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Spivakovsky et al. (2023) questioned the effectiveness of Positive Behaviour Support as an intervention for reducing challenging behaviour and the use of restrictive practices as a behaviour management approach. This article responds to their critique. We argue that the literature supports the effectiveness of Positive Behaviour Support when it is properly implemented. As employees of a Positive Behaviour Support service provider, our position is also supported by our experience of the use of Positive Behaviour Support and its beneficial outcomes. To ensure a high level of fidelity in the implementation of Positive Behaviour Support, it needs to align with the elements that underpin Positive Behaviour Support (i.e., elements of applied behaviour analysis, person-centred practice, human rights, system change) rather than simply implementing Positive Behaviour Support to meet existing legislative requirements. In conclusion, when Positive Behaviour Support service provision and implementation in Australia is correctly aligned with the core components of Positive Behaviour Support, positive outcomes for people with disabilities, including a reduction in the use of restrictive practices, can be achieved. [ABSTRACT FROM AUTHOR]

Background: Research shows that up to 43% of disability support workers (DSWs) report poor psychosocial work outcomes (e.g., stress, job burnout, low job satisfaction). This study examined whether the job demand-control-(support) model offers a valid explanation of DSW burnout and work engagement. Method: 325 DSWs completed online measures of burnout, work engagement, workload, job control, and supervisor or colleague support. Results: Significant three-way interactions between workload, control and colleague support were found for emotional exhaustion and personal accomplishment (burnout), and vigour (work engagement). High workload, low job control and low colleague support was related to higher burnout and lower work engagement, and high colleague support or job control reduced the impact of workload on these outcomes. Conclusions: Given the promising findings in relation to the job demand-control-(support) model, organisations looking to enhance DSW wellbeing in the workplace should address issues around job control, workload and support in combination as opposed to separately.

Diagnostic genetic testing and non‐invasive prenatal testing (NIPT) for conditions associated with disability are becoming increasingly available to consumers. This genetic information can be used in the disability setting to inform factors such as prognosis, management, and reproductive decision‐making. Genetic counselors (GCs) play an important role in the provision of genetic testing and NIPT, and their attitudes toward disability can influence how genetic information is communicated and shape patients' responses. This study aimed to evaluate and describe Australasian GCs' experience with and attitudes toward disabilities to identify potential biases and training needs. A cross‐sectional survey was distributed to 400 GCs registered with the Human Genetics Society of Australasia. Of the 106 respondents (participation rate: 26%), a significantly greater proportion were more comfortable interacting with individuals with physical disability as compared to intellectual disability (p < 0.001). GCs with personal experiences with disabilities reported significantly greater comfort interacting with people with intellectual disability than those without experience (p = 0.012). Qualitative analysis revealed discomfort was less reflective of bias than inexperience and apprehension about communicating disrespectfully. GCs believed people with disabilities experience discrimination and that having a disability could make a person stronger, wiser, and more motivated. Most GCs viewed prenatal testing for disabilities positively as it allowed for decisions regarding continuing the pregnancy and/or provided opportunity to prepare. Challenges identified for prenatal counseling included negative societal attitudes and the low visibility of disability. GCs felt that 'personal beliefs' was the primary factor influencing the decision to terminate a pregnancy affected by disability. These findings highlight important education and training needs for GCs to improve preparedness and comfort when communicating with people with a disability. [ABSTRACT FROM AUTHOR]

Background: This study assessed the effectiveness of a cross‐departmental case review panel—the Multicap Complex Behaviour Forum (CBF)—in reducing challenging behaviour exhibited by people with intellectual disabilities. Methods: Thirty participants (15 CBF participants and 15 matched‐control participants) took part in the study. Behavioural data was collected for each CBF participant (and their matched control) for the three‐month period before entering the CBF, during their time in the CBF, and the 3 months after exiting the CBF. Results: There was a significant interaction of group and time observed, with the CBF participants showing more change in behavioural incidents across time. Associated with this change was a noticeable reduction in staff injury costs related to the challenging behaviour of the CBF participants. Conclusions: This study demonstrates that positive behavioural and organisational outcomes are enhanced by fostering collaboration across multiple organisational systems when it comes to supporting people who exhibit challenging behaviours. [ABSTRACT FROM AUTHOR]

Background: Quality behaviour support plans (BSPs) are critical for achieving positive outcomes for people with intellectual disability who exhibit challenging behaviour. This study measured the quality of BSPs for technical accuracy and appropriate readability. Method: Ten disability support organisations provided 139 BSPs for evaluation using the Behavior Support Plan Quality Evaluation (BSP-QE II; to assess technical accuracy) and Flesch readability scores (to assess readability). Results: The mean BSP-QE II score (M = 6.53) classified the BSPs analysed as "weak." Of interest, the elements of the BSPs that were subject to specific statutory regulation displayed greater quality. The readability scores indicated that plans were written using language that may not be understandable to typical direct support staff. Conclusions: Poor quality BSPs, or those too complex to be readily understood, may not be implemented fully. Statutory regulation positively influences BSP quality; however, a more detailed focus on training and quality assurance is indicated.

Previous research has highlighted that factors such as large workload, role ambiguity, lack of support from colleagues, and challenging behaviour are associated with higher levels of burnout within the disability support worker (DSW) population. The aim of this research was to investigate which factors contribute the most to the prediction of the three facets of burnout--feeling exhausted and overextended by one's work (emotional exhaustion), detached and callous responses towards work (depersonalisation) and a lack of achievement and productivity within one's role (personal accomplishment). The factors chosen for analysis within this research were analysed within four categories linked to theories of burnout development ("individual," "interpersonal," "organisational" and "demographic"). A sample of 108 DSWs completed a questionnaire booklet that contained standardised measures of burnout and job stressors related to disability work. Results highlighted the importance of predictors such as challenging behaviour (interpersonal), workload (individual), supervisor support (individual), work-home conflict (individual), job feedback (individual), role ambiguity (organisational), low job status (organisational), role conflict (organisational), gender (demographic) and work hours (demographic) when predicting one or more of the facets of burnout. In conclusion, disability services and organisations may benefit from focusing on remodelling their staff-related organisational practices in order to prevent the development of burnout in their DSWs (e.g., increase supervision and support practices). (Contains 7 tables.)

