Complex challenging behaviour can, by its very nature, present as confused and hard to understand. Yet it is in appreciating this function of the behaviour or “hearing” the message it conveys that we are able to formulate a range of helpful interventions. Assessment involves sifting through all the available information, piecing together those parts that seem relevant in order that a position of relative clarity can be reached. It is about understanding the problem behaviour within the context of a person’s life. It forms the foundation for the behaviour support plan that follows.
Our comprehensive assessment includes a full records review, interviews with the service user and their family as well as health and other professionals and. A review of an individual’s person centred plan is of particular value given that it often provides a blueprint of the person, identifying hopes and fears, preferences and dislikes, strengths and needs – information that not only informs the functional analysis of the behaviour but also offers an insight into potentially powerful motivators that might be of value as part of a positive behaviour support plan.
Alongside the assessment, recording systems are implemented to monitor outburst behaviour and establish a baseline for its frequency and severity.
Analysis and interpretation of this information enables us to form one or more theories of behaviour. The ensuing behaviour support plan aims to test the validity of these conclusions and ultimately provide a solution to the problem behaviour.
Our behaviour support plans detail a range of Proactive and Reactive interventions designed to promote changes in behaviour and improvements in people’s quality of life.
Proactive Strategies are designed to achieve behavioural improvements over time and consist of ecological change, positive programming and focused support.
Behaviour occurs within a context and can often be a function of the environment we inhabit, be that physical, social or occupational. Many of the elements that constitute our basic philosophy of care fall into this category, reflecting the importance of ecology in promoting positive behaviour.
Sometimes, people’s behaviour can be explained through a mismatch between them and this environment. Our assessment aims to identify and evaluate the “fit” between an individual and their environment and to offer recommendations for improving this. Fortunately, there are many ways in which ecological improvements can be achieved and the situation rapidly improved.
While ecological changes aim to improve the fit between a person and their environment, positive programming aims to improve the person’s skills and competencies and thus their ability to cope with the environment.
General skills development focuses on improving people’s repertoires of socially appropriate responses in everyday situations. Having a wider range of responses increases the possibility of positive behaviour, especially when reinforced by stimulating and rewarding experiences.
In some situations, challenging behaviour exists because it serves a useful function for the person. Functionally equivalent and related skills development aims to teach people alternative, more socially appropriate ways of meeting or communicating those needs.
At the same time, the unpredictable and often uncontrollable nature of the world means that there will inevitably still be occasions when a poor “fit” exists between the person and their environment or where they are presented with a situation for which they have no suitable response available. Teaching coping and tolerance skills is a way of supporting people to cope with naturally occurring aversive events such as loud noise, crowded buses, disappointment etc.
If proactive strategies are concerned with improvements in behaviour over time, reactive strategies are concerned with managing those behaviours when they do occur in order to keep people safe and restrictive practices to a minimum. By formulating clear guidelines, interventions become more predictable.
By reviewing our behaviour support plans regularly we can ensure they continue to be effective. Periodic service reviews measure the team’s compliance with the plan as well as the integrity of the data collected. Quarterly evaluation reports detail the most recent analysis of behavioural observations allow the support plan to be fine-tuned and an ever more sophisticated understanding of the behaviour to be developed. At the same time, this data can be a valuable source of information to other professionals, informing and influencing their decision-making.