Here at Proactive Approaches, we are passionate about ‘Evidence-Based Practice’…
The short article below gives a fascinating look at 4 pieces of research and considers how you can significantly lower your instances of challenging behaviour by making ONE important change to your current practice.
The Evidence:
The following research shows that a study of 138 cases where STAFF-PRODUCED behaviour support plans and interventions were used resulted in a reduction of challenging behaviour by a staggering 77% (McClean et al 2005) and a further study involving a sample of 19 individuals (Grey & Mclean 2006) whereby STAFF-PRODUCED support plans (FBAs and IBSPs) were produced, with staggering results of challenging behaviour decreasing by 89%!
Reviews demonstrate how ‘behavioural interventions based upon the results of functional assessments are effective in reducing challenging behaviour’. (Carr et al. 1999; Grey & Hastings 2005: McClean et al 2005). Additionally, an insightful study (Snell et al 2005) examined the extent to which functional behaviour assessments occur in practice. It revealed how over a 5 year period involving 111 case studies, only 2/3 of studies reported the use of antecedent procedures and only ½ reported teaching functionally equivalent skills as an intervention.
Emerson (2011) states that “…PBS is so fundamental in dealing with challenging behaviour that it is no longer the task of practitioners to demonstrate its efficacy, the task is now one of effective dissemination.
The Solution to Reducing Challenging Behaviour by 89%
This highly effective solution is to implement STAFF-DEVELOPED (not expert-developed) behaviour support plans, drawn from Functional Behaviour Assessments (STAFF-CONDUCTED) paving the way for multi-element interventions (STAFF-EXECUTED). This approach is a key element of PBS.
Furthermore, a review of outcomes associated with PBS conducted by (Carr et al 1999) revealed that PBS is effective in reducing 50% to 67% of all cases of challenging behaviour, and incredibly, these success rates almost DOUBLE (suggesting up to approximately 98% success rates) when interventions are based on a prior FBA (Functional Behaviour Assessment).
Where You Could Be Going Wrong & Why You May Be Experiencing Higher Levels of Challenging Behaviour Than Is Necessary
- Many services use experts (often external), such as psychologists to produce and oversee behaviour support plans and intervention strategies. The external expert attempts to pass strategic information directly to your staff. BUT….the expert approach is proven to be less effective in reducing challenging behaviours than staff carrying out functional behaviour assessments and IBSPs themselves (as evidenced in (McClean et al 2005)
- Staff NOT seeing the value of the expert intervention (We have experienced this again and again, over the last 10 years of working with hundreds of organisations). The staff-conducted FBA & IBSP approach avoids this problem entirely.
- Staff feel as though they are EXCLUDED by the expert model and that their input is either not required or not valued. Again, by staff producing the support plans and implementing interventions, they are now integral to the challenging behaviour reduction strategy.
- This lack of value and feeling of staff exclusion often results in instructed processes being completed incorrectly or not at all (an example of this would be ABC charting where staff are asked to write down all the antecedents, behaviours and consequences surrounding an incident. We have found that staff often state that the reason for not completing ABC recording forms is lack of time, we have experienced a great many cases where the actual reason was that the staff did not see the value. In contrast, staff-conducted FBAs and IBSPs will focus on ensuring that all processes are practical and implementable and have the staff at the centre of the process, thus ensuring full engagement.
The above points are based on a service HAVING THE FUNDING to utilise external experts. We realise that many services are not able to offer their service users the luxury of external experts. In this case, you will be delighted by the results of these studies which prove that the external expert model is far less effective!
So How Do You Start Reducing Challenging Behaviour by 89%?
Utilise an ‘In House’ (NOT an external expert) model of FBA production. Ensure your team is trained in how to conduct an FBA that includes the following:-
- How to Plan and Prepare for Conducting Your FBA
- Define problem behaviours in detail
- Gather information via Indirect and Direct Assessment (ensure you use more than one type of ABC recording!)
- Triangulate your data
- Summarise the results of the FBA
- Interpret the information from the Assessments & Formulate Hypotheses
- Whether you need to & how to go about Testing your hypotheses
- Implementing your carefully construed interventions
- Ongoing Data Review
