Positive behaviour support Getting it right from the start

74 Positive behaviour support: Getting it right from the start - Facilitators reference manual
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Changing background factors
Possible background factors
Changes
Personal
The person appears to no longer be able to do the
things they once could
The person has a urinary tract infection
The person has been on high doses of psychotropic
medication for over three years
The person has a large appetite and only gets to eat at
main meal times
The person does not see other people as a source of
enjoyment ( based on many failed experiences and
much criticism in the past)
Person is non-speaking and has no communication
skills
Person has recently began to head bang, withdraw
from others and avoid eye contact
Person’s methods of communication are hard to
understand
Document skills the person can no longer do
and discuss with the medical practitioner
Medical treatment
Refer to psychiatrist for a medication review
Provide the person with nutritious meals through
the day
Build rapport with the person by offering things
that they like
Complete a checklist of communication
competencies to identify person’s level of
communication
Document new behaviours and discuss with
medical practitioner
Complete a personal communication dictionary
Environmental
The person has few opportunities to exercise choice
Staff have low expectations of what can do and so
don’t provide her with many opportunities
The person lives in an overcrowded and unstimulating
house
The BSP does not focus on positive behaviour support
strategies and instead focussed on the restrictive
interventions
Increase the number of choices available to the
person
Provide training to staff on recognising the
strengths of service users, and then get them to
build a strength list for the person
Improving the person’s accommodation by
internal modifications, or by adding a flat and
fitting it out with materials of the person’s
choosing
A functional behaviour assessment needs to
be completed to identify the functions of the
behaviour
A combination of environmental strategies and
skills development strategies are put in place
The person does not interact with others much
The atmosphere in the person’s support service is
tense because of simmering disputes between staff
There is a lack of predictability in the activities of the
day from the person’s point of view
Increase the number of interactions the person
has with others by encouraging a hobby which
will act as a springboard for interaction
Introduce a grievance process
Introduce an activity sequence chart