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Positive behavioral support (PBS) employs applied behavioral analysis to enhance the quality of life of people who behave in challenging ways. PBS builds on the straightforward and intuitively appealing notion that if people know how to control their environments, they will have less need to behave in challenging ways. Accordingly, PBS focuses on the perspective of those who have behavioral issues, and assesses success via reduction in incidences of challenging behaviors. The qualitative research presented in this report approaches PBS from a different viewpoint and, using thematic analysis, considers the impact of PBS training on the lived experience of staff who deliver services. Thirteen support staff who work for a company supplying social care and supported living services for people with learning disabilities and complex needs in the northwest of England took part. Analysis of interviews identified five major themes. These were: (1) training: enjoyable and useful; (2) widening of perspective: different ways of thinking; (3) increased competence: better outcomes; (4) spill over into private lives: increased tolerance in relationships; and (5) reflecting on practice and moving to a holistic view: “I am aware that people…are not just being naughty.” These themes evidenced personal growth on the part of service providers receiving training. Explicitly, they demonstrated that greater awareness of PBS equipped recipients with an appropriate set of values, and the technical knowledge required to realize them.

Thirty-six mothers of children aged between 5 and 8 years with intellectual disabilities completed five self-report questionnaires measuring variables related to behavioural and emotional difficulties, levels of care demand, family supports, coping and positive perceptions.The relationships among these variables were investigated using a working model proposed by Hastings and Taunt (2002). Child behavioural and emotional problems in the non-clinical range predicted low levels of care demand. Formal social support was an effective form of support for mothers; helpfulness of formal social support predicted mobilizing the family to acquire and accept help in the community; and mobilizing the family predicted levels of strength and family closeness.The majority of respondents rated agreement with statements that their child was: a source of happiness or fulfilment; a source of strength and family closeness; and a source of personal growth and maturity.The theoretical and clinical implications of these results are discussed.

Interventions for children with autism based upon Applied Behaviour Analysis (ABA) has been repeatedly shown to be related both to educational gains and to reductions in challenging behaviours. However, to date, comprehensive training in ABA for teachers and others have been limited. Over 7 months, 11 teachers undertook 90 hours of classroom instruction and supervision in ABA. Each teacher conducted a comprehensive functional assessment and designed a behaviour support plan targeting one behaviour for one child with an autistic disorder. Target behaviours included aggression, non-compliance and specific educational skills. Teachers recorded observational data for the target behaviour for both baseline and intervention sessions. Support plans produced an average 80 percent change in frequency of occurrence of target behaviours. Questionnaires completed by parents and teachers at the end of the course indicated a beneficial effect for the children and the educational environment. The potential benefits of teacher implemented behavioural intervention are discussed.

Staff attributions for challenging behaviour are purported to relate to staff responses to such behaviour. To elucidate this relationship, much recent work has relied on eliciting staff attributions to written descriptions of a client engaging in challenging behaviour. However, current attribution theory suggests that eliciting attributions in relation to written descriptions is likely to be qualitatively different from attributions to known clients with challenging behaviour. Thirty-four staff completed the Challenging Behaviour Attribution Scale (CHABA) with respect to a client with whom they worked before, during and after completing a longitudinal course in assessment and intervention for challenging behaviour. Significantly more staff attributed challenging behaviour to negative reinforcement and self-stimulation after training. There was a significant reduction in the number of staff attributing challenging behaviour to positive reinforcement after training. However, a number of deficiencies in the CHABA were identified which may render interpretations inconclusive.

This study employs a multiple baseline across individual design to describe positive behaviour support for five people in community settings. The individuals represent all people with intellectual disability residing in one county with long-standing challenging behaviour resulting in serious physical injury. Five types of outcome are presented: rates of behaviour, rates of medication, psychiatric symptomatology, quality of life and revenue costs. The systems of support required to maintain outcomes and develop real lifestyles include behaviour support planning, mental health review, on-call intensive support and emergency respite care. Behaviours reduced to near-zero levels following implementation of positive behaviour support and improvements were sustained over 24 months. The use of psychotropic medications reduced by 66 percent over the same period. Quality of Life Questionnaire scores improved significantly for three of the five participants. The results are discussed in the context of a framework for supporting people with severe challenging behaviours in the community.

