Learning Disabilities - Adult Services Workforce Development
Positive Behaviour Support: Origins and Key Features
During the mid – late 1980’s services for people with learning disabilities were
undergoing major changes in philosophy and direction. A key part of this change was
the closure of the large long – stay hospitals. These hospitals were beginning to be
replaced by community based houses. This led to some criticisms of the use of
aversive interventions when supporting people with learning disabilities and who may
present challenging behaviour. It went against the aims of the core values of
community presence, community participation, dignity, choice and respect which the
services were now aiming for. As Allen ( 2006) said, ‘the use of aversion became
increasingly and appropriately criticised as in conflict with the values.’ It was against
this backdrop that positive behaviour support came to the forefront.
Gary La-Vigna et al published several works around Positive behaviour Support from
the mid 1980’s onwards. But it was, perhaps, the influencing paper by Horner et al
(1990) which set the standard of positive behaviour support. The paper defined
positive behaviour support as, ‘an understanding of why, when and how behaviours
happen and what purpose they serve for the individual, (Horner et al, 1990).’ You
can eliminate a behaviour, but if you fail to find out the reason why that behaviour is
occurring, the behaviour may manifest itself as another behaviour. That behaviour
could be worse than the one you were originally trying to eliminate. By using a
functional analysis to determine the purpose of the behaviour, a trigger can be
altered to reduce the likelihood of the behaviour occurring. The paper also points
out that a behaviour may be used to achieve more than one outcome, or multiple
behaviours may be used to achieve one outcome for the individual. This highlights
the need to find out what purpose the behaviour is serving for the person.
The paper also highlighted the need to teach new skills to the individual to
communicate an unmet need as an alternative to the behaviour challenge. As
Donnellan et al, (1984, p11) said, ‘a dangerous behaviour may be the individual’s best
way of expressing something extremely important to them.’ As Horner et al, (1990)
advocated, ‘skills teaching is a central intervention, as a lack of critical skills is often a
key contributing factor in the development of behavioural challenges.’ Using skills
teaching to express the persons need can enhance the person’s quality of life. This
enhancement can be used as an intervention and an outcome, as Horner et al, (1990)
suggests, ‘it can achieve reductions in behaviour as a side effect.’
Another key feature of positive behaviour support is that it needs to be effective for
that person and achieve the same outcomes that the behaviour served. ‘The
intervention needs to be maintained over a long period for it to be successful, as the
challenging behaviour is often of a long-term nature, (Horner et al, 1990).’
Successful and Correct?
Positive behaviour support represents an effective way of supporting people who
may challenge the services who provide them support. It’s person centred approach,
proactive interventions and the teaching of alternative skills can achieve long term
effects. Historically people who present challenging behaviour have been at risk from
neglect and abuse, whilst also having limited opportunities in life. It gives support staff
effective tools to support people who may challenge, within the current legislation.
Where previously, the use of aversive methods and punishment may have caused
staff to inadvertently to operate outside of legislation. It recognises that alongside
proactive strategies there should be reactive strategies included to maintain the
safety of all those concerned. ‘As change strategies may not completely eliminate risk
behaviours from behavioural repertoires, (LaVigna et al, 1989; Horner et al, 1990;
Carr et al, 1990).’
Positive behaviour support’s goal is not only to promote behavioural change in
individuals, it is also to achieve enhanced community presence, choice, respect,
community participation and dignity, so is a values led approach. ‘It reduces or
eliminates the use of punishment approaches, (Horner et al, 1990).’ It therefore
represents the most ethically sound intervention option around at the present time.
References
Albin, R.W., Lucyshyn., J.M, Horner., R.H & Flannery, B.K. (1996). Contextual fit for
behavioural support plans. Koegel, L.K, Koegel, R.L & Dunlap, G (Eds), Positive
Behaviour Support: including people with difficult behaviour in the community, (pp. 81-87).
Baltimore, Paul H. Brookes.
Bailey, J.S., Kern, L., Koegal., R.L & Dunlap, G. (1990). Towards a Technology of
nonaversive Behavioural Support. The association for persons with severe handicaps, vol,
15, 125-132.
Donnellan, A., LaVigna, G., Negri-Shoultz, N & Fassbender, L. (1988). Progress without
Punishment. New York: Teachers College Press.
Horner, RH. Dunlap, G & Koegel, R. (1990). Positive Behaviour Support: Definition,
Current Status and future Direction. Learning Disability Review 11, 4-9.
Author - Adrian Clyne
Date - 21/09/10
NOT TO BE REPRODUCED WITHOUT THE AUTHOR’S PERMISSION