What is PBS?
Positive Behaviour Support is an approach for supporting individuals with autism, a learning disability, and a range of other complex care needs. The aim of Positive Behaviour Support is to create a ‘good fit’ between a person and the environment that they live in.
Often there can be challenges for an individual within the environment in which they live that produces, what has been described as, challenging behaviour. All too often a person with autism and/or a learning disability is unable to communicate the challenges that they face within the environment that they live.
The person may experience:
- Discomfort (e.g., noise, smells, or other sensory input that is uncomfortable)
- Requests or activities that are too difficult, they don’t enjoy, or that they do not see as important for them. The type of request may be too difficult, how the request is delivered may create anxiety, or there may be something about the person that is delivering the request
- The need to be with others, the desire to spend time with people they like or love, but the person does not know how to achieve this
- The need for something (highly preferred item)
- They would like to go somewhere (highly preferred activity)
What is regarded as ‘challenging behaviour’ can be seen as a way that a person with autism and/or a learning disability has learnt to communicate these needs. The individual may be non-verbal, or their communication may be limited as a result of their different learning needs.
The person may have learned that using behaviours that challenge can be more effective at producing the desired outcome than using spoken communication. Through understanding the individual, their diagnosis, and what the person is trying to communicate, a Behaviour Analyst can support them by optimising the person’s environment and creating a good fit.
The process of Positive Behaviour Support begins with assessment. The Behaviour Analyst will complete a very detailed and thorough Functional Behaviour Assessment. The aim of this assessment is to identify different aspects of the person’s life that do not fit well and where behaviour may be used to communicate this. The assessment uses various approaches to understand the behaviour of concern.
This includes:
- The person’s history
- Clinical reports from different professionals
- Structured interviews with people that have observed the behaviours of concern
- Interviews with people that know the person best – family, teachers, other professionals
- Data collection around the specific behaviour
- Direct observation
The analysis of the various findings from the Functional Behaviour Assessment point to the factors that lead to, maintain, and reinforce challenging behaviour. Once the Behaviour Analyst has identified the variables that lead to the behaviours, they are then able to pinpoint the strategies and interventions to support with the reduction of these.
Positive Behaviour Support uses the scientific method to create hypotheses around challenging behaviour. The Behaviour Analyst is then able to utilise data to confirm their predictions from the assessment, and to ensure that the strategies and interventions are successfully addressing the behaviours of concern.
The use of data to monitor the effectiveness of the intervention means that the Behaviour Analyst is able to use this information to optimise the intervention to lead to the best outcome for the individual.
The overall aim of Positive Behaviour Support is to improve the quality of life for the person, their family, and to create opportunities for meaningful engagement with day-to-day life.
This is done through:
- Reducing incidents of challenging behaviour
- Supporting the individual to meet their needs through appropriate communication
- Making appropriate communication more effective and more efficient than challenging behaviour
- Reducing exposure to things that produce anxiety, discomfort, or that are aversive
- Developing tolerance and resilience to things in the environment that can create anxiety or discomfort
- Skills based teaching
- Increasing independence
The process of planning, monitoring, and evaluating the strategies and interventions for supporting the individual are highly individualised and ‘Person Centred’. The individual and their family must be at the centre of creating the plans to enable the person to engage in activities that are meaningful to them.
This will increase the quality of the individual’s life and increase their overall wellbeing. The Behaviour Analysts role is to provide ongoing leadership to ensure that this plan is embedded in all aspects of the individual’s life. The Behaviour Analyst provides ongoing monitoring of the effectiveness of the strategies, interventions, and the effectiveness of the plans towards a better quality of life.
The Behaviour Analyst also monitors any barriers or restrictions that prevent the success of the Positive Behaviour Support plan and will work with the family and other agencies involved to remove any barriers towards success.
The Positive Behaviour Support plan is a document that is produced following the Functional Behaviour Assessment. This document outlines the strategies and interventions that were identified follow the Functional Behaviour Assessment. The Positive Behaviour Support plan is a ‘road map’ and provides the structure for family and all agencies involved to provide a consistent environment that fits well with the individuals own support needs.
The majority of the strategies outlined are positive and proactive to reduce the triggers that lead to challenging behaviour, and to reduce the events that maintain the behaviours. These strategies support development and growth and the learning of new skills.
The approach of Positive Behaviour Support is progressive and developmental, which means that through Person Centred Planning, the strategies and interventions can be delivered at the individual’s pace. A progressive approach is also important for family members and other agencies as they will be instrumental in the delivery of the support. They will receive training and support from the Behaviour Analyst.
A key dimension of Positive Behaviour Support is that it is ‘do-able’ and, with support, should be accessible for the family members and carers supporting the individual.
The approach of Positive Behaviour Support, the analysis, the development of a Person Centred support plan, the training and guidance to those involved, all aim to create the best fit possible to make it possible for the individual to live a meaningful life.