can be made as needed. Hence, by using a data driven approach measured steps towards reducing restrictive practices can take place.
By continuing to complete the behaviour data collection forms and incident forms in the assess stage and tracking progress towards SMART goals in the prevent stage progress can be measured. Hence, by using data to inform a theoretically driven and ethically sound Positive Behaviour Support plan can be implemented and take measured steps toward reducing restrictive practices.