Complex Behaviour Support Services
Complex behaviours are also known as “challenging behaviour” or “behaviours of concern” which have been used to refer to the “difficult” or “problem” behaviours shown by children or adults with a learning or intellectual disability. Such behaviours include aggression (e.g., hitting, kicking, biting), destruction (e.g., ripping clothes, breaking windows, throwing objects), self-injury (e.g., head banging, self-biting, skin picking), outbursts and many other behaviours (e.g., running off, screaming, eating inedible objects, getting ‘stuck’ in repetitive movements, difficult sexual behaviours).
Challenging behaviour puts the safety of the person or others at risk and/or has a significant impact on the person’s or other people’s quality of life.
Why do these behaviours happen?
There is always a reason for challenging behaviour. In many cases, it’s a way for a person to control what is going on around them and to get their needs met. They also might be ill or in pain, or want to get something. It’s important to understand the reasons behind challenging behaviour for change to happen!
How can we stop these behaviours?
There is no quick fix although there is a lot that can be done to prevent or reduce challenging behaviour: - Work out if the person is in pain or bored - Is there a way of teaching the person to show you what they want in another way? - Develop their communication skills - Keep a record of the behaviour - When safe to do so, ignore it and distract the person - Ask your GP/social worker if the person can get a referral for a ‘‘functional assessment’’ to better understand the reasons behind their behaviour
Behaviour support services
Behaviour support is about creating individualised strategies for people with disability that are responsive to the person’s needs, in a way that reduces and eliminates the need for confining or restricting them. Behaviour support services focus on evidence-based strategies and person-centred supports that address the needs of the person with disability and the underlying causes of behaviours of concern, while safeguarding the dignity and quality of life of people with disability who require specialist behaviour support.
What is a restrictive practice?
The NDIS Act 2013 defines a restrictive practice as ‘any practice or intervention that has the effect of restricting the rights or freedom of movement of a person with disability’. There are five restrictive practices that are subject to regulation and oversight by the NDIS Commission:
- Chemical restraint – medications given to change behaviours.
- Mechanical restraint – splints, gloves or helmet to prevent self harm, restrictive clothing, straps to prevent movement.
- Physical restraint – holding someone down even to stop them hitting themselves.
- Environmental restraint – locking doors to prevent access, restricting access to; certain cupboards or rooms, dangerous items and personal effects such as their mobile phone.
- Seclusion – time out in a room they are unable to leave, a person sent to their room to calm down and told they cannot come out until they have calmed down.
- Also of note is that the use of surveillance technology may be interpreted as contributing to a restrictive practice in some circumstances.
The use of restrictive practices for people with disability can present serious human rights breaches. The decision to use a restrictive practice needs careful clinical and ethical consideration, taking into account a person’s human rights and the right to self-determination. Restrictive practices should be used within a positive behaviour support framework that includes proactive, person-centred and evidence-informed interventions. There are some circumstances when restrictive practices are necessary as a last resort to protect a person with disability and or others from harm. The NDIS Commission’s role is to provide registered NDIS providers and NDIS behaviour support practitioners with clear guidance to ensure appropriate safeguards are in place with the aim of reducing and eliminating the use of regulated restrictive practices where possible.
If a support includes a regulated restrictive practice or use is likely, or if the person is having a functional behaviour assessment or a behaviour support plan is being developed, the provider must be a registered NDIS provider.
Enable All is NDIS Registered and has stringent policies and systems in place to ensure that Behaviour Support is carried out in line with the requirements set by the NDIS Commission. We are registered to manage restrictive practices as an Implementing Provider. Management and our Support worker team understand the complexities and have considerable experience providing support for those who have challenging and complex behaviours.
Many of the Enable All support team have additional qualifications in Mental Health as well as years of experience providing support to those with complex and challenging behaviours.
How does Enable All engage with clients, carers and families?
To ensure we provide safe, effective, comprehensive and sustainable supports our team will:
- Meet with you (the client), family (informal supports) and required mental health professionals to ensure a client focussed service provision. Communication is the key to ensure supports are coordinated and funded according to the NDIS plan
- Compare the support needs of the client with the availability of our qualified and experienced employees and recruit new people when required
- Arrange a meeting with the client and all involved with their support to ensure everyone understands their role and responsibility
- Develop Care Plans and provide the supports as recommended and agreed Supports will be continuously monitored, documented and updated where and when required
TIP – If you are concerned that restrictive practices may be currently used with the support of a person with disability and the provider is not NDIS registered, you can get further information from the NDIS Quality and Safeguards Commission on 1800 035 544 or call us for initial advice.