Positive Behaviour Support - Department of Human Services - Vic ...
Positive Behaviour Support - Department of Human Services - Vic ...
Positive Behaviour Support - Department of Human Services - Vic ...
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Case study: ROSIE TYLO<br />
*A clear description <strong>of</strong> the behaviours <strong>of</strong> concern is required<br />
Hitting others with a closed fist (using her right hand), usually to the upper body.<br />
Possible triggers for<br />
the behaviour:<br />
• New staff<br />
• Noisy environments<br />
• Staff changes<br />
• Tiredness<br />
• Constipation<br />
• Headache<br />
Possible warning<br />
signs that the person<br />
may display:<br />
• Red-faced<br />
• Excessive pacing<br />
• Muttering under her<br />
breath.<br />
• Using threatening<br />
language<br />
• Erratic behaviour that<br />
does not settle<br />
• Avoids eye contact<br />
<strong>Positive</strong> behaviour support: Getting it right from the start - Facilitators reference manual 85<br />
Remember: intervene early when you see early warning signs, in order to prevent behaviour escalating.<br />
Phase 1 Response: Rosie is red-faced and paces excessively<br />
Strategy: Encourage communication, for example, ‘What’s wrong?/Can I help you?<br />
If R positively, encourage Rosie to engage in problem solving as per Problem Solving Program, This<br />
should be done in a quiet area, without interruptions.<br />
Phase 2 Response: Rosie continues pacing plus muttering under her breath.<br />
Strategy: Encourage relaxation in her bedroom as per Relaxation Program.<br />
Provide as much assistance to Rosie with this program as she requires.<br />
Check with her as to whether she wants you to stay with her or be left alone.<br />
If she chooses to complete the program alone, check in periodically without disturbing her.<br />
If Rosie refuses to engage in relaxation, but the precursor behaviours cease, provide positive<br />
reinforcement in the form <strong>of</strong> verbal praise for her calming down. Continue to observe her from a<br />
distance for a period <strong>of</strong> 15 minutes.<br />
If Rosie refuses to engage in relaxation, and the precursor behaviours continue, encourage her to<br />
complete an alternative, preferred activity (see Rosie’s menu <strong>of</strong> activities). Continue to observe her<br />
from a distance for a period <strong>of</strong> 15 minutes.<br />
If Rosie refuses to engage in relaxation and attempts to, or actually succeeds in, carrying through<br />
with the target behaviour, proceed to Phase 3.<br />
Phase 3 Response: Rosie engages in target behaviour: Hitting others with a closed fist (using her right<br />
hand), usually to the upper body.<br />
Strategy: PRN VALIUM.<br />
Remember: potentially difficult situations may be<br />
avoided if you minimise these possible triggers<br />
(see do’s & don’ts list)<br />
a) Redirect Rosie to another room (away from other clients). Instruct her to sit down. One staff member<br />
should stay with Rosie (at a safe distance, that is, on the other side <strong>of</strong> a table but not engage in<br />
conversation with her).<br />
b). The second staff member should attend to the person who was target <strong>of</strong> Rosie’s aggression. If the<br />
person was a staff member, they should not be the one to stay with Rosie, but be allowed some<br />
time away from the person.<br />
c). Once 15 minutes has passed with no precursor or target behaviours being displayed, usual activities<br />
should be resumed.<br />
Staff should ensure that the individual needs <strong>of</strong> both clients and staff are met.<br />
Staff should not, at this time, enter into discussion with Rosie about the behaviour that she has<br />
displayed. When the time comes to fill out her incentive chart, Rosie and staff will discuss her behaviour<br />
across the whole day.<br />
Talking to Rosie about the episode whilst in Phase 4 Recovery, can actually escalate Rosie’s behaviour.