Background: Physical activity (PA) programs for adults with intellectual disability (ID) have positive impacts, at least in the short term. No research has been reported on the effect of long-term engagement in PA programs for adults with ID. This paper explores the physical and psychosocial benefits gained by two individuals with mild ID who participated in a long-term PA program. Method: Accelerometery was used to collect PA data during the program and for 7-day periods outside of the program. To explore the psychosocial outcomes gained from participating in the program, participants and their caregivers were interviewed about their participation experiences. Results: Across time, a decrease in the amount of light activity engaged in during sessions was found, with participants gradually increasing their moderate to vigorous activity. Psychosocial benefits, including meeting new people and gaining social acknowledgement were reported by participants and caregivers. Conclusions: Long-term, sustainable, low cost PA programs (such as the one under investigation) can minimise barriers to physical activity for people with ID. (Contains 2 notes and 5 tables.)

Within the healthcare service sector across many Western countries, clinical governance frameworks have been adopted to ensure consistent and effective service provision. There is merit in adopting such frameworks within disability service organizations as a mechanism to enhance service quality. This study explored whether disability service organizations exhibit organizational climates conducive to supporting clinical governance from the perspective of allied health professionals (AHPs). A total of 88 AHPs completed the Clinical Governance Climate Questionnaire via an online questionnaire. AHPs reported that planned quality improvement initiatives tend to be crisis‐driven within their organizations, with immediate and pressing work pressures taking precedence. AHPs also report that clinical risk data are routinely collected within their organizations, with a lack of consensus around how this information is used to improve practice. In addition, dedicated time for professional development was not available to many of the AHPs, and many reported the presence of hierarchies. Correlation analyses implied that planned quality improvement initiatives appear to be the lynchpin to ensuring quality service provision within disability service organizations. Further research into the organizational climate issues identified in this study is needed—from the perspective of all staff working within disability service organizations—in an effort to inform the development of strategies to effectively implement clinical governance in disability services. [ABSTRACT FROM AUTHOR]

Copyright of American Journal on Intellectual & Developmental Disabilities is the property of American Association on Intellectual & Developmental Disabilities and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A family having to relinquish the care of their family member with a disability is a situation that is often dealt with by disability services. In precipitous situations, the relinquished individual usually is placed in respite care until suitable permanent accommodation is organized or he or she is able to return to the family home. To examine to what extent the literature has discussed the issues associated with the need for urgent respite and how this need may link to relinquishment of care, the authors undertook an extensive review of relinquishment of care. The literature indicated that many families and carers feel that their respite needs are not being met and that certain individual and family characteristics are associated with need for urgent respite (such as severe disability, poor support, and carer distress). The dearth of studies on relinquishment of care makes it difficult to draw clear, validated statements from the literature about this issue. However, extrapolation from the literature on respite and relinquishment involving other client groups' points toward increased requests for respite being an early warning sign for relinquishment. The literature also notes that challenging behaviors, poor coping and lack of support, dire financial concerns, and carer distress are factors that often lead to relinquishment. The literature also notes that interventions such as active support and cognitive behavioral therapy can support families who are considering relinquishment or have relinquished care. The authors conclude that trends reported with regard to respite inadequacies reinforce the belief that for families and carers to receive maximal benefit from using respite, their respite allocation must be regular and planned in accordance to their needs. Overall, empirically based information regarding relinquishment of care involving people with intellectual disabilities is limited; hence, increased research on this issue is needed to expand the current knowledge base and the identification of strategies to more effectively support families. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusions\nIMPLICATIONS FOR REHABILITATIONThis paper introduces a practice framework for individualised positive behaviour support (PBS). The framework incorporates existing function-based PBS principles and integrates contemporary research and Australian legislation to frame practice elements through a human rights lens. It is designed to support people with disability of varied aetiologies across the lifespan in various settings (e.g. home, schools, and aged care).Existing research and literature have been reviewed, including key theories and current formulations to inform a new practice framework that reflects recommendations for applications in community settings.The PBS Pathway (PBS-P) framework promotes culturally sensitive and socially valid strategies for empowering the person and their supporters via a clear practice framework. It emphasises evidence-based practices while acknowledging the need for flexibility to meet individual needs.The PBS-P framework offers a pragmatic approach and focused lens for critical thinking and reflective applications within PBS. It promotes a universal approach across the lifespan and service settings, contributing to a shared understanding of PBS as a rights-based practice. The framework’s alignment with current legislation supports adoption within existing systems; however, successful implementation requires skilled practitioners, adequate funding, and policies to support knowledge translation.The positive behaviour support pathway framework guides individualised practices for people across the lifespan and service settings, with emphasis on data-based decision making to inform socially and culturally valid intervention planning.The framework aligns with current legislation and addresses current concerns relating to poor behaviour support practices and urgent recommendations for practices that protect and promote human rights.The positive behaviour support pathway framework guides individualised practices for people across the lifespan and service settings, with emphasis on data-based decision making to inform socially and culturally valid intervention planning.The framework aligns with current legislation and addresses current concerns relating to poor behaviour support practices and urgent recommendations for practices that protect and promote human rights. [ABSTRACT FROM AUTHOR]