Behaviour that tends to satisfy the desires of the respondent is Positive Behaviour . It will become apparent that by this definition some positive behaviour may lead to antisocial (so called “negative”) responses and hence is not recommended. Furthermore, some behaviour that is itself socially acceptable and apparently positive is not, by this definition, actually positive because it does not tend to satisfy the desires of the respondent. The reverse is also true: some behaviour that is social not acceptable and apparently negative is yet actually positive because its operates to satisfy the desires of the recipient. Illustrations of Positive Behaviour
Actions that can be classified under the following headings are customarily called positive:
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Although in some ways, the line between positive and negative behaviour exists in the eye of the beholder. Your value system, which stems from your family and cultural background as well as your own life experiences, will determine what you believe to be positive behaviour. Your feelings about yourself and life in general will also colour your perceptions. When adults feel positive about themselves, they are better able to understand and accept children’s behaviour. Positive behaviours are those which help children/venerable person move along toward the goal of becoming well-adjusted, fully functioning adults. In other words, behaviour that is typical of a particular stage of development, that paves the way for the next stage, is positive. Positive behaviour is not, therefore, the same thing as compliance with adult wishes, especially if those adult wishes reflect a lack of knowledge of children’s or venerable person’s development.
Some positive behaviour can appear downright negative! Some authors argue that there are predictable times in the lives of all children/venerable person when their behaviour “falls apart”: when they seem to move backward in development in ways that perplex and dismay their parents and caregivers. These times invariably signal a rapid spurt of physical, cognitive, or socioemotional growth. An example might be the child on the verge of walking, whose frustration at being left behind evokes a sudden change in disposition and screams of rage. We can view these periods, not as crisis points, but rather as “touch points,” unparalleled opportunities for understanding and supporting development, if we anticipate them positively and avoid becoming locked in power struggles.
By studying child/venerable person development and carefully observing the behaviour of many them, you can learn to adjust your expectations so that the behaviour you expect is within the bounds of possibility for children to achieve. By observing the behaviour of a particular child child/venerable person over time, you can begin to understand what particular behaviours mean for that person. You may begin to see how behaviour that seemed irritating to you actually serves a positive function for a child/venerable person.
Focusing on positive behaviour places negative behaviour in better perspective and develops a more accurate impression of the whole child/venerable person. It allows you to emphasize strengths and help children overcome weaknesses. Early childhood educators with heightened awareness of positive behaviours will set the stage so that those behaviours can occur, and will respond in ways that make these acts occur more often. In other words, they will use techniques of indirect and direct guidance.
Positive behavioural support
According the Department of health, Positive behavioural support (PBS) provides a framework that seeks to understand the context and meaning of behaviour in order to inform the development of supportive environments and skills that can enhance a person’s quality of life. Evidence has shown that PBS-based approaches can enhance quality of life and also reduce behaviours that challenge which in turn can lead to a reduction in the use of restrictive interventions. It is founded on principles that have applicability for a much broader range of people and may use different terminology.
PBS provides a conceptual framework which recognises that people may engage in behaviours that are challenging because: • they have challenging or complex needs that are not being met – these could be associated with unusual needs and personal preferences, sensory impairments, or mental or physical health conditions • they are exposed to challenging environments in which behaviours of concern are likely to develop – examples might include environments which are barren and lack stimulation, where there are high levels of demand placed on people, where there may be institutional blanket rules, restricted or unpredictable access to preferred activities and those things the person values and where there is insufficient availability of positive social interactions, or where personal choices are not offered and/or honoured • they typically have a generally impoverished quality of life. PBS approaches comprise a number elements:
• Using person-centred, values-based approaches to ensure people are living the best life they possibly can. This involves assisting a person to develop personal relationships, improve their health be more active in their community and to develop personally. When done properly, person centred planning processes make sure that those who support people get to know them as individuals. • Skilled assessment in order to understand probable reasons why a person presents behaviours of concern; what predicts their occurrence and what factors maintain and sustain them (this area of assessment is often referred to as a functional assessment). This requires consideration of a range of contextual factors including personal constitutional factors, mental and physical health, communication skills and the person’s ability to influence the world around them.
