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Creating a behaviour support plan

When creating a behaviour support plan, it is important to decide on which strategies to adopt. Once chosen, the strategies need to be applied consistently by everyone who encounters the targeted behaviours. While it might seem difficult at first, these techniques will eventually become second nature.

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Antecedents

What occurs before the behaviour (and may have triggered it)?

The antecedents are simply all the relevant things that happened before the behaviour occurred. They can also be considered as triggers for the behaviour, such as:

  • things that other people did or said
  • an emotional state, e.g. depressed, tired, anxious
  • the environment, e.g. hot, noisy, cramped, smelly, bright lights.

Managing these antecedents, or triggers, is a proactive way to avoid behaviours occurring in the first place. Here are some useful strategies:

  • build and maintain good rapport
  • avoid or minimise known triggers
  • involve the person in discussing triggers
  • work together on possible coping strategies in dealing with triggers
  • suggest and encourage these strategies when a trigger occurs
  • sometimes a distraction or redirection away from the trigger may be all that is necessary.
  • graduated exposure to the antecedent

This is useful when antecedents cannot or should not be avoided. With time and patience, it can be a powerful technique. For example, Kirsten starts screaming in supermarkets due to sensory overstimulation. Her mother says they will just stand outside the supermarket for 30 seconds then go home. The next time, they go in for 30 seconds then go home. This is gradually lengthened until Kirsten has adapted to this difficult environment.

Preparing for the antecedent

An inability to cope with chaos, unpredictability and lack of routine is common after a brain injury. For example, if Chris finds the activity and noise of a supermarket unpleasant, it can help to talk about expected reactions and ways to cope before the event.

Behaviour

What happens during the behaviour (what does it look like?)

Before you respond to an actual behaviour, the key is to understand the purpose of the behaviour and what it may be expressing about unmet needs. Although emotions can be running high, there are still strategies that can prove useful during the behaviour itself:

  • stay calm and speak in an even tone
  • give simple directions and prompts about coping mechanisms
  • use non-threatening hand gestures
  • manage your personal safety and remember the strategies agreed on for dangerous incidents
  • recognise when it is time for disengagement/exit strategies for crisis situations
  • ignore the behaviour.

In some cases, behaviour occurs in order to get attention, so the best strategy may be to ignore it. As with many of these techniques, tactical ignoring is best linked with positive reinforcement. For example, a child is ignored during a tantrum, but is rewarded with praise, a treat or favourite activity once the tantrum is over.

Consequences

What are the immediate and delayed reactions from everyone involved? The consequences, or our responses to a challenging behaviour, are very important. For example, a pleasant consequence can simply reward the behaviour, while a negative consequence may discourage it.

Pleasant consequence: ‘When I yell everyone gives me what I want’.

Negative consequence:  ‘When I yell everyone ignores me completely’.

When we use the ABC technique to analyse behaviour, we tend to stop reacting emotionally in ways that often make the situation worse. A consistent response from everyone to challenging behaviour can have a very strong effect over time.