Positive Behaviour Support Nick Barratt MSc BCBA Head

Positive Behaviour Support Nick Barratt, MSc, BCBA Head of Behaviour Support

The science of human behaviour Behaviours that challenge Positive behaviour support

Behaviour Analysis … the scientific study of learning and behaviour

Why do we do what we do?

To understand behaviour, we must understand the context in which it occurs

Context – ABC model A • Antecedent Before the behaviour B • Behaviour C • Consequence After the behaviour

Context Antecedent Behaviour Consequence You have finished your You wave and mime The waiter brings the bill. meal in a restaurant. writing a cheque. The waiter walks past. Context

Context Antecedent Behaviour Consequence A two-year-old walks The two-year-old A burned, painful hand. into the kitchen. The gas reaches up to investigate. hob is on, and is making an interesting hissing sound. Context

Context Antecedent Behaviour Consequence You are driving at 40 mph You slow down. When you pass the in a 30 mph zone. You camera at 30 mph, it see a speed camera. does NOT flash. Context

Context Antecedent Behaviour Consequence You are at a party. You tell a joke with Some people smile, sexual content. others look embarrassed. No one laughs. Context

Consequential causality The consequences of a behaviour affect the probability of it occurring again. B. F. Skinner

Consequences that increase behaviour Get something you want Avoid something do NOT want Consequences that decrease behaviour Get something you do NOT want Lose something you want

Context Antecedent Behaviour Consequence You have finished your You wave and mime The waiter brings the bill. meal in a restaurant. writing a cheque. The waiter walks past. Context

Context Antecedent Behaviour Consequence A two-year-old walks The two-year-old A burned, painful hand. into the kitchen. The gas reaches up to investigate. hob is on, and is making an interesting hissing sound. Context

Context Antecedent Behaviour Consequence You are driving at 40 mph You slow down. When you pass the in a 30 mph zone. You camera at 30 mph, it see a speed camera. does NOT flash. Context

Context Antecedent Behaviour Consequence You are at a party. You tell a joke with Some people smile, sexual content. others look embarrassed. No one laughs. Context

Consequential causality also applies to challenging behaviour

Consequences (functions) Sensory Escape Attention Tangible

Can you do the washing up? SLAP! Don’t worry. I’ll do it.

But… Maria is more likely to self-injure in this situation if she slept badly the night before

Social Physical Context biological Activity

Combined contexts Biological Activity Tiredness Request = Challenging behaviour Slaps self

Summary Context A-B-C model “C” probability Functions (SEAT)

So, how can we help?

Positive Behaviour support The approach of choice

Principles of behaviour support ethically and clinically valid Must be

Behaviour support – assumptions Values base of person-centred thinking and inclusion

Behaviour support – assumptions Used strategies that are scientifically validated… procedures from Applied Behaviour Analysis

Positive Behavioural Support Improve quality of life Reduce challenging behaviour

PBS intervention The stages 1. Functional behaviour assessment 2. Behaviour Support Programme 3. Training and implementation 4. Review

1. Functional behaviour assessment Identify the Antecedents and Consequences that influence behaviour A • Antecedent B • Behaviour C • Consequence

1. Functional behaviour assessment Function-based interventions are twice as likely to be successful Carr et al. (1999)

2. Behaviour support programmes Address antecedents Improve quality of life Teach new skills Defuse or manage incidents

Address antecedents Social Physical Antecedents biological Activity

Social Increase social contact Support 2 -way communication Consider interactional style

Activity Meaningful Available Doable Facilitate choice Increase predictability

Biological Check for underlying health problems Consider sleep and food

Physical Ensure people have things to do Minimize restrictions Consider behaviour when planning environments

Improve Quality of Life Communication & Social Interaction Health Relationships - Family and Others Activities and Skill Development Physical Environment Service Management Service Staff Wider Organisation

Teach the person new skills Alternatives to challenging behaviour Coping skills

Can you do the washing up? SLAP! Don’t worry. I’ll do it.

Can you do the washing up? No Don’t worry. I’ll do it.

Defuse or manage incidents Diversion Environment & proximity Physical intervention Aftermath strategies

3. Training and implementation Behaviour skills training Present in service Contextual fit

4. Review Quantitative and qualitative Outcomes and delivery

The science of human behaviour Behaviours that challenge Positive behaviour support

The science of human behaviour √ Behaviours that challenge Positive behaviour support

The science of human behaviour √ Behaviours that challenge √ Positive behaviour support

The science of human behaviour √ Behaviours that challenge √ Positive behaviour support √

Resources • Family Carers • Service Providers • Commissioners • People with learning disabilities • Direct support workers http: //pbsacademy. org. uk/

nick. barratt@dimensions-uk. org