Understanding Behaviour as Communication: A Guide for Carers

When someone is distressed, their behaviour often carries a message long before they can put feelings into words. In care settings, what looks like refusal, aggression, withdrawal, or repeated requests can be a person trying to communicate a need, protect themselves, or make sense of an overwhelming moment.

This guide explains how to understand behaviour as communication in practical, everyday terms. It is written for carers, support workers, foster carers, residential staff, and anyone supporting children and adults who may struggle to express needs safely. It also shows how this approach supports safer, more respectful care and reduces the likelihood of restrictive responses.

If you want structured skills training for staff teams, our positive behaviour support training hub explains how we teach evidence-informed approaches that focus on understanding need and improving quality of life.

What does “behaviour as communication” mean in care?

“Behaviour as communication” is the idea that actions, body language, and patterns of responding can be meaningful messages. This is especially important when someone has limited verbal communication, finds conversation hard under stress, or has learned that words do not keep them safe.

In care, it helps to assume that behaviour makes sense from the person’s perspective, even when it feels confusing or risky to others. Rather than asking “How do we stop this?”, the first question becomes “What is this telling us?”

People might be communicating:

• Physical discomfort (pain, illness, sensory overload, hunger, fatigue)
• Emotional distress (fear, shame, grief, frustration, loneliness)
• A need for predictability (uncertainty, sudden change, unclear expectations)
• A need for autonomy (feeling controlled, rushed, or not listened to)
• A need for connection (seeking attention, reassurance, or proximity)

Many safeguarding and behaviour support frameworks emphasise that identifying unmet needs early is safer than responding late in a crisis. For example, NICE guidance on behaviour that challenges in the context of learning disabilities highlights the importance of understanding triggers and function before using restrictive practices.

Why behaviour is purposeful: function, not intention

A common misunderstanding is to treat behaviour as a deliberate choice to “cause trouble”. In reality, behaviour is often purposeful because it works, even if the person is not consciously planning it.

Function is about what the behaviour achieves. Intention is about what someone meant to do. In high stress, many people are not choosing a strategy so much as reacting to a felt sense of threat or overwhelm.

Common behaviour functions include:

• Escape or avoidance (getting away from a demand, situation, or sensation)
• Access (getting something wanted: a person, object, activity, preferred routine)
• Attention or connection (getting proximity, reassurance, interaction)
• Sensory regulation (changing internal sensation: calming, stimulation, pain relief)

When teams focus on function, they can build safer alternatives that meet the same need without harm. This is one of the foundations of PBS and functional assessment.

The ABC model: a simple way to spot patterns

The ABC model stands for Antecedent, Behaviour, and Consequence. It is a straightforward tool that helps carers and staff teams step back and understand patterns over time.

A: Antecedent (what happened before)

Antecedents are events or conditions that increase the likelihood of the behaviour. They can happen minutes before, or they can build across a whole day.

Examples include:

• Being asked to stop a preferred activity
• Unexpected change to routine
• Noisy or crowded spaces
• Being touched without warning
• Feeling judged, corrected, or “told off” in front of others
• Physical factors such as pain, constipation, or lack of sleep

B: Behaviour (what you saw and heard)

This is the observable action. Keep it specific and factual. Instead of “was aggressive”, note what happened: “threw a cup”, “pushed a chair”, “swore”, “hit own head with hand”, “ran from the room”.

C: Consequence (what happened after)

Consequences are what followed the behaviour, including how staff responded and what changed in the environment. This matters because consequences can unintentionally reinforce behaviour if they meet the person’s need.

Examples include:

• Demand removed (escape achieved)
• Staff member sits close and talks for a long time (connection achieved)
• Person moved to a quiet room (sensory relief achieved)
• Peers leave the area (space achieved)

Using ABC charts for a short period can reveal patterns that are not obvious in the moment. If you need help turning observations into a team plan, our positive behaviour support training includes practical tools to move from description to prevention strategies.

Trauma and the nervous system: why stress changes behaviour

For some people, especially children in care or adults with histories of trauma, the nervous system may stay on high alert. Under stress, the body can move quickly into survival responses: fight, flight, freeze, or shutdown.

This means behaviour can look “out of proportion” to the situation because the person is not responding only to what is happening now. Their body may be responding as if danger is repeating.

Trauma-informed practice encourages staff to ask:

• “What happened to you?” rather than “What is wrong with you?”
• “What does safety look like for you?”
• “What helps you feel in control without anyone being harmed?”

In our training, we separate the practical skills of prevention from the values that sit underneath them. Organisations using our programmes have documented up to an 80% reduction in incidents. Our training is certified against the Restraint Reduction Network Training Standards. Manchester Metropolitan University evaluated the RRN Training Standards as a national framework, not our programme directly. We also emphasise that effective support depends on everyday relational safety, predictability, and consistent boundaries.

If your setting is building staff confidence around trauma-aware responses, our trauma informed practice training hub explains the focus areas we cover.

Practical examples: what behaviour might be communicating

Below are examples you can use in team discussions. The goal is not to guess perfectly, but to generate safe hypotheses you can test by changing the environment and support.

Example 1: Refusing personal care

• Possible message: “I feel exposed or unsafe” or “I need more control and choice”.
• Support ideas: offer choices (timing, staff member, order of steps), explain each step, ask permission before touch, use privacy and warmth, reduce rushing.

Example 2: Shouting when asked to transition

• Possible message: “Change feels unpredictable” or “I am not ready”.
• Support ideas: visual countdown, clear first-then language, transitional objects, short warning before changes, consistent routines.

Example 3: Hitting out during a boundary setting

• Possible message: “I feel trapped” or “I am overwhelmed and I need space”.
• Support ideas: reduce audience, offer space, lower voice, keep language brief, avoid cornering, plan de-escalation early.

Many organisations combine a PBS approach with structured de-escalation skills so staff can respond earlier and more consistently. Our de-escalation training hub outlines the communication and prevention strategies we teach across sectors.

How to respond when behaviour is communicating a need

When emotions rise, staff often feel pressure to act quickly. A communication-based approach still prioritises safety, but it focuses on reducing threat, meeting need, and preventing repetition.

1) Regulate yourself first

Your tone, distance, and pace communicate safety or danger. Slow down. Keep your voice calm. Reduce extra language. If you feel flooded, swap with a colleague where possible.

2) Offer safety and predictability

Use short, respectful phrases that show you have noticed distress and you are there to help:

• “I can see this is hard.”
• “You are safe. I am here.”
• “Let’s take a moment.”

3) Give choices that do not overwhelm

Choice supports autonomy, but too many options can increase stress. Offer two clear choices, both acceptable to you.

• “Would you like to sit here or by the door?”
• “Do you want water or a quiet minute first?”

4) Look for the smallest unmet need

Ask yourself: what is the simplest need that could be driving this? Pain? Hunger? Confusion? Shame after a mistake? Sensory overload? A recent upsetting call?

If you can meet a basic need quickly, do it. If you cannot, acknowledge it and offer a plan: “We cannot do that right now, but we can do this instead.”

5) Debrief and adjust the plan

After the incident, capture what you noticed and what helped. If you are seeing repeated incidents, it may be time for a more formal functional assessment and a proactive plan.

CTA: If you want help building consistent plans across a staff team, contact us to discuss on-site training that fits your setting and risk profile.

How understanding behaviour as communication can reduce restrictive responses

When staff can spot early signs and respond to underlying need, the intensity of incidents often reduces over time. This matters because restrictive interventions carry physical and psychological risks, and they can damage trust if used frequently.

Communication-based support shifts the focus to prevention:

• Better early recognition of distress cues
• Clearer routines and fewer surprises
• More consistent boundaries and responses across staff
• Environmental changes that reduce sensory overload
• Teaching alternative communication strategies

In high-risk environments, there may still be occasions when physical safety is at risk. However, teams that invest in prevention and de-escalation often see fewer crises that reach that point.

CTA: If your service is reviewing its approach to restrictive practices, explore our restraint reduction training hub for practical strategies that support safer care.

Team tools: quick steps you can use this week

If you want to put this approach into practice quickly, here are small actions that improve consistency across a team.

• Start every handover with “what is the person communicating?” Keep it practical and specific.
• Use a shared ABC template for two weeks on repeat incidents, then review patterns as a team.
• Agree early intervention scripts so staff use similar language in similar moments.
• Identify top three triggers and top three effective responses for each person supported.
• Check pain and health basics routinely, not only after an incident.

CTA: If you would like a training day that gives staff shared language and practical tools, speak to us about a programme aligned to PBS and de-escalation.

FAQ: Behaviour as communication in care

What does behaviour as communication mean in care?

It means viewing behaviour as a meaningful response that can express need, distress, or attempts to stay safe, particularly when someone struggles to communicate clearly in the moment.

How do you respond to behaviour that is communicating a need?

Start with safety and calm, then look for unmet needs such as pain, fear, overload, or lack of control. Offer clear choices, reduce demands where appropriate, and record patterns so the team can adjust support consistently.

Why do children in care show behaviour that challenges?

Many children in care have experienced loss, instability, or trauma. Behaviour that challenges can be linked to stress responses, difficulties trusting adults, fear of rejection, or unmet attachment needs. A trauma-informed, consistent approach can help rebuild safety.

What is functional behaviour assessment and why does it matter?

Functional behaviour assessment is a structured way to identify what triggers behaviour and what the person gains or avoids. It matters because it helps teams create proactive strategies and teach safer alternatives rather than relying on reactive responses.

How can understanding behaviour as communication reduce restraint?

It supports earlier intervention, clearer prevention plans, and better consistency across staff. When needs are recognised and met sooner, incidents are less likely to escalate to a point where restrictive responses are considered.

References and further reading

• NICE guideline NG11: Behaviour that challenges and learning disabilities (2015), available at https://www.nice.org.uk/guidance/ng11
• British Psychological Society: “Understanding behaviour in the context of developmental trauma” (overview resources), see https://www.bps.org.uk