Background Positive behaviour support emphasises the impact of contextual variables to enhance participation, choice, and quality of life. This study evaluates a sequence for implementing changes to key contextual variables for 4 individuals. Interventions were maintained and data collection continued over a 3-year period. Method Functional assessments were conducted with 4 individuals with exceptionally severe challenging behaviours. Interventions were based on the multi-element model of behavioural support (LaVigna & Willis, 2005a LaVigna, G. W., & Willis, T. J. (2005a). A positive behavioural support model for breaking the barriers to social and community inclusion. Tizard Learning Disability Review, 10(2), 16–23. [Crossref], , [Google Scholar] ). Dependent variables were behavioural ratings of (1) frequency, (2) episodic severity, (3) episodic management difficulty, and measures of (4) mental health status, and (5) quality of life. The intervention sequence was low arousal environment, rapport building, predictability, functionally equivalent skills teaching, and differential reinforcement strategies. Results Substantial reductions in target behaviours were observed, along with incremental improvement in mental health scores and quality-of-life scores. Conclusion The study demonstrates the efficacy of positive behaviour support for people with exceptionally severe behaviour in individually designed services

Living arrangements for older adults with intellectual disability are an important aspect of service provision. However, relatively little work has examined service users’ satisfaction and dissatisfaction with where they live. Interviews were conducted with 92 service users with intellectual disability aged over 40 living in residential accommodation or with parents or guardians. A questionnaire addressing service users’ living arrangements was completed by 103 carers or guardians. Service users identified physical features of living arrangements, the provision of activities, and staff as primary contributors to satisfaction. Primary contributors to dissatisfaction were staff issues such as hindering personal independence, impatience and personnel shortages. Service users living with family or guardians were more likely to report being happy but also to report loneliness than those in group homes. Carers’ responses largely mirrored those provided by service users but differences emerged with respect to appropriateness of existing accommodation.

The literature on challenging behaviour is large, with heavy emphasis on behavioural approaches. In recent years more attention has been given to the effect of psychiatric illness on the behaviour of people with intellectual disability. However, theoretical differences between disciplines can lead to one or other approach dominating the assessment process. Increasingly, functional assessment is receiving attention as an assessment approach by both psychiatrists and psychologists. When used properly it can give a holistic overview of the individual and their behaviour, allowing a team approach to assessment and treatment that ensures the consideration of all possible psychiatric/medical/behavioural/environmental possibilities (a bio-behavioural model) in the aetiology and maintenance of challenging behaviour. This case study illustrates the effectiveness of teamwork in this area using functional assessment as a tool. The case also illustrates the possible futility of such comprehensive assessments of challenging behaviour in the absence of appropriate resources to implement the recommendations of such an assessment.

The study evaluated the effects of type of information naive participants received about challenging behaviour on ratings of acceptability of two multi-element treatment plans. Three groups of 20 undergraduate students with no experience of intellectual disability watched an identical 5 minute acted video of an individual with an intellectual disability engage in aggressive behaviour. Voiceover on the video differed: one group was exposed to information derived from a functional assessment, one to causal information that reflected personality and emotional factors, and the third to no causal information. Participants then rated two multielement treatment plans: one based upon functional assessment, and the other upon general non-aversive interventions. Results indicate that all groups were more accepting of the functional plan. However, individuals exposed to information derived from functional assessment were less accepting of non-functional treatment plans. Results have implications for staff cultures and the explanations for challenging behaviours that these cultures endorse

Background Effectively supporting individuals with intellectual disabilities who display challenging behaviours continues to be a priority for service providers. Person‐focused training (PFT) is a model of service delivery which provides staff with skills in functional assessment and intervention development. Existing longitudinal data from a study of 138 cases suggest that implementation of staff‐developed behaviour support plans through PFT is effective in reducing challenging behaviour in approximately 77% of cases [McClean et al.Journal of Intellectual Disability Research (2005) vol. 49, pp. 340–353]. However, no control group was used in this study. Method The current study involves the use of a control group of individuals with challenging behaviours matched against those selected for PFT over a 6‐month period. Groups were matched on type of challenging behaviour, duration of challenging behaviour, gender and level of disability. Information on the frequency, management difficulty and severity of challenging behaviour was collected pre‐ and post‐training using the Checklist of Challenging Behaviours (CCB) for both groups. Observational data were collected for the target group alone. Rates of psychotropic medication were tracked across the training period. Results Significant reductions in the frequency, management difficulty and severity of challenging behaviour were found for service users in the target group but not in the control group after 6 months. No significant changes were found in the use of psychotropic medication for either group over the 6‐month period. Conclusion Overall results suggest that PFT is an effective model for providing support to individuals with challenging behaviours.

A retrospective analysis was carried out on the diagnostic assessments of 67 children with an Autism Spectrum Disorder (ASD), in order to (1) examine the use of assessment instruments used to diagnose autism and whether they reflect the critical domain areas requiring assessment, (2) evaluate whether the information reported in initial assessments is such that they will facilitate subsequent evaluation of progress across developmental domains, and (3) examine the nature and type of interventions recommended. Results indicated that over one-quarter of all assessments did not include a measure of adaptive functioning and almost one-third did not include a measure of intellectual functioning. Furthermore, a substantial number of assessments did not provide enough information to evaluate progress after diagnosis across these domains. Results also suggest that children with autism rarely receive a follow-up assessment following diagnosis. The most common recommendations in relation to intervention were placement in an Early Intensive Behavioural Intervention programme (EIBI) and input from a multidisciplinary team. However, less than one third of assessments recommended the development of an Individual Education Plan. Results are discussed in the context of the role of psychological assessment and intervention for children with an ASD in the Republic of Ireland.

