Implementation of learning about PBS brings about significant reduction in challenging behaviours


We have posted previously about positive behaviour support (PBS) which includes a range of approaches based upon  person centred values which use quality of life improvements for the person as an intervention and an outcome measure.

This Irish study set out to look at the components of positive behavioural support interventions to try to identify which components were most effective and which factors might mediate effectiveness.

The researchers worked with 61 staff working with people with learning disabilities and challenging behaviours. The staff completed longitudinal competency-based training in PBS. Following the training, each of the participants conducted a functional assessment and developed and implemented a PBS plan for one individual. The researchers therefore had 1,272 interventions available for analysis.

They took a range of measures of challenging behaviour at baseline, at 6 months, and at follow up, which was on average at 26 months.

What they found was a significant reduction in the frequency, management difficulty, and episodic severity of challenging behaviour over the duration of the study.

Following the functional analysis, the most common function of behaviour was identified as escape, and it accounted for 77% of challenging behaviours identified.

They found the most commonly implemented components of PBS interventions were setting event changes and quality-of-life-based interventions. When looking for associations with decreased in behaviour frequency, they found that only treatment acceptability was related to such decreases.

They conclude that there was no single intervention component found to have a greater association with reductions in challenging behaviour.

A component analysis of positive behaviour support plans, McClean B & Grey I, in Journal of Intellectual and Developmental Disability 37, 3 , 221-231

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John Northfield

After qualifying as a social worker, John worked in community learning disability teams before getting involved in a number of long-stay hospital closure programmes, working to develop individual plans for people moving into their own homes. He worked for BILD, helping to develop the Quality Network and was editorial lead for the NHS electronic library learning disabilities specialist collection. This led him to found the Learning Disabilities Elf site with Andre Tomlin as a way of making the evidence accessible to practitioners in health and social care. Most recently he has worked as part of Mencap's national quality team and also been involved in a number of national website developments, including the General Medical Council's learning disabilities site.

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