communication assessment for people who engage in behaviours of concern (boc) module 3 : behaviour...

Communication Assessment for People who engage in

Behaviours Of Concern (BOC)

Module 3 : Behaviour Support Plans

Hilary Johnson, Nick Hagiliassis, Barbara Solarsh,

Teresa Iacono, Jo Watson, Teena Caithness

Office of the Senior Practitioner, Disability Services, VictoriaOffice of the Senior Practitioner, Disability Services, Victoria

“The Black Balloon” (2009)

• What is Charlie doing at the checkout?

• Did Thomas know there was going to be a problem?

• What message is Charlie giving his father and brother?

• What is the A-B-C?

• How could you change the A?

We would like to thank Tristram Miall, Producer,

and Elissa Down, Director for permission to include

this scene from “The Black Balloon” (2009)

 1. Something to Communicate about

2. The desire to communicate

3. The need to communicate

4. Opportunities to communicate

5. A means of communication

6. Someone to communicate with

Shea and Mount (1982)

What we need to give a message

 1. ↓ Desire to communicate

2. ↓ Something to Communicate about

3. ↓ Need to communicate

4. Opportunities to communicate

5. A means of communication

6. Someone to communicate with

Autism Spectrum Disorder

Challenging Behaviour - known as Behaviours of Concern (BOC)

Culturally abnormal behaviours of such an intensity, frequency or duration that the physical safety of the person or others is likely to be placed in serious jeopardy, or behaviour which is likely to seriously limit the use of, or result in the person being denied access to ordinary community facilities

Emerson (2001)

Behaviours of Concern (BOC)

Any behaviour that:

• is a barrier to the person participating in, and contributing to their community

• undermines, directly or indirectly, a person’s rights, dignity or quality of life

• poses a risk to the health and safety of a person and those with whom they live and work

McVilly (2002)

Small Group Work

Select a behaviour of concern and describe it

Write your answers on butcher’s paper

Defining a Behaviour of Concern (BOC)

O’Neil, Horner, Albin, Sprague, Storey & Newton (1997)

behaviour What is the behaviour?

topography How is it performed?

frequency How often it occurs per day, week or month?

duration How long it lasts when it occurs

intensity How damaging or destructive

Case Study: Jessica

• Small group activity

• Read the sheet

• Answer the questions on the back of the sheet

Formulation Jessica20 years

Moderate/severeID

No expressive language

Difficulties with receptive language

Anxious when there is noise ↓ order and routine

Refuses to get out ofcar at Day Program

Grabs visitor’s bags andwalks to front door

Not looking atphoto of shoes

Becomes anxious

Behaviour is a method of communicating a message.

People do not behave randomly.

All behaviour functional for the individual.

Understanding the person

• Watch and record - make observations

• Review file notes

• Talk to people

• Read books– Mc Villy (2002)

• Assessments– PBS training A-B-C charts, STAR charts– O’Neill & Horner (1990)– LaVigna & Willis (2003)

The multi-element modelLaVigna and Willis (1995) BSP based on five quality of life (QOL) values

1. Presence and participation in the community;

2. Fulfilling valued roles and gaining social respect;

3. Maintaining satisfying personal relationships with friends and family;

4. Expressing personal preferences and making choices; and

5. Gaining skills and competencies

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SUPPORT PLAN

MEDIATION

SPEED & DEGREE OF EFFECTS

SIDE EFFECTS SOCIALVALIDITY

CLINICAL/EDUCATIONAL

VALIDITYGENERALIZATION OF EFFECTS

DURABILITY OF EFFECTS

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What is the purpose of a Behaviour Support Plan (BSP)?

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Proactive Immediate Response Strategies

Behaviour Intervention Support Plan

• PROACTIVE STRATEGIES

Change the environment

Teach Skills

Short Term Change Strategies

• IMMEDIATE RESPONSE STRATEGY

Situational Management

Behaviour Support Plan (BSP)

Proactive strategiesImmediate response strategies

Change the environment

•Personal factors

•Offer choices

•Positive interactions with person

•Predictability

Teaching skills

•General skills

•Replacement skills

•Communication

•Independence

•Coping

Short-term change strategies for rapid change to behaviour

•Changing setting events, triggers

•Incentive programs

•Situational control

Follow the BSP

Don’t teach new skills

RIDs

Case Study: AAC strategies in BISP

CHANGE THE ENVIRONMENT

Daily schedules

Weekly schedules

Monthly schedules

Who’s Here Today Chart

Strategies for communicating “change”

Key Word Signing

A Book About Me including PCD

TEACH SKILLS

Choice Making Program

Key Word Sign

Wait Help Break Programs

Social Stories *

Key Word Signing

Emotion Based Social Skills

SHORT TERM CHANGE

Augmentation of House Rules

Rules and Expectations

Visual augmentation of Incentives Program

IMMEDIATE RESPONSE STRATEGIES

Follow the BSP

All of the above

Use of AAC

“Communication and Challenging

Behaviour” (2007)

• Rhys

• Laura

• Sean

• Isobel

We sometimes think that these children are being

naughty, when actually it’s their only means of

communicating… until we find a different way they’ve got no

choice really…