This is an exploratory study into parents’ experiences of educational approaches for their children with autism. Fourteen interviews took place, seven with parents whose children were attending a school which provided Early Intensive Behavioural Intervention (EIBI) and seven with parents whose children were receiving typical statutory education provision in a special class for children with autism attached to a mainstream school. In line with current Department of Education and Science guidelines, this class adopted an eclectic mix of approaches. Thematic analysis of responses from a 30-item interview generated six themes: availability of resources; assessment; communication; staff training and qualification; inclusion and mainstreaming; and parent experiences and roles. Responses pointed to a disparity in parental experiences regarding the provision of educational services between the ABA and non-ABA school with parents reporting greater overall satisfaction with the ABA school.

Background Positive behaviour support (PBS) emphasises multi-component interventions by natural intervention agents to help people overcome challenging behaviours. This paper investigates which components are most effective and which factors might mediate effectiveness. Method Sixty-one staff working with individuals with intellectual disability and challenging behaviours completed longitudinal competency-based training in PBS. Each staff participant conducted a functional assessment and developed and implemented a PBS plan for one prioritised individual. A total of 1,272 interventions were available for analysis. Measures of challenging behaviour were taken at baseline, after 6 months, and at an average of 26 months follow-up. Results There was a significant reduction in the frequency, management difficulty, and episodic severity of challenging behaviour over the duration of the study. Escape was identified by staff as the most common function, accounting for 77% of challenging behaviours. The most commonly implemented components of intervention were setting event changes and quality-of-life-based interventions. Conclusion Only treatment acceptability was found to be related to decreases in behavioural frequency. No single intervention component was found to have a greater association with reductions in challenging behaviour

This research aimed to discover whether staff training in PBS (Positive Behavioural Support) improves service user quality of life. The study used t-tests to compare service user quality of life, as measured by the World Health organisation's WHOQOL BREF, in supported living homes where staff had received PBS training versus supported living homes where staff had not received PBS training. Results show that, although quality of life was good across the board, environmental quality of life was significantly better in those supported living homes where staff had been trained in PBS. The conclusion reached is that PBS training positively influences environmental quality of life for service users, and that it should continue to be the focus of organisational investment.

Introduction 1; I. Reclamation and Flood Protection.2 ; A. Fill Requirements 6; B. Flood Levels 8; C. Navigation and Tidal Barriers 11; D. Tidal Prisms 12; E. Interior Drainage 13; F. Crossings 15; G. Levee and Wall Design. 18; H. Levee and Wall Alignment 20; 1. New Jersey Turnpike 21; 2. Hackensack River Park Area 21; 3. Berrys Creek Canal 21; 4. Overpeck Creek 22; I. Real Estate 22; J, Cost Estimates 24; K. Summary and Comparison of Plans 27; II. Soil and Foundation Study 30; A. Soil and Geological Conditions 30; B. Foundation Problems and Techniques To Combat These Problems 31; 1. Spread Footing 31; 2. Raft or Mat Foundation 32; 3. Pile Foundation 32; 4. Caissons 33; 5. Special Techniques 33; C. Fill 34; D. Foundation Evaluation and Cost 36; III. Environmental Health Study 43; A. Water Supply 44; B. Wastewater Disposal 48; C. Water Pollution 54; D. Solid Waste Collection and Disposal 55; E. Vector Control 58; F. Radiological Health Aspects 59; G. Summary 60; H. Concluding Remarks 62; IV. Air Pollution: Pollution Factors and Control Procedures in the New York-New Jersey Area 65; A. Topographical and Climatological Factors 66; 1. Wind Speed 69; 2. Wind Direction 70; 3. Turbulence 71; 4. Precipitation 72; 5. Anticyclonic Stagnation 72; 6. Air Temperature 76; B. Inventory of Emissions 75; 1. Sulfur Oxide75 ; 2. Carbon Monoxide 80; 3. Nitrogen Oxides 82; C. Economic Consequences of Air Pollution 85; D. Pollution Control Practices and Proposals. 90; 1. Inter-state Air Pollution Control Agency 90; 2.-3. Control of Emissions of Sulfur Dioxide from Power Generation Plants 92; 4. Control of Emissions of Sulfur Dioxides from Space Heating 93; 5. Control of Sulfur Compounds from Industrial Processes 94; 6. Control of Carbon Monoxide Emissions 95; 7. Control of Emissions from the Abex Corporation -Mahwah, New Jersey 96; E. The New Jersey Air Pollution Control Act 97;