Behavioural Supports & Strategies

Behaviour is a Form Of Communication

Everyone’s behaviour is a form of communication.  Another way to think of it is that everyone we do we do for a reason (good or bad).  The first and last rule with challenging behaviours is to listen.

What are Positive Behavioural Supports (PBS) in the NDIS?

PBS is a person-centred, evidence-informed approach to understanding and responding to behaviours of concern. The goal of PBS is to improve quality of life by identifying the reasons behind a person’s behaviour and implementing positive, practical strategies that meet their needs, uphold their dignity, and strengthen their everyday relationships and routines.

Within the NDIS, a PBS plan is developed by a behaviour support practitioner who is authorised and works for a registered NDIS provider. The practitioner works closely with the person, their family, carers, support workers, and key people in their life—such as educators, employers, and allied health professionals. They begin by conducting a functional behaviour assessment, which looks at what is happening before, during, and after a behaviour to understand why it is occurring.

Using this information, the practitioner develops a tailored PBS plan that supports the person’s goals, promotes skill development, and reduces the need for restrictive practices. This may involve changes to the environment, introducing functional alternatives to challenging behaviours, and supporting everyone around the person to respond in ways that are respectful, consistent, and informed by human rights.

PBS is more than just behaviour change—it is a holistic biopsychosocial approach that takes into account the person’s health, mental wellbeing, relationships, and environment. Practitioners may also provide training for families and support teams, assist with emotional and behavioural regulation strategies, and offer ongoing support to review and adjust the plan over time.

By focusing on quality of life and individual strengths, PBS empowers people with disability to thrive—safely, confidently, and with greater control over their lives.

PBS under the NDIS is a specific 'stated' support within a participants plan, which will always be NDIA managed. The type of support provides for the formulation and ongoing support and management by a registered PBS practitioner as well as social skills development. Your NDIS Experts at AHEAD can assist in all areas of positive behaviour supports. Contact us today to discuss how we can help.

What is a Behaviour Support Plan (BSP)?

This plan provides carers with a step-by-step guide to managing challenging behaviour. It is based on the results of a behaviour assessment.   Let’s look at some important parts of any BSP.

Short-term

• Often contact is made when things are at crisis point, short term quick strategies can help to understand the situation and relieve some of the pressure but no BSP is a quick-fix.  It takes time and effort.

• Safety planning

• Quick strategies and changes to help the here & now

Long-term

• A deeper dive will bring out longer-term strategies

• Really understanding what is going on for the person, what a good life looks for them and everyone working as a team

• Life-long learning

• Getting supports and care right

Proactive strategies. These are used to make sure that the person has got what they need. They also describe ways to teach the person communication and other skills. Examples include:

• Look for triggers

• Teach skills e.g. a sign for “finished”

• Be aware of how you talk to the person e.g. firm, funny and calm

• Adjust the environment e.g. dim the lights, tie hair back to stop someone pulling hair

• Rewards

• Routine and structure

• Boundaries

• Make sure carers have training and regular breaks.  Training should include strategies for themselves, looking at the environment.  They should also be referred for assessment and support should factors such as mental health be identified

Reactive strategies are designed to keep the person and those around them safe. Examples include:

• Do not respond to the behaviour

• Give reminders

• Distract the person

• Give the person what they want

• Remove yourself from the situation e.g., leave the room

• A good plan has more proactive than reactive strategies

De-escalation techniques

When dealing with someone who is exhibiting challenging behaviour, de-escalation techniques can be incredibly helpful. Here are some strategies to consider:

Look and listen: Pay close attention what is going on, note what happened prior or what is coming up that might cause a reaction.  Keep everyone safe but let the person express themselves.

Wait: Be with the person to make sure they are safe, but don’t be intrusive, logic will not work when a person is in fight, fright or freeze mode (we call in brain stem thinking) the brain isn’t processing.

Connect: Establish a connection in a way that works for the person, this might be stopping what you are doing, or sitting in silence, you might not be able to connect at the time or wait and reconnect until things have calmed down.  Don’t blame, punish or stay heightened, a clean slate every time is needed.

Non-Threatening Posture: Slightly incline your head to show you’re listening, perhaps nod slowly to indicate you see / hear them and understand.  Adopt a non-threatening posture.

Stay Calm: Avoid becoming emotional or reactive. If safe, take a moment to regroup.

Maintain Distance: Stand to the side (about 45°) and keep an arm’s length away.

