Intellectual disability means a Positive Behaviour
Management Strategies for
Family Members
significantly reduced ability to Challenging & Complex behaviours: the ABC approach
understand new or complex It can be very stressful dealing with behaviour issues, but the ABC model is
Health Management for
Associated Healthcare
Conditions + Links
Defining Intellectual Disability
information and to learn and
apply new skills (impaired
intelligence). This results in
a reduced ability to cope
independently (impaired social
functioning), and begins before
adulthood, with a lasting effect
on development.
Disability depends not only
on a child’s health conditions
or impairments but also and
crucially on the extent to which
environmental factors support
the child’s full participation and
inclusion in society.
The use of the term intellectual
Preparing for the antecedent
An inability to cope with chaos, unpredictability and lack of routine is common
after a brain injury. For example, if Chris finds the activity and noise of a
supermarket unpleasant, it can help to talk about expected reactions and ways
to cope before the event.
Snapshot Of Causes Of Id
In Australia
• Down syndrome – 12–15% of all
Australians with ID (Bittles &
Glasson, 2004)
Behaviour
• Autism spectrum disorder
What happens during the behaviour (what does it look like?)
(causing severe or profound
a handy way to understand what is happening, and respond instead of just Before you respond to an actual behaviour, the key is to understand the limitation) – 0.5% of Australians,
reacting. It involves looking at the: purpose of the behaviour and what it may be expressing about unmet needs. with 71% experiencing severe or
Although emotions can be running high, there are still strategies that can prove profound limitation (Australian
useful during the behaviour itself: Bureau of Statistics, 2014a)
• Antecedents (what happened before the behaviour?)
• Behaviour (what is the actual behaviour?)
• Consequences (what happens afterward?)
This is an effective technique for taking the emotions away from challenging
behaviours, analyzing these behaviours, then creating effective responses.
When creating a behaviour support plan, it will be important to work out which
strategies you will use. These strategies are not to be used occasionally, but
will need to be applied consistently by everyone who encounters the targeted
behaviours. While they may be difficult at first, your chosen techniques will
eventually become second nature.
Antecedents
What occurs before the behaviour (and may have triggered it)?
• Cerebral palsy (with ID) – 0.07–
• Stay calm and speak in an even tone
• Give simple directions and prompts about coping mechanisms
• Use non-threatening hand gestures
0.2% of Australians (Australian
Cerebral Palsy Register, 2013
• Fragile X (with ID) – <7,000
• Manage your personal safety and remember the strategies agreed on for
Australians (Brown, 2010)
dangerous incidents
• Recognize when it's time for disengagement/exit strategies for crisis
situations.
Defining Quality Of Life
• Ignoring the behaviour
The World Health Organisation
In some cases, behaviour occurs to get attention, so the best strategy may be defines Quality of Life as
to ignore it. As with many of these techniques, tactical ignoring is best linked “individuals” perception of their
position in life in the context of the
disability in the context of the The antecedents are simply all the relevant things that happened before the with positive reinforcement. For example, a child is ignored during a tantrum, WHO initiative “Better health, behaviour occurred. They can also be considered as triggers for the behaviour, but is rewarded with praise, a treat or favourite activity once the tantrum is culture and value systems in which
such as: over. they live and in relation to their
• things that other people did or said Consequences children who have been placed in • emotional state (e.g. depressed, tired, anxious etc.) What are the immediate and delayed reactions from everyone involved? institutions because of perceived • the environment (e.g. hot, noisy, cramped, smell, bright lights). The consequences, or our responses to a challenging behaviour, are very way by the person’s physical
important. For example, a pleasant consequence can simply reward the health, psychological state, level of
behaviour, while a negative consequence may discourage it. independence, social relationships,
better lives” includes children
with autism who have intellectual
impairments. It also encompasses
disabilities or family rejection
and who consequently acquire Managing these antecedents, or triggers, is a proactive way to avoid
developmental delays and behaviours occurring in the first place. Here are some useful strategies:
psychological problems.” (WHO) • Build and maintain good rapport
• Avoid or minimize known triggers
• Sometimes a distraction or redirection away from the trigger may be all that
is necessary
• Involve the brain-injured person in discussing triggers
• Work together on possible coping strategies in dealing with triggers
• Suggest and encourage these strategies when a trigger occurs.
Graduated exposure to the antecedent
This is useful when antecedents can't or shouldn't be avoided. With time and
patience, it can be a powerful technique. For example, Kirsten starts screaming
in supermarkets due to sensory overstimulation. Her mother says they will just
stand outside the supermarket for 30 seconds then go home. The next time,
they go in for 30 seconds then go home. This is gradually lengthened until
Kirsten has adapted to this difficult environment.
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goals, expectations, standards and
Pleasant consequence: "When I yell everyone gives me what I want".
concerns. It is a broad ranging
concept affected in a complex
personal beliefs and their
relationship to salient features of
Negative consequence: "When I yell everyone ignores me completely". their environment.” (World Health
When we use the ABC technique to analyse behaviour, we tend to stop Organization, 1997, p. 1).
reacting emotionally in ways that often make the situation worse. A consistent Source: www.nds.org.au/images/
response from everyone to challenging behaviour can have a very strong effect LearnNDevelop/Chronic-Illness-
over time. and-People-with-Intellectual-
“
Disability.PDF
”
Our vision is to passionately support individuals and their
families to lead fulfilled lives.
EBL QUARTERLY NEWSLETTER 15