Patterns of behaviour provide important data, skilled analysis of which enables key areas of unmet need to be understood. • The use of behaviour support plans which have been informed by an assessment of these factors in order to ensure that aspects of the person’s environment that they find challenging are identified and addressed, that quality of life is enhanced and that wherever possible people are supported to develop alternative strategies by which they can better meet their own needs. These are referred to as primary preventative strategies. • The behaviour support plan must detail the responses such as de-escalation techniques, distraction, diversion and sometimes disengagement to be used by carers/staff when a person starts to become anxious, aroused or distressed. These are referred to as secondary preventative strategies and aim to promote relaxation and avert any further escalation to a crisis. • Behaviour support plans include guidance as to how people should react when a person’s agitation further escalates to a crisis where they place either themselves or others at significant risk of harm.
This may include the use of restrictive interventions. Within behaviour support plans these are as identified as tertiary strategies. Any person who can reasonably be predicted to be at risk of being exposed to restrictive interventions must have an individualised behaviour support plan. Care programme approach care plans, personal recovery plans or other personalised approach planning structures may also incorporate behaviour support plans. They must always include clear evidence of health and social needs assessment, and be created with input from the person, their carers, relatives or advocates. This should identify: • The context within which behaviours of concern occur
• Clear primary preventative strategies which focus on improvement of quality of life and ensuring that needs are met • Secondary preventative strategies which aim to ensure that early signs of anxiety and agitation are recognised and responded to • Tertiary strategies which may include detail of planned restrictive interventions to be used in the safest possible manner and which should only be used as an absolute last resort What are the Positive Strategies for Supporting Behavior Improvement?
There are many possible contributors to the development of challenging behaviours. It is important to investigate and evaluate these, but also to take action sooner rather than later, since many behaviors can become increasingly intense and harder to change as time goes on. Often a necessary approach to managing behaviour involves a combination of addressing underlying physical or mental health concerns, and using the behavioral and educational supports to teach replacement skills and self-regulation. There is no magic pill, but there are a number of strategies that can often be helpful. The use of Positive Behavior Supports is more than just a politically correct approach to behavior management. Research shows that it is effective. The alternative is usually punishment, which decreases the likelihood of a behavior by taking something away (such as removing a favorite toy) or doing something unpleasant (yelling, spanking.)
While punishment might work immediately, it has been shown to be ineffective in the long run and can increase aggressive behavior, provide a model for additional undesirable behaviors, and strain the relationship with the caregiver (you). It is worth noting that to continue to be effective and maintain improvements, positive supports and feedback need to be ongoing as well. “Withholding reinforcement for problem behavior (i.e., extinction) is technically an example of punishment. Proponents of Positive Behavior Support (PBS) acknowledge that controlling access to reinforcement is necessary when trying to change behavior. What PBS does not condone is the use of aversive (e.g., demeaning, painful) procedures to suppress behavior.
Such approaches have been demonstrated to be ineffective in producing durable changes in people’s behavior and do not improve to quality of their lives.” –Association for Positive Behavior Support If you have made changes to improve your child’s health or happiness, and these have not helped to improvehis behaviour in a reasonable time frame (a couple of weeks), or you are concerned about safety, help may be needed. Positive strategies and an intervention plan can be developed by a behavioral or educational team, usually in response to what is learned in a functional behavior assessment (FBA) as described in the previous section.
When several challenging behaviors exist, it is important to establish priorities. You may want to first target behaviors that are particularly dangerous, or skills that would help to improve situations across several behavioural scenarios. Remember to set goals that are realistic and meaningful. Start with small steps that can build over time. A non-verbal child is not likely to speak in full sentences overnight, but if learning to hold up a ‘take a break’ card when he needs to leave the table allows him to exit, and keeps him from throwing his plate, that is a huge success.
A plan for our team should meet four essential elements:
Clarity: Information about the plan, expectations and procedures are clear to the individual, family, staff and any other team members. Consistency: Team and family members are on the same page with interventions and approaches, and strive to apply the same expectations and rewards. Simplicity: Supports are simple, practical and accessible so that everyone on the team, including the family, can be successful in making it happen. If you don’t understand or cannot manage a complicated proposed behavior intervention plan, speak up! We have to recognize that many skills take time to develop, and that changes in behavior require ongoing supports to be successful.