Non-Aggressive Posture and Voice: Avoid crossing your arms, or waving them around. Keep your voice low and talk in short phrases it is unlikely the person can process anything else.

What Does Challenging Behaviour ‘Look’ Like

Children and adults with learning disabilities and / or mental health may display ‘‘problem’’ or ‘‘unusual’’ behaviours. These can include:

• Aggression (e.g. hitting)

• Self-Injury (e.g. head banging)

• Destruction (e.g. throwing)

• Other (e.g. spitting)

It can be stressful, upsetting and impact on the lives of the whole family and everyone who cares for and about the person.

Why Does It Happen

There is always a reason for challenging behaviour. In many cases, it’s a way for a person to control what is going on around them and to get their needs met. They also might be ill or in pain, or want to get something. It’s important to understand the reasons behind challenging behaviour for change to happen!

What Can Be Done

There is no quick fix. Having said that, there is a lot that can be done to prevent or reduce challenging behaviour:

• Work out if the person is in pain or bored or feels in danger

• Is there a way of teaching the person to show you what they want in another way? Develop their communication skills

• Keep a record of the behaviour

• When safe to do so, ignore it and distract the person

• Engage a behavioural support practitioner to work with everyone to help understand the behaviour and work together as a team to improve things

• If the person doesn’t have behaviour supports in their NDIS speak with your support coordinator or the NDIS directly.  Practitioners can often provide services under a different line item, this can often get you started whilst more appropriate funding can be sought.  Please note if there are any restrictive practices only a registered positive behavioural practitioner can be used and only registered providers can implement an authorised plan

Creating A Behavioural Support Plan

To create a BSP takes collaboration.  Everyone involved with the person’s care should be involved in creating a behaviour support plan. Here are 8 key steps to make a plan:

• Write a description of the behaviour(s)

• Work out the reasons for the behaviour

• Write ‘proactive’ “Green” strategies to help the child or adult stay happy and calm. Think about what new skills the person may need to learn to help them in the future e.g. a sign for “finished”, to wait for 30 seconds etc.

• Recognise the early warning signs of the behaviour (when a person becomes anxious) and think about how to respond when you see these. This is the ‘active’ “Amber” part of the plan.

• Record the ‘reactive’ “Red” strategies (what to do when the behaviour occurs) to keep people safe.

• Record the ‘post reactive’ “Blue” strategies (what to do after the behaviour). We need to be careful here as there is a risk of the behaviour escalating again.

• Get agreement from all the key people in the person’s life

• Review the plan. Is it working?  If not why not.

Decoding Challenging Behaviour

Behavioural support is about decoding challenging behaviour.  Think of your behavioural support practitioner as a detective ready to look and unravel the clues.  This will involve collaborating with the person with challenging behaviours and those that interact and care for them, conducting assessments, gathering data and generally getting to know the people involved and the situation.  People will be asked to contribute in different ways so a holistic approach can be taken.

This is a huge list, and no two people are the same, so these are very broad strategies to get everyone thinking.

• Frustration (often linked to not being able to communicate needs and wants)

• Pain (physical, emotional and psychological)

• Trauma (triggered by events, places, people, senses)

• Abuse response (trying to let people know something is wrong)

• Mental health (not all people with challenging behaviour have mental health concerns just as not all people with mental health exhibit challenging behaviours) of the individual or those around them

• Learned behaviour - we often become what we see, how are others behaving towards and in the persons environment, is there any important history of what may have been seen and experienced

• Challenging behaviour gets a reaction, sometimes that is interpreted as better than nothing

• They don’t know what else to do or how else to act (replacement behaviours come in here with lots of positive reinforcement)

• Change (to routine, environment, carers)

• Boredom (lack of engaging activities)

• People (those in caring role, interacting, tone of voice, cadence, friendly or scary)

• Environment (over or under stimulating, bright lights, scared - dark, unsure, phobia, uncomfortable, new or a change, too hot, too cold, to noisy

• Individual preferences (lack of choice & control, respect)

• Lack of training or knowledge (human rights, de-escalation techniques, strategies, disability specific topics, communication, how to implement BSP and / or strategies)

Keeping everyone safe

It is important for everyone involved to be safe. Below are some number that can help 24/7

Emergency services including police, fire and ambulance 000.

Beyond Blue 1300 224 636

Lifeline 11 13 14

Kids Helpline 1800 551 800

The disability abuse line is available Monday - Friday 9am to 5pm AEST 1800 880 052.

Make note of your nearest hospital.  Have an emergency evacuation and safety plans.

Have: Emergency contacts, and informal support numbers, medication and condition information handy along with a short version the behavioural support plan handy.

Restrictive Practices

In extreme cases restrictive practices may need to be used. Implementing providers must report them to the NDIS Qality Safeguard Commission NQSC and ensure state / territory authority authorisation. All efforts to establish an interim plan should be made within 1-month of the first use and a comprehensive plan within 6-months. Each use of an unauthorised restrictive practice used by a provider is considered an incident and must be reported to the NQSC. A reduction / fade out plan must be made, whilst in use any restrictive practice must be used only as a last resort, the least restrictive and amount of time possible.

A restrictive practice is anything that restricts the rights and freedom of movement of another.  This may be to stop or try to prevent behaviours but may also be due to omission (not doing something) or done for someone's own convenience (can’t be bothered).   They are broken down into 5 categories:

• Seclusion

  • Taken away from others

  • Not being included in activities

• Chemical restraint (drugs, prescribed by a doctor or otherwise) is the use of medication or a chemical substance primarily to influence a person’s behaviour, not including medication prescribed for mental disorders, physical illness, or conditions however this can be sometimes difficult to ascertain the purpose, if there is any doubt your behaviour support practitioner will investigate further in order to satisfy NDIS requirements

• Mechanical restraint is any type of device that prevents the person moving freely, restraint (except age-appropriate required car seats)

  • Helmets, restrictive clothing, gloves or splints

  • Bedrails / tables

  • Not putting (or keeping charged) electric wheelchair batteries

• Physical restraint is the use or action of physical force to prevent, restrict, subdue or enforce movement of a person’s body, or part of their body, or to stop their freedom of movement for the primary purpose of influencing their behaviour. This does not include hands-on techniques used reflexively to guide or redirect a person away from potential harm

  • Being held down (even if holding down arm for blood test)

  • Making a person go in a certain direction 

• Environmental restraint is the restriction of a person’s free access to all parts of their environment, including items or activities

  • Not having keys to their house

  • Locking away knives or not having access to porcelain crockery only plastic, putting a lock on the fridge

  • Taking away or not giving access to belongings or forms of communication (augmentive communication or mobility equipment)

  • Locked doors, placing items in front of doors or any area that restrict full access

Restrictive practices and the NDIS

• All restrictive practices must be authorised by the NDIS via a behavioural support plan lodged by a registered positive behavioural support practitioner, of proficient level or above, it is good practice to engage with supervision

• If any doubt if something is a restrictive practice the NDIS behavioural support team must be consulted

• Only registered providers can implement restrictive practices (if with an unregistered provider a transitional plan must be made as a matter of urgency - however negative effects of a change of provider must be considered)

• If only implemented by family members the two types of PBS plans must still be compiled and the family educated on procedures, disability rights and encouraged to reduce / fade out / eliminate. As there is no implementing provider on the NDIS portal, the PBS plans are logged as 'drafts'

• All use of restrictive practices must be reported, have procedures and a plan to reduce and eliminate made

Abuse Is Still Abuse

Do not confuse the absence of particular practices, acts or omissions from the restrictive practices as being okay.  Any form of abuse is not okay.

Everyone deserves to be treated with dignity and respect, to feel safe in their home and environment.  Everyone has the right to choice and control, along with the right to participate and live their best life.

Never use words or any form of intimidation against another, facilitate access to their own funds, take care of others how you would like to be cared for.  Ask their opinion, if required support them to make decisions, do not make decisions for them.

The only one who knows ‘what is best’ is that person.  We are all the experts in our own life.

How Your NDIS Experts Can Help

Our staff can assist you with supports ask Your NDIS Experts today. We operate Australia-wide, 7-days a week, as we know disability doesn't just happen during office hours. We offer tele-health services, fly or drive in for intensive support or groups of clients and limited face-to-face supports in the Peel Region Western Australia.

We have staff available now in the following areas:

• Behavioural supports

• Individualised programs

• Therapy, assessments and recommendations

• Psychosocial recovery coaching

• Case management, for when it's complicated

• Skill development and training, decision-making and budgeting

• Parent / carer training

• General and employment related counselling

Email┃wecare@aheadsupports.com.au

Website ┃ www.adheadsupports.com.au 

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