An evaluation of positive behavioural support for people with very severe challenging behaviours in community-based settings

Abstract

This study employs a multiple baseline across individual design to describe positive behaviour support for five people in community settings. The individuals represent all people with intellectual disability residing in one county with long-standing challenging behaviour resulting in serious physical injury. Five types of outcome are presented: rates of behaviour, rates of medication, psychiatric symptomatology, quality of life and revenue costs. The systems of support required to maintain outcomes and develop real lifestyles include behaviour support planning, mental health review, on-call intensive support and emergency respite care. Behaviours reduced to near-zero levels following implementation of positive behaviour support and improvements were sustained over 24 months. The use of psychotropic medications reduced by 66 percent over the same period. Quality of Life Questionnaire scores improved significantly for three of the five participants. The results are discussed in the context of a framework for supporting people with severe challenging behaviours in the community.

From Causes of Aggression to Interventions

“…Two excellent studies were reported by McLean and Grey (2007) and McLean, Grey and McCracken (2012) concerning the use of positive behavioral support with people who have more severe intellectual impairments, some of whom also had autism. What characterizes their work with these nine individuals are very detailed background assessments concerning medical, psychiatric, communicative and cognitive and environmental factors, alongside a functional assessment of the behavior obtained through careful observation.…”

Integrating Best Practices in Positive Behavior Support and Clinical Psychology for a Child With Autism and Anxiety-Related Problem Behavior

“…The effectiveness of a PBS approach has been demonstrated in a variety of home, school, and community settings (Duda, Clarke, Fox, & Dunlap, 2008;R. E. March & Horner, 2002;McClean, Grey, & McCracken, 2007). Research has demonstrated positive outcomes using PBS with typically developing children (Horner et al, 2009), children and youth with behavior disorders (Dunlap, Clarke, & Steiner, 1999), and children with autism and other developmental disabilities (Blair, Fox, & Lentini, 2010).…”

Reliability and utility of the Behaviour Support Plan Quality Evaluation tool (BSP‐QEII) for auditing and quality development in services for adults with intellectual disability and challenging behaviour

“…Furthermore, the view that one can ‘fix’ challenging behaviour by means of short term intervention is clearly not in line with research evidence (cf. Bird & Luiselli 2000; McClean et al . 2007).…”