Avril Quinn Joanne Lynch Behaviour Support Specialist CNM2 1

A better life:

The implementation and effect of Positive Behaviour Support in a

Community Residential Service within the Daughters of Charity Dublin Service

My Story- ‘Getting to know me!’

RoseRose

42 year old lady

Downs Syndrome

Moderate intellectual disability

Borderline Personality disorder

Autism

Challenging behaviour

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Ah! The circle of life.

How it all comes togetherin the end!

Birth

Infancy

ChildhoodAdolescence

Early Adulthood

Mid-Life

Old AgeDeath

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Issues for Rose

Lack of engagement in meaningful activities and relationships

No clear boundariesLack of structure and routineIssues in A.D.L.’s (bathing, changing

her clothes, getting up for work in the a.m., mealtimes, change in planned activities).

Lack of opportunities for choice, community participation and skills development

Severe challenging behaviour

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Issues for the staff supporting Rose

Agency/Unfamiliar staff’s lack of understanding and skills in supporting Rose and her complex needs

Lack of staff knowledge, training & skills

Lack of staff confidenceSplitting of the staff teamInconsistencies in staff approach in

delivering incentives for Rose to display appropriate behaviour

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Environmental Strategies:

Positive Programming

Direct Interventions

Reactive Strategy:

Staff training

Protocols

A risk benefit analysis

Team meetings

A visualstructured

daily planner

Rules Contract

Tension relief skills

Independence skills

Ability to predict& make choices

Coping skills

Relaxation training

Tolerance training

Antecedent control strategies e.g. non-breakable plates and cups

A DRO schedule

Weekly preparation in the form of social stories, weekly calendar and visuals for outings

Relaxation activities

De-escalation protocol

Post Incident Protocol

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My Moving Forward Plan

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“Moving to my new home”:

My Moving forward plan” consisted of a visual calendar for the two weeks prior to the move

Names of any new staff that will support me in my new house was in the plan

A picture of my suitcase was in it to help me start thinking of what I need to pack

My new rules contract for my behaviour in my new house

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“Moving to my new home”:

A plan of action for me and for the staff supporting me to move was completed outlining what we were all going to do each day to prepare and move to the new house.

This consisted of a series of structured and consistent routines that would be built on daily to reduce my anxiety levels

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How is my Life Better?How is my Life Better?

I make everyday choicesI make important decisions about

my lifePeople treat me with respectI take part in every day activitiesI am part of my local communityI am safe from bullying & abuseI get help to stay healthy

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My Future DreamsMy Future Dreams

I would love to have a job that I enjoy & I’m good at!!

Introduce new things to me but not all at the same time

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Dreams can come true

What does it take to What does it take to maintain maintain this this structure & support?structure & support?

Staff trainingAll staff working with Rose will

receive a specialised induction that is specific to Rose’s needs and characteristics. This will be ongoing to accommodate staff changes.

Organisational/managerial commitment

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What does it take to What does it take to maintain maintain this structure & this structure & support?support?

“Support services are not there to fix or cure people but to support them to live the life they have chosen”

Respect how Rose chooses to liveCommunicationConsistencyDedicated and matched team of staff

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The Future (at present)The Future (at present)

• I will need to live my life within this supportive structure provided by staff and others.

• I measure my quality of life by my capacity to obtain security and remove fear.

• That optimal goal is largely influenced by my ability to accept and trust in the support and structure created by staff and others.

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““See the Person,See the Person, See Me, See Me,

See My Potential”!!See My Potential”!!

The world is my oyster’! The world is my oyster’!