In some cases, especially when you are ignoring a behavior that used to ‘work’ for your child, behavior may get more intense or more frequent before it gets better. Your team should keep good records and track progress and responses to intervention to know if the plan is effective. Being realistic at the outset is crucial. It can help parents and caregivers appreciate that they are making small yet meaningful changes in their lives and the lives of the individual they care for. Making goals realistic means they are achievable. Being realistic keeps the picture positive. It focuses attention on progress towards to a goal, rather than perfection.
Setting a real Positive Behaiviour Support
Our team should develop strategies for you to use to increase the behaviors you want to see in your child. These will need to be individualized to his particular needs and challenges. They can often be helpful in building a sense of pride in accomplishments and personal responsibility, and a sense of what is expected. This will reduce the anxiety and reactivity that results in aggression or other behaviors. Some helpful strategies: Celebrate and build strengths and successes: we tell him what he does well and what you like. A sense of competence often fosters interest and motivation. Strive to give positive feedback much more frequently than any correction or negative feedback. ‘Great job putting your dishes in the sink!’ Respect and listen to him: We may have to look for the things he is telling you, verbally or through his choices or actions. ‘You keep sitting on that side of the table. Is the sun in your eyes over here?’ Validate his concerns and emotions: Do not brush aside his fears or tell him not to worry.
His emotions are very real. Help to give language to what he is feeling. ‘I know you do not like spiders. I can see that you are very afraid right now.’ ‘I can see that you are angry that our plans have changed.’ Provide clear expectations of behavior: Show or tell your child what you expect of him using visual aids, photographs or video models. A great way to teach new skills is Tell-Show-Do. Set him up for success: Provide accommodations. Accept a one word answer instead of demanding a whole sentence. Use a larger plate and offer a spoon to allow him to be neater at the dinner table. Use Velcroshoes or self-tying laces if tying is too frustrating. Ignore the challenging behavior: Do your best to keep the challenging behavior from serving as his way of communicating or winning. This is hard to do, but in the long run it is effective. Do not allow his screams to get him out of brushing his teeth, or his biting to get him the lollipop that he wants. Behaviors may get worse before you start to see them get better. Stay the course! And make sure all family and team members are consistent in this approach and that you pair this with other positive strategies.
Alternate tasks: Do something that is fun, motivating or that your child is good at. Then try something hard. He will be less inclined to give up or get agitated if he is already in a positive framework. Teach and interact at your child’s or loved one’s learning level: Take care to set him up for growth and accomplishment, rather than the anxiety produced by constant failure or boredom. Give choices, but within parameters: Everyone needs to be in control of something, even if it is as simple as which activity comes first. You can still maintain some control in the choices that you offer. ‘Do you want to eat first, or paint first?’ Provide access to breaks: Teach the individual to request a break when he needs to regroup (e.g. use a PECS card that represents “break”). Be sure to provide the break when he asks so he learns to trust this option and does not have to resort to challenging behaviors.
Promote the use of a safe, calm-down place: Teach him to recognize when he needs to go there. This is a positive strategy, not a punishment. Set up reinforcement systems: Use simple, predictable processes that reward your child for desired behavior. Catch him being good and reward that, verbally and with favored activities, objects or ‘payment.’ ‘I love that you stayed with me during our shopping trip. You earned a ride on the airplane toy!’ Allow times and places for him to do what he wants: Even if it is a ‘stim’, it is important to provide these options when it is not an intrusion or annoyance to others. Reward flexibility and self control: ‘I know you wanted to go to the pool today and we were surprised when it was closed.
For staying cool and being so flexible about that change in plans, let’s go get some ice cream instead!’ Pick your battles: Strive for balance. Focus on the behaviors and skills that are most essential. Be sure to include positive feedback and intersperse opportunities for success and enjoyment for you, your family, and your loved one with autism. Be resilient. Celebrate the fun and the good things! Use positive/proactive language: Use language that describes what you want the individual to do (e.g. ‘I love how you used a tissue!’ ), and try to avoid saying ‘NO’, or ‘don’t’ (e.g. ‘stop picking your nose.’ ).
Setting Realistic Behavioral Goals:
Setting goals allows us to objectively measure progress toward an identified desired outcome. It also allows caregivers and parents to ask themselves, “What behavioral changes would really make the greatest improvements in our lives together?” It allows them to identify what really matters. For instance, it may be more important to address a behavior such as throwing things during a classroom activity than to address that person’s tendency to stand up during meals.
Adapt the Environment
As you learn to think like a detective about your child’s behaviour, your observations (or the FBA) are likely to show that behaviour occurs at specific times, with certain people or in particular environments. You and your team will need to tune in, learning to recognize the signs of increasing tension, anxiety or frustration that eventually lead to challenging behaviours. Often there is a ramping up, or escalation period, and learning to recognize that early and using many of the approaches here can help to calm a situation and prevent behavioural outbursts. Sometimes these signs may be very subtle—red ears, a tapping foot, heavier breathing, higher pitched speech—but it is essential that everyone on the team responds to the importance of tuning in and working towards de-escalation. Changing the environment can often reduce behavioral episodes. Expand situations, relationships, places and opportunities that are successful.
If possible, try to adjust or avoid situations that are triggers for challenging behaviour. Incorporate ways to reduce frustration and anxiety and increase understanding. Below are some things to consider when working to create a more successful environment: Organize and provide structure: Provide clear and consistent visual schedules, calendars, consistent routines, etc. so that the person knows what is coming next. Inform transitions and changes: Recognize that changes can be extremely unsettling, especially when they are unexpected. Refer to a schedule, use countdown timers, give warnings about upcoming changes, etc. we can use Visual Supports: Pictures, text, video modeling and other visuals are best for visual learners, but they are also critical because they provide information that stays.
The ATN Visual Supports Tool Kit provides a step-by-step, easy-to-understand introduction to visual supports. Provide a safe place and teach when to use it: A calming room or corner, and/or objects or activities that help to calm (e.g. bean bag) provide opportunities to regroup and can be helpful in teaching self-control. Remove or dampen distracting or disturbing stimuli: Replace flickering fluorescent lights, use headphones to help block noise, avoid high traffic times, etc.
Pair companions or staff appropriately for challenging activities or times: Some people are more calming than others in certain situations. If going to the store with dad works better than with mom, focus on that and celebrate successes. Consider structural changes to your home or yard: These changes might address some of the specifics of your situation to increase independence or reduce the risks when outbursts occur. Making Homes that Work includes a range of potential changes that can be made to reduce property damage, improve safety, and increase choice and independence.
Communicate to Others
Many families have found it helpful to communicate to those around them about their child’s special needs and some of the behavioral situations that might arise. Sometimes it is helpful to let others know what is going on so that they can also be observers and help provide helpful input about your child. Some families have found it helpful to talk to their neighbours, or to communicate with others in the community using stickers, cards, or other visuals. Parents can carry a note card standing such this one :
Positive and Proactive Care: reducing the need for restrictive interventions People with learning disabilities whose behaviour is challenging will have physical interventions used on them at some point in their lives. In the absence of a lawful reason, using force, or threatening to use force, could give rise to a criminal charge, as could locking someone in their room. The Mental Capacity Act defines the unlawfulness, and the appropriate penalties for actions of illtreatment or neglect. A physical intervention in relation to challenging behaviour is described by the British Institute for Learning Disabilities (Harris et al, 1996) as ‘A method of responding to the challenging behaviour of people with learning disability and/or autism which involves some degree of direct physical force which limits or restricts the movement or mobility of the person concerned.’
They define three types of physical intervention direct physical contact between a member of staff and a service user: for example holding a person’s arms and legs to stop them attacking someone the use of barriers such as locked doors to limit freedom of movement: for example placing door catches or bolts beyond the reach of service users materials or equipment that restricts or prevents movement: for example placing splints on a person’s arms to restrict movement.
The Department of Health/Department for Education and Skills guidance (2002) outlines the requirements when physical intervention are planned and these include agreement by the multidisciplinary team, including consultation with others as appropriate put in writing, together with the behavioural plan (they should never be the only plan for managing behaviour) be supervised by appropriately trained staff be recorded, so that the circumstances of any physical intervention and methods used can be monitored. This guidance also emphasises that the physical interventions should be used as infrequently as possible be in the best interests of the service user be part of a broader treatment strategy not cause injury maintain the person’s dignity.
And also, The Human Rights Act (HRA)15 imposes a duty on public authorities, (including NHS Trusts, Local Authorities, and police forces) and services exercising functions of a public nature not to act in a manner that is incompatible with the European Convention on Human Rights13 (ECHR) rights that have been made part of UK law by